"Busy little girl syndrome"

Pediatricians spend a lot of time talking about pooping and peeing. So, it's only fitting to blog about it, too. . .

I have recently seen several little girls aged 3-6 years old in my practice with a common problem:  they have to pee "all the time", every hour or so, and sometimes are having accidents.  This is of course alarming to parents, who are worried about a urine infection.  It is important to check the child's urine for an infection, but if finding there is none, what is the next step?  Often, simply changing the way the little girl uses the bathroom will cure the problem, which I call "the busy little girl syndrome".  

Typical 3-6 year old girls do not have good bathroom habits.  They are busy little preschool and kindergarten students who often have to use adult sized toilets.  They go to the bathroom in a rush.  Pants are pushed down to just above the knees, and their hands grasped on the toilet seat so they won't fall in. Then, as soon as they pee enough to relieve some pressure on their bladder, they are "done!", and stop, rub dry, and pull up their undies and pants.  

Going pee in this manner can cause lots of problems:  1.) Sitting with the thighs together means that the urine has to spray through the closed and sensitive labia and surrounding skin on it's way out and into the toilet.  This can cause irritation and sometimes even a rash.  2.) Sitting upright and gripping the toilet seat so as not to fall in causes the back of the thighs and therefore all the the muscles that control the "private parts", to be tense-- making it difficult to relax the muscle that lets all the urine come out of the bladder. 3.) Going to the bathroom quickly often means that, while some pee did come out, the bladder did not have time to fully empty.  4.) Rubbing or "wiping" dry can be irritating to sensitive skin.  

"Proper Pottying" can be taught to your little girl:  

1.  push your undies and pants down all the way to the ankles before sitting on the toilet.  

2.  Sit on the toilet and spread the knees apart (at least shoulder's width or a little wider).  This allows the labia to open up so the pee can go straight out and down into the toilet, without spraying much.

3.  Lean the body forward, with elbows or forearms relaxing on the thighs.  This makes the bladder (in the lower belly) smash up against the upper thighs which helps it to empty better.  

4.  Sing a little song (the ABC's works well)-- this makes the child stay on the toilet long enough for the bladder to empty fully. (It also allows time for them to realize "gosh, maybe I have to poop, too!".)

5.  Drying off:  "PAT, PAT, PAT" .  no wiping after going pee, just patting.  

**** Bonus points for giving a nightly bath (no bubbles) instead of a shower and swishing water gently around/at the vaginal area to clean out any stray bits of toilet paper, poo, or whatever else is stuck there causing irritation to the sensitive vaginal skin.  

Happy pottying!