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Children's Health

Decreased Urination in a Two Year Old

11/23/2010

Question:

Yesterday my two year old daughter only urinated twice, once in the morning. Today she has only urinated once, and it is now 7:00PM. I am very worried about this. She drinks plenty of fluids. She is potty trained, so I know that she isn`t urinating and me just not realizing it. What could be going on?

Answer:

Your child could have urinary dysfunction. This can arise from many sources, for example, a painful bladder infection could cause her to avoid urinating because it burns or aches when she urinates. Neurological problems in the brain and spinal cord (thankfully these are rare) as are tumors and other abnormal growths can also make it hard to empty the bladder. Psychological and behavioral problems are common sources of voiding problems.

Two is a difficult age for such problems. The speech and language skills of most toddlers are limited, so they can't tell you a lot about what they are thinking or feeling. They are often fearful of strangers touching them, and they are built to want the opposite of what parents want as they try to define who they are, that is, I am not my parents! Nevertheless, they love their parents and want to please them. It's a tough spot for a young child to be in!

So you can see that it is not a simple matter. The best thing to do is to take her to see the doctor for a good evaluation, including a thorough neurological and abdominal exam and assessment of the genitalia. A urine sample can be tested in the office to see if there is evidence of infection and to check the urinary pH to see if it is too acidic or too alkaline. If the urine color is dark yellow, she is not getting enough to drink. If it is tea colored, rust colored or pink, there is blood in her urine. Depending on what her doctor finds, he or she may refer you to a bladder or kidney specialist for more tests and exams.

I hope you find an answer soon that quickly resolves the problem.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University