Most common among adult women, urinary tract infections (UTIs) can affect anyone at any age. Even children can get them. According to the American Urological Association, UTIs in kids are fairly common, occurring in up to 8% of girls and 2% of boys.
When a child gets a UTI, the experience is not fun. Detecting and treating the problem in the urinary tract gives quick relief and prevents potential complications.
What Causes UTIs in Kids
Bacteria are almost everywhere. But they are not in urine—at least not normally. Sometimes, however, bacteria—often from a bowel movement—enter the urinary tract through the urethra. Once there, they make themselves at home. And if your child’s immune system doesn’t get rid of the bacteria, a urinary tract infection (UTI) can develop.
UTIs come in three main forms:
- Bladder infection. This is the most common type of UTI in kids. It causes cystitis, an inflammation of the bladder that causes pain and swelling.
- Kidney infection. Also called pyelonephritis, this UTI typically starts in the bladder and travels to the kidneys. Left untreated, kidney infections can cause kidney damage in children.
- Urethritis. This UTI is confined to the urethra.
Children with vesicoureteral reflux are more likely to experience UTIs. Normally, urine flows from the ureters to the bladder. With vesicoureteral reflux, urine from the bladder backwashes into the ureters and sometimes the kidneys. This increases the risk of bacteria in the urinary tract. While this may cause no problems, it can result in UTIs.
Symptoms of a UTI in Childhood
Symptoms of urinary tract infections in children vary. UTIs in kids who are too young to describe their symptoms may cause the following:
- Bloody urine
- Difficulty gaining weight
- Fever
- Fussiness or irritability
- Lack of appetite
- Vomiting
- Urine that has a strong smell
Older children, on the other hand, may experience symptoms such as:
- Back pain or pain in the lower abdomen
- Fever
- Frequent urination
- Pain or burning sensations when urinating
- Regressing from previous toilet training success
- Urine that smells strongly or is bloody, cloudy or abnormally dark
If your child experiences any of the symptoms above, call your child’s pediatrician. Describe the symptoms and follow the doctor’s orders, which may include taking your child to the emergency room.
Diagnosing UTIs in Kids
UTI symptoms can mimic other conditions. As a result, symptoms alone are not enough to make a diagnosis of UTIs in kids. A definitive diagnosis requires laboratory testing.
For the test, your child urinates in a sample cup. If this isn’t possible, the doctor uses a catheter or other method to collect urine.
The urine is submitted to a laboratory where technicians run one or both of the following tests:
- Urinalysis. A urinalysis reviews the color of your child’s urine. More importantly, it evaluates the chemical makeup of urine and checks for bacteria under a microscope.
- Urine culture test. A urine sample is placed in an airtight container in the laboratory. During the next one or two days, laboratory technicians monitor the sample to see whether any bacteria grow. If there is growth, the technician can pinpoint the type of bacteria present and confirm a UTI.
With both urinalysis and urine culture tests, the goal is to find bacteria that indicates an infection. Infants who have been diagnosed with UTI and have a fever may also undergo kidney and bladder imaging. If these imaging exams have abnormal results, more testing can help find the root cause of the problem.
UTI Treatment for Children
All UTIs in kids that cause symptoms require treatment. Otherwise, the UTI stays around. The infection may then grow worse and put the child at risk for kidney damage, growing problems, high blood pressure and more.
Depending on the type of bacteria present, your doctor may prescribe one or more of the following:
- Antibiotics. Pediatricians treat UTIs in kids with antibiotics, such as penicillin. The antibiotic chosen depends on the location of the infection and the type of bacteria. Children typically take oral antibiotics. Your child should have symptomatic relief within a few days but should continue taking the medicine until all doses are used. Severe UTIs may require more intense therapy. Your child may need hospitalization if intravenous (IV) or injected antibiotics are required.
- Numbing medication. Your doctor may prescribe this if your child experiences significant pain when urinating. The medication numbs the urinary tract lining, reducing pain and improving quality of life.
In some cases, your doctor may order follow-up tests after successful treatment to examine various parts of the urinary tract. The goal is to ensure your child’s kidneys are in good shape and the urinary tract is ready to fight off future infections.
Helping Children Avoid UTIs
There is some discussion about whether cranberry juice is effective at lowering a woman’s UTI risk, but it appears that it does not prevent UTIs in kids. However, there is limited research on whether drinking cranberry juice is an effective preventive technique in women or children.
In fact, there is no proven method to completely prevent UTIs. But there are ways to reduce your child’s risk of infection. The American Academy of Pediatrics offers the following risk-reducing tips:
- Avoid perfumed soaps or bubble baths, as they can irritate the urethra.
- Females should always wipe from front to back after using the restroom.
- Put on dry clothes immediately after swimming and dry off completely after bathing.
- Stay away from caffeine, spices and chocolate, all of which can irritate the bladder.
- Wear cotton underwear and comfortable pants that aren’t tight.
You can also help your child avoid UTIs by encouraging him or her to drink plenty of water and to go to the restroom when the need arises. If your child is constipated, consult your pediatrician about treatment options. Doing this promptly can also help prevent UTIs. Additionally, if your child wears diapers, change them often. This limits the number of bacteria that can potentially enter your child’s urinary tract.
More to Read
- Urinary Tract Infections: Prevention is Key
- Should I Take My Child to the Emergency Room?
- Why is Respiratory Syncytial Virus Rising in Children?
- How Serious Is a Hernia?
Medically reviewed by Esther Kim Liu, MD, FAAP.
