Urinary Tract Infections (UTI)
What is a urinary tract infection (UTI)?
Your urinary tract includes the kidneys, bladder, and the urethra. An infection can occur in any part of the urinary tract. Normally, urine in the urinary tract does not contain bacteria (germs). When harmful bacteria get into the urinary tract they can cause an infection. Bacteria enter the urinary tract through the urethra (opening where urine comes out). If bacteria get into your child’s bladder, it can cause a bladder infection called cystitis. If bacteria travel up to the kidneys, it may cause a kidney infection called pyelonephritis. Symptoms of pyelonephritis are similar to cystitis, but the child will feel more ill. How did my child get a UTI?
Most of the time bacteria come from the rectal area or from stool. The bacteria enter the urethral opening and begin to grow inside the bladder. The bacteria will irritate the bladder and cause pain. The bacteria can travel further up the urinary tract to the kidneys causing pain, fever, and back or abdominal pain. There are certain things that can contribute to the risk of getting a UTI.
- Bubble baths
- Girls wiping “back to front” instead of “front to back” after a bowel movement
- Holding urine for a long time instead of urinating when there is an urge to empty the bladder
- Chronic constipation
- Problems in the urinary tract
- Part of the urinary tract is blocked or part of the urinary tract did not develop normally
- Abnormal backward flow of some urine from the bladder up the ureters towards the kidney (reflux)
What are the signs that my child might have a UTI?
Young children may not be able to tell you that they are in pain. You may notice that your child has fever, is fussy, or is not eating well. He/she may just “not feel good.” Vomiting is another common symptom. If your child is in diapers, you may notice that his/her urine has an unusual or strong smell. The older child may complain of:
- Tummy ache
- Frequent urination of small amounts of urine
- Burning, stinging, pain or chills when urinating
- Pain under the side of the rib cage or lower back
- Wetting accidents, your child may feel a strong urge to urinate and he/she can’t “hold it”
- Unusual smelling or cloudy urine
How are urinary tract infections treated?
UTIs are treated with antibiotics. After a clean catch urine specimen is collected, your doctor may give you an antibiotic that will kill the most common types of bacteria. Your doctor may want to test a sample of urine directly from your child’s bladder. If so, a small thin tube will be inserted into your child’s urethra to collect urine directly from the bladder for a urine culture. The antibiotic may be changed within a day or two if the urine culture has bacteria that need to be treated with a different medication.
If your child is able to drink fluids, the medicine (liquid or pills) may be given by mouth. Follow your healthcare provider’s instructions carefully for giving the medicine. After a few doses of medicine your child will begin to feel better, but several days may pass before all the symptoms are gone. Even if your child is feeling better, do not stop giving the medicine. GIVE THE MEDICINE UNTIL IT IS GONE OR YOU ARE INSTRUCTED BY YOUR HEALTHCARE PROVIDER TO STOP. Infections may return, and germs can resist future treatment if the medicine is stopped too soon.
If your child cannot drink fluids or has bacteria in his urine which requires treatment with a stronger medicine, it may be necessary to give the antibiotic through an IV. An IV is a small, thin, hollow tube which is inserted into a vein to give fluids and medications directly into the bloodstream. Your child’s physician or nurse will explain this procedure to you if it is needed.
Ask your child’s doctor if you can give your child acetaminophen or ibuprofen (Tylenol® or Motrin®) as needed for pain. Some prescription pain medications may also contain acetaminophen or ibuprofen. Check all labels carefully to avoid overdosing your child.
Encourage your child to drink fluids. Avoid drinks with caffeine, such as iced tea or soda. Caffeine can irritate the bladder.
Good bathroom habits:
- If your child wears diapers, change dirty diapers as soon as possible.
- Teach your daughter to wipe herself front to back after she uses the bathroom.
- Teach your child to urinate regularly. Tell your child to not hold in urine for a long time. Going to the bathroom frequently can prevent a UTI. Children who have had repeat UTIs should urinate every 2 to 3 hours during the day. Drinking lots of fluids will help your child urinate more often.
- Teach your child to take time to completely empty the bladder. Do not rush bathroom visits.
- Teach your daughter to lower her pants and underpants to her ankles and sit comfortably with legs spread apart. She should put her feet on a step stool if her feet do not touch the floor to help keep her legs apart. This reduces the risk of urine being retained in the vagina because the lips of the vagina were squeezed together when her feet were dangling instead of on a step stool. Retained urine allows bacteria to grow that can move up the short urethra and cause a UTI.
- Teach your son to open his pants and underpants so he can urinate without pressure on his penis.
- Cotton underpants are recommended.
When should I call the doctor?
If your child devleops any of the following:
- Fever with back pain or chills
- Frequent urination
- Frequent urination during the night
- Bad-smelling urine
- Bloody or discolored urine
- Pain below the navel (belly button)
- Vomiting and unable to keep medicine down
- Refuses or unable to take fluids by mouth
- Acts very sleepy or is very fussy
Follow up with your child's doctor:
Do not miss any follow-up appointments with your child’s doctor. Most children feel better within a few days to one week after they start taking antibiotics.
If your child is very young or gets urinary tract infections frequently, your doctor may schedule radiology tests to see if there is a problem in his/her urinary tract.
Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.