When a baby urinates frequently and urgently, parents are, of course, even more anxious. Frequent urination is a clinical symptom, and the most important thing is to find out the cause of it, and then prescribe the right medicine. How can frequent urination be caused? How often does a child need to urinate before it is considered frequent? The frequency of urination in normal children depends on their age. One month after birth, your baby will urinate about once every hour. At one year of age, they urinate about once every two hours. Only after the age of three does a child urinate closer to once every three hours. After puberty (around 12 years old), it is closer to every four or five hours for adults. These are just averages. Each child’s frequency is a little different. The frequency of urination should be outside the child’s normal range, not strictly compared to the numbers in the book. What can cause frequent urination? There are many causes, so you should rule out the common ones first and then look for the less common ones. As for where to start, a history and a careful physical examination can provide important clues. Is there any urgency or painful urination? Do you drink more water than usual? Do you lose urine at night? What previous illnesses or surgeries have you had? What recent events have caused anxiety in your child? Here are some common causes: 1. Urinary tract infection: Due to inflammation and sensitivity of the bladder, the child may urinate frequently, urgently, or even painfully. The urine looks cloudy and even has blood. If the kidneys are also affected, the child may have a fever and vomit. The fastest way to check is urine routine, microscopic examination and urine culture. 2. Diabetes: Careful history taking will reveal that these children are thirsty and drink a lot of water. Some of this is due to the hot climate. The best way to do this is to have the child and parents make a diary of water intake and urine output. The diagnosis can be made at a glance. However, some are due to diabetes. Last month, I saw a child referred to the pediatric urology clinic who, in addition to being thirsty, was also mentally ill and had low weight. At first glance, I suspected diabetes mellitus. A urine routine was done immediately and the urine sugar was found to be extremely high. The diagnosis was later confirmed with blood glucose. After controlling the acidosis, the child was started on insulin. There are other endocrine-related polyuria. 3. Lesions of the bladder: small volume of the bladder, neurogenic bladder, spinal embolism, and functional unstable contractions of the bladder are also encountered from time to time. The shape of the spinal sacrum, the nervous system of the lower limbs and the function of the anal sphincter should be clear on physical examination. Further investigations, ultrasound, cystography, urodynamics and even MRI of the spinal cord are sometimes required. Urodynamic testing becomes very important. Some children have overactive bladder (OAB), which can be controlled with some medications. Many heal on their own after a period of time. 4. Advanced renal failure: These children are usually old and have a clear diagnosis. The kidneys have lost their ability to concentrate, and the amount of urine starts to increase, causing frequent urination. Dialysis or kidney replacement is needed. In summary, there are many causes of frequent urination. The diagnosis should be confirmed by a pediatric urologist before prescribing the right medication. Systematic examination and correct diagnosis are very important.