Pediatric Surgery - Pediatric Urology

Fernando A. Ferrer, MD; Christina Kim, MD;
Heidi Sweeney, APRN; Susan Marai, RN;

The Four Point Program

1. Increase Fluids
Give your child plenty of water and fresh or frozen fruit juice to drink (add twice the amount of water that is required on the can). Drink half body weight (in pounds) in ounces of water. Example: child weighs 60 lb, drink 30 oz of water a day.
2. Timed Voiding
Have child empty bladder completely, every two hours, in a steady stream. (You can run the sink water to demonstrate a “steady stream” to your child.) Watch timers are helpful (buzz ever 2 hours). Some children need to double void (pee, pull up pants, walk to door, turn around, pull down pants and pee again).
3. Daily stool. Increase fiber.
Click here for more info. Daily fiber intake= age of child in years + 5= total grams of fiber a day. Example. 5 year old child; 5+5= 10 grams fiber daily.

Sit on the toilet: poop sit, 10-15 minutes at a time, after breakfast and dinner.
The child should have one bulky bowel movement per day. If the child is a “choosy” eater, 1/4 of a Metamucil cookie, along with increased fluids, should help. Miralax and chocolate chewable exlax may be prescribed.

4. Correct Toileting Habits.
Remind your child to always wipe from front to back. Avoid bubble baths. Use castile soap or non-scented soap. Use non-scented laundry detergent.

Some tips that may help your child urinate in a steady stream:

• Whistle while the child is trying to urinate.
• Keep some Cheerios on the back of the toilet; throw some in and have the child try to “sink” them.
• For girls, turn the child facing the toilet so that the child can watch the stream of urine.
• Avoid foods that irritate bladder. See list.