Urination Problems with 4 Year Old Female.

Hi M.,

If it is a UTI (and it sure sounds like it), your daughter is probably miserable. I agree about having her drink A LOT, especially pure cranberry juice if you can get her to (it's really sour). You can probably find the cranberry juice at a health food store or a store like Whole Foods or Fresh Market. It ain't cheap, but it solves the problem for me (I know some may dispute that, but I've had it work many times)! There are also cranberry tablets, but that would probably be hard for a little one. Even if you are going back to the doctor, the cranberry and heavy volume of liquids should help her feel a little better while you wait to get in.

Good luck,
L.

I completely agree, if another visit to the doctor doesn't help then it is time for a second opinion. Issues like this can cause more damage.

Ah the female problems! I have chronic bladder infections, so I have been through the ringer on these tests, and the dr not hearing when you have the real deal symptoms. I am always watchful of my girls for UTI's, i hate for them to be in this kind of discomfort.

I definitely think you should take her in to be retested. Even though it is unpleasant, a catheter is really the best way to get urine for testing on this. Sometimes it takes time for it to show up, and if it gets worse it could cause a serious kidney infection, so go with your gut and go back in. In any case, it could be the sign of an underlying disorder, the symptoms and actions you are describing are definitely something to take action on. It could be some kind of physical malformation that is just coming up, or even a kidney stone, or something she ingested that is causing bladder irritation.

Make sure to stay away from caffeine and chocolate, as those will irritate an already sensitive urinary tract.

You also need to get this settled before the holidays. Since it will take some time to process the results, insist that they give her something to ease her discomfort, like Hyoscyamine/hycosamine aka Levsin (http://en.wikipedia.org/wiki/Hyoscyamine). Also ask if you can go directly to the lab to have her pee for them, so the processing time is cut down. Finally make sure they culture the results, not merely look to see if there is blood/bacteria. Culturing will help them to get the correct antibiotic and be able to see if there is even a small amount of bacteria, but it will take longer.

Best of luck ... feel free to email me if you need anything, questions or support. Keep in mind the dr's offices are thinking about the holidays too, so you need to be on top of your kid's care.

A. Moore

to play it safe take her for a second check with a different doctor that know more about kidneys and bladders.
if nothing shows but with pain i believe it will. then it may be her feeling like not moms baby and wanting more of mom.
i have two girls and 4 granddaughters and every time the was some pain there was a reason for it. any thing from uti to kidney stones.

if the hurt cont. and the urge to go is always there aske them to test her for "IC" you can learn more at www.ic-network.com

It could be a yeast infection - they will cause redness and painful urintation, and if it is yeast, hydrocortisone cream won't help.
I'd get a second opinion, but in the meantime, I'd also give her yogurt and cranberry juice.

My daughter does this occasionally, when she said it hurt 2 days in a row and refused to pee, I also noticed she was very red in that area. I took her in to see the Dr.he said it looked like a fungal infection at the opening of her vagina, not exactly a typical yeast infection. He gave us a topical ointment to use 2 times per day and it was fine in about 3 days. She still gets this from time to time, I use the ointment for a day or two and it will clear up. Maybe there's another Dr. you could see or just go back letting the Dr. know what he told you to do isn't helping and she's having accidents and is in pain. God Bless.

Run do not walk back to the doctor. I had my first UTI at 5 weeks of age. I have had them my entire life and had every thing imaginable. One thing that was consistent thru out was that my Urine NEVER SHOWED INFECTION until the 3rd day of the culture. They will try to tell you that if it isn't immediate or within 24 hours that it is not an infection. ThAT IS NOT SO. THis baby has a full blown kidney or bladder infection by now. I would take her back TODAY and get her rechecked, if they refuse to do the cultures as you ask, change dr's. GOOD Grief, they should have told you to come right back if she wasn't better withing 48 hours. I hope she is better quickly

She needs to see the doctor again. If her pediatrician says again that nothing is wrong, then she needs to see a pediatric urologist. If this isn't normal behavior for her, and she is complaining of pain, she needs to be retested for infection, etc.

