UTIs in children
Urinary tract infections, or UTIs, are fairly common, affecting about 3 percent of children in the US each year. They are more common in girls, who have about an 8 percent risk of contracting a UTI, compared to a 2 percent risk in boys. In most cases, a UTI is caused by bacteria. They aren’t typically serious and can be treated by your doctor with antibiotics.
Symptoms of a UTI in young children and infants are not always the same as symptoms in older children. For babies, watch for fussiