What is a Urinary Tract Infection (UTI) in Children?
Being a parent comes with countless joys, but watching your child suffer is certainly not one of them. Urinary Tract Infections (UTIs) are among those unwelcome illnesses that can bring discomfort and pain to your little one.
UTIs are common in children, particularly in girls, though identifying the signs can sometimes be challenging. It's vital to get your child treated quickly, as an untreated UTI can escalate into a more severe kidney infection.
A UTI is essentially a bacterial infection within the urinary tract. This infection can occur anywhere in the system, including the ureters, bladder, urethra, and kidneys.
Infections of the lower urinary tract (the urethra and bladder) are more common and are often referred to as cystitis. If the infection spreads from the bladder up to the kidneys, it's called pyelonephritis.
What are the Symptoms of a UTI in Children?
Spotting a UTI in infants and very young children can be difficult because they may not be able to articulate how they feel. Your child might simply present with a fever, loose stools, irritability, or a refusal to eat.
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Painful Urination: A UTI can cause the lining of the urinary tract to become red and swollen, so your child might complain of pain, burning, or a stinging sensation when peeing.
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Lower Back Pain: They might also complain of pain around their lower abdomen, back, or pelvis, along with a strong urge to urinate.
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Difficulty Controlling Urine: Your child may struggle to control their bladder, possibly experiencing unexpected leaks or wetting accidents.
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Unusual Urine Appearance/Odor: You might notice your child's urine has a foul smell, appears cloudy, or contains blood.
How Do Doctors Diagnose a Child's UTI?
If you suspect your child has a UTI, it's important to seek medical attention promptly. Your doctor will typically take the following steps:
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Symptom Review: As a first step, your doctor will discuss your child's symptoms and conduct a physical examination.
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Urine Tests: Next, a urine sample will be requested. This will undergo a urinalysis to check for red blood cells, white blood cells, bacteria, protein, and other signs of infection. A urine culture test will also be performed to identify the specific type of bacteria causing the infection and determine the most effective medication for treatment.
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Ultrasound: If your child experiences recurrent UTIs, your doctor might order an ultrasound to examine the kidneys and bladder.
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VCUG: In certain situations, your doctor may recommend a voiding cystourethrogram (VCUG) to investigate why your child is having recurrent infections. A VCUG is a minimally invasive test that uses a special X-ray technique to visualize your child's urinary tract and bladder.
What Causes UTIs in Children?
UTIs are most commonly caused by bacteria, with Escherichia coli (E. coli)—a bacterium typically found in the gut—responsible for the majority of cases.
While urine is normally sterile, bacteria can enter the urethra from the skin around the anus, penis, or vagina. Once inside, these bacteria can multiply and lead to an infection.
What Are the Risk Factors for UTIs in Children?
Certain conditions make it easier for bacteria to enter or remain in a child's urinary tract. The following factors can increase a child's risk of developing a UTI:
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Poor toilet hygiene.
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Infrequent urination or holding urine for too long.
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Abnormal urinary tract function or structural abnormalities.
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Bubble baths and the use of harsh soaps.
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Wearing tight clothing.
Girls are more prone to UTIs than boys due to their shorter urethra, which is also closer to the anus. This makes it easier for bacteria from stool to reach the bladder. Additionally, constipation, insufficient fluid intake, and poor diaper hygiene can increase UTI risk.
How Are UTIs in Children Treated?
Antibiotics play a crucial role in treating UTIs in children. The specific type of antibiotic and the duration of treatment will depend on the bacteria causing the infection and its severity.
It's essential to ensure the prescribed course of antibiotics is fully completed to eradicate the infection. An incompletely treated UTI can recur or even spread. Therefore, your doctor may order a repeat urine test a few days after starting antibiotics to confirm the infection has cleared.
In addition to the antibiotics prescribed by your doctor, you should encourage your child to drink plenty of fluids. Warm compresses or over-the-counter pain relief medication can also help alleviate discomfort.
How Can You Prevent UTIs in Children?
Several strategies can help reduce your child's chances of developing a UTI:
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Encourage Frequent Urination: Your child should be encouraged to use the restroom as soon as they feel the urge, as holding urine in the bladder can promote bacterial growth. They should also be encouraged to fully empty their bladder when urinating.
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Teach Good Hygiene: It's vital to teach children proper hygiene practices. Girls should be taught to wipe from front to back to prevent bacteria from the rectum from spreading to the urethra. For infants, frequent diaper changes help prevent the spread of UTI-causing bacteria.
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Avoid Irritants: Steer clear of bubble baths and scented soaps for girls, as these can cause irritation. Additionally, girls should wear cotton underwear, as cotton is less likely to trap moisture and foster bacterial growth.
What Are the Complications and Risks of Untreated UTIs in Children?
If left untreated, a Urinary Tract Infection (UTI) can lead to a kidney infection, which may result in more serious conditions such as kidney abscesses, reduced kidney function, kidney swelling (hydronephrosis), and even kidney failure. Severe UTIs can potentially lead to sepsis, which can cause organ failure and, in rare cases, be fatal.
When to Call the Doctor
The early signs of a UTI in children can be easy to miss. Young children, in particular, may have difficulty describing their discomfort.
If your child has an unexplained fever without a runny nose or other obvious cause, especially if accompanied by pain during urination, it's best to consult a doctor. Early treatment can often prevent the infection from becoming severe.