Understanding Urinary Tract Infections (UTIs) in Children
Urinary Tract Infection (UTI) is a common bacterial infection that occurs in the urinary system. The urinary system includes the kidneys, ureters, bladder, and urethra. UTIs are more common in children than many people realize, and prompt diagnosis and treatment are important.
What is a UTI?
A UTI happens when bacteria—usually from the digestive tract—enters the urethra (the tube that carries urine out of the body) and travels up into the bladder. Less often, the bacteria can travel all the way up to the kidneys.
- Cystitis: An infection located only in the bladder. This is the most common type of infection.
- Pyelonephritis: A more serious infection located in one or both kidneys. This requires immediate attention.
Why Are Children Prone to UTIs?
- Incomplete Bladder Emptying: Children who “hold it” or don’t fully empty their bladder give bacteria time to multiply.
- Wiping Direction (Girls): Improper wiping (back-to-front) can easily transfer bacteria from the rectum to the urethra.
- Constipation: A full, hard colon can press on the bladder and prevent it from emptying completely.
- Structural Issues: Some children have underlying conditions like Vesicoureteral Reflux (VUR), where urine flows backward from the bladder to the kidneys, increasing the risk of infection.
Signs and Symptoms
The symptoms of a UTI vary depending on the child’s age and where the infection is located.
| Age Group | Common Signs/Symptoms |
| Infants/Toddlers | Often general and non-specific – Unexplained fever (high temperature, Irritability or crying during urination, poor feeding or vomiting, foul-smelling or cloudy urine, failure to gain weight (Failure to Thrive) |
| Older Children |
Symptoms are more specific – Pain or burning during urination (Dysuria – a frequent, urgent need to pee, often passing only a little urine), wetting accidents (new-onset daytime or nighttime), pain in the lower abdomen or the lower back/side (Flank Pain) Kidney Infection Warning: High fever, chills, and back/side pain require immediate medical attention |
Diagnosis and Testing
If a UTI is suspected, your child’s doctor will need to get a urine sample for testing.
- Urine Dipstick: A quick test to check for signs of infection (such as white blood cells or nitrites.)
- Urine Culture: The urine sample is sent to a lab to see if bacteria grew. This confirms the diagnosis and identifies the specific bacteria, allowing the doctor to choose the best antibiotic.
Getting a Urine Sample
- Infants/Toddlers: May require a catheter (a thin tube placed temporarily into the bladder) or a urine bag to get a clean, uncontaminated sample.
- Older Children: Can usually give a “midstream clean-catch” sample—urinating into a sterile cup after cleaning the genital area.
Further Testing – Imaging
If a child has a fever with a UTI, or has recurring UTIs, the doctor may recommend imaging tests to check for underlying problems, testing can include:
- Renal Ultrasound: Uses sound waves to look at the size and shape of the kidneys and bladder.
- VCUG (Voiding Cystourethrogram): An X-ray test to check for Vesicoureteral Reflux (VUR) or blockages by watching the flow of urine.
Treatment and Prevention
Treatment
- Oral Antibiotics: UTIs are treated with a course of antibiotics to kill the bacteria. It’s important to complete the entire course of medication, even if your child feels better quickly.
- IV Antibiotics: If a kidney infection (Pyelonephritis) is suspected, a child may need to be treated in the hospital with intravenous (IV) antibiotics.
Prevention Tips
The best way to prevent UTIs is through good habits:
- Proper Wiping: Teach girls to always wipe from front-to-back.
- Hydration: Encourage your child to drink plenty of water to flush bacteria out of the bladder.
- Regular Bathroom Breaks: Encourage the child to urinate every 2-3 hours and to empty the bladder completely each time. Do not let them “hold it” for too long.
- Treat Constipation: Ensure the child has regular, soft bowel movements.
- Appropriate Clothing: Avoid tight-fitting clothes and synthetic underwear; cotton is best to keep the area dry.