Children sometimes balk at the idea of collecting their urine in a cup, particularly if the idea is new to them. The assistance that may be required can seem like an invasion of privacy, and intervention with this elimination function can seem inappropriate. A child’s resistance can prolong the collection process, making it more stressful for the child and the parent, so you will want to prepare the child and comfortably guide him or her through the process. The procedure itself is not painful unless there is an infection or rash.
Boys do not seem to mind collecting a urine specimen as much as girls, particularly younger girls, notes Karen Szafran, CPNP, a nurse practitioner in a pediatric practice. "The boys tend to think of it as target practice," she explains. Holding the cup is what makes them most uncomfortable, she adds.
Here are some suggestions to minimize the stress of the moment.
Anticipate — Inquire at the time you make the appointment if a urine sample will be required (for example, when you suspect a urinary tract infection or are preparing for a kindergarten physical). You may also want to know if it must be a "clean catch" (a sterile specimen) so you can prepare the child to wipe with towelettes first.
Rehearse — Letting the child rehearse is helpful, advises Goldberger. If you know before your office visit that a urine sample will be needed, spend some time the day before or that morning preparing your child. Ask the child if he or she can do this trick: let a bit of urine out into the toilet, then stop the flow and start again. Tell the child he or she will be asked to do this at the clinic or doctor’s office.
Raise Their Comfort Level — Explain that even grown-ups collect a sample of urine this way when their doctors need them to or that even mothers need to use the towelettes when a sterile specimen is required. Assure them this is a normal procedure that is not difficult.
Drink Up — Encouraging the child to drink before the office visit can help the child need to urinate when it is time to collect the sample.
Simplify — Ask what supplies are on hand to make the collection as easy as possible. For a younger girl, putting 3 to 4 urine specimen cups in a potty seat may allow you to collect the sample more easily than catching the flow midstream in a cup, suggests Szafran. A receptacle placed in the toilet, such as a bedpan, can be simpler and more familiar for a child than catching urine in a cup.
Cope with Pain — If urination is painful due to infection or a rash, there are several strategies you can use, offers Goldberger. One is to suggest the child "blow the feeling away" by blowing out a breath just as the urine starts to flow. Introducing this idea in advance gives the child time to rehearse technique. You can also suggest focusing on another body part, for example, feeling mother’s hand on your forehead or a cool cloth on your leg, suggests Goldberger. Dripping cool water over the irritated area just as urination begins can be soothing (but cannot be used if a sterile specimen is required).
Turn on the Tap — The sound of running water can help the child begin to urinate.
Be Cool — For an adolescent who may be embarrassed to carry a urine specimen through the halls, you can ask for a bag or other suitable camouflage, suggests a nursing handbook.
Make It Interesting — When the test is for albumin, or protein in the urine, tell the child the nurse will have to dip a special paper strip into the urine for a color test. Ask the child to guess what color the strip will turn, and ask the nurse if the child can watch the strip being dipped. Or ask the child to guess what color the urine will be in the cup: golden yellow, pale yellow, clear, or purple from this morning’s grape juice.