Urinary Tract Infections in Childhood

Causes

UTIs are caused by bacteria. The bacteria may enter the bladder or the kidneys.

Risk Factors

Things that may raise a child's chance of a UTI include:

• Problems in the urinary tract, including:
  • Vesicoureteral reflux—urine flows backwards from the bladder up into the kidneys
  • Urinary obstruction—something is blocking or slowing the flow of urine
• Holding urine for long periods of time
• Not fully emptying the bladder
• Poor hygiene and toilet habits
• Clothing that is too tight, especially if it is not cotton
• Family history of UTIs
• Uncircumcised penis

Symptoms

Symptoms may depend on the child's age and the severity of the UTI. A child who has a UTI may have:

• The feeling that they need to urinate more often
• Only a small amount of urine when they do urinate
• Pain or burning when they urinate
• Fever
• Diarrhea
• Irritability
• Fatigue
• Stomachache
• Urine that smells foul or has blood in it
• Accidents where urine leaks even though the child is potty trained

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The doctor may also ask for a urine sample. Tests may include:

• Urinalysis—a laboratory examination of a urine sample
• Urine culture—to identify the specific bacteria involved
• Complete blood count and other blood tests if your child has a fever

Imaging tests may be ordered if UTIs happen over and over again. The test may include ultrasound or scans and x-rays. They will look for problems in the urinary tract structure.

Treatment

The goal of treatment is to clear the infection. This may be done with:

Antibiotics

Antibiotics will help fight the bacteria that is causing the infection. Some severe infections may need antibiotics to be given with an injection or IV.

Fluids

Fluids can help flush the bacteria out of the system. It will also decrease the concentration of the urine. This may make it more comfortable to urinate.

Pain and Fever Relief

UTIs can be uncomfortable and cause fever. Over the counter pain medicine can help.

Note: Do not give aspirin or aspirin products to a child who has a current or recent infection. It may cause serious problems.

Prevention

To help reduce a child's chances of a UTI:

• Talk to the child's doctor if the child has an abnormality of the urinary system. Surgery may be needed.
• Make sure that girls learn to wipe from front to back.
• Encourage children to go to the bathroom often—at least several times a day.
• Retract the foreskin of the penis on a regular basis. This will help keep the area clean.
• The doctor may prescribe antibiotics for a child who has UTIs often. This may help prevent a new infection.