It does sound like a bladder or UTI infection. My daughter is prone to them too. Some clear up on their own, but she will describe pain and will have accidents at night and even sometimes day. She is 8. Some require antibiotics, but then that can lead to yeast infections.

For future reference, one thing we have learned - she cannot take bubble baths. We keep thinking she will outgrow this, but if we allow her to take one more often than not she will have pain/irritation the next day or two. She can use colored dye in the tub and foaming soaps, but no bubble bath.

Do you put bubble bath in her bath water? If so, it may be the source of the problem. Just reduce the amount that you put in the tub or switch to a mild dish detergent like Ivory. It doesn't sound as though the doctor examined her but reached his conclusion from the urinalysis results. It might be a good idea for her to actually have an exam -- scary, I know, but it might be what's needed. Some girls have a urethra that's too narrow and don't complain until the pain is really bad because how would they know it's not normal? Also, and I really hate saying this but it is a possibility, there may be something more sinister going on and you need to know. Good luck, Mom.

Take her to a Pediatric Urologist and stress strongly to them her problems and how this is not the norm. I went through a very similar situarion with my 3 yr old daughter. Please keep me posted. My email is ____@____.com.

It was probably too soon to see the infection last time. There is a test you can buy over the counter or take her back to the Dr.

I would call the nurse immediately and tell her the symptoms are continuing/worsening. When she says "hurt" does she mean it burns or does she feel pain when she pushes to tee-tee. I would also not hesitate to take her to another doctor that was recommended from a mom I trust and have a 2nd opinion. A wonderful cream to use on her is Desitin - the old standby for diaper rash. Sometimes my little girls gets red I think from not wiping well. We will wipe some Desitin on her tee-tee area and by morning everything is well. It is a great cream and won't cause more irritation in that sensitive area. We use the white creamy type of Desitin. I also agree with some of the others that she may have a yeast infection and there are lots of OTC remedies for that and your doctor/nurse could tell you which one is best for a 4 yr. old.

I'm concerned that her doctor recommended hydrocortizone cream for something they don't understand. The doctor is not trying to investigate further but only offering a possible symptom reliever.

Ask whether they did an actual culture. If not, have them do one. The fact that they saw no "signs" of infection leads me to suspect that they just checked visually and her urine did not look cloudy or have any blood in it that they could see with the naked eye.

It's Friday. Don't delay; see them again, and if no solution is found, call for a referral to a urologist. Be willing to use a walk-in clinic over the weekend. This shouldn't wait, even if some cream or pain-relief oral med *did* work. The problem must be solved, not just the symptoms relieved. It does sound like a UTI, and UTIs can, if left untreated, turn into kidney infections, which can be life-threatening.

L.

PS in spite of her having accidents and burning urination, don't withhold water. In fact, the more liquids she takes in, the less it should hurt to pee, and the better she will flush out the UTI (keep her sugars, including from juices, to a minimum, though; bacteria thrive on sugar). In fact, one of the causes of UTIs is dehydration; it enables any exposure of the e. coli to take hold, while more urination of more diluted urine flushes it out. Keep that girl drinking, drinking, drinking her fluids! In the long-term, too. We Americans are chronically dehydrated. Don't let her be, too :)

I dont know why they would prescribe hydrocortizone, she likely has a yeast infection, my girls got them quite often from taking baths. They have been taking showers since they were about your girl's age because of them - I purchased a slide bar from Lowe's to bring the shower head down to their level, and so I wouldn't get soaked helping them out (it's also easier on the knees and back than bending over the tub). Try using Miconazole Nitrate, its the 3-day insertable yeast cream you can buy over the counter. Just apply it topically (do NOT use the suppositories) 2 to 3 times per day. If the symptoms do not improve within a few days, or continue to get worse, I suggest you get a second opinion. My girls see Dr. Robin Gonzalez at the Saints North facility at NW 63rd & Broadway Ext. She reminds me of Mrs. Frizzle on "The Magic Schoolbus", is very practical and the girls really like her. I hope this helps :}