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Voiding pattern in healthy newborns
G Gladh1, D Persson, S Mattsson
1Department of Health and Environment, Division of Pediatrics, Faculty of Health Sciences, Linköping, Sweden. gunilla.gladh@ped.us.lio.se
Insights
This study establishes normal voiding parameters in healthy newborns, finding they void hourly with significant variability. Healthy infants did not leak urine during bladder provocation tests.
Area of Science:
- Neonatal physiology
- Pediatric urology
Background:
- Investigating bladder dysfunction in infants often uses a 4-hour observation period.
- Establishing normative data is crucial for interpreting infant voiding patterns.
Purpose of the Study:
- To establish reference values for voiding frequency, intervals, volumes, and residual urine in healthy newborns.
- To assess the utility of a 4-hour observation protocol for neonatal voiding assessment.
Main Methods:
- A 4-hour observation protocol was applied to 51 healthy newborns (3-14 days old).
- Voiding parameters, feeding, sleeping, crying, defecations, and urinary stream were recorded.
- Provocation tests were used to assess urinary leakage.
Main Results:
- Healthy newborns voided approximately once per hour with a median volume of 23 mL.
- Significant inter- and intra-individual variability was observed in all voiding parameters.
- Double voidings and sizable residual urine volumes were common; diuresis was high compared to school children.
- No urinary leakage occurred during provocation tests.
Conclusions:
- The 4-hour observation protocol provides valuable reference data for neonatal voiding.
- Healthy newborns exhibit considerable variability in voiding parameters and can retain significant residual urine.
- Neonatal bladders demonstrate continence during provocative maneuvers.
Abstract:
A 4-hour observation period has been used in infants to investigate suspected bladder dysfunction. The aim of the present study was to extend the usefulness of this protocol by establishing reference values for voiding frequency, intervals, volumes, and residual urine in healthy newborns. The study included 51 healthy newborns, 26 girls and 25 boys, aged 3 to 14 days. During a 4-hour period, all micturitions and residuals were recorded as well as feeding, sleeping, crying, and defecations. The observation was completed with the child undressed to observe the urinary stream during one void. Different provocation tests were tried to induce urinary leakage. All newborns voided with a stream, about once per hour, with a median volume of 23 mL. For each voiding parameter, there was a large inter- and intra-individual variability. Double voidings were common as well as sizable residual volumes. The diuresis was about six times higher than in healthy school children. The healthy newborns did not leak during provocation tests such as manual compression of the bladder. Neurourol. Urodynam. 19:177-184, 2000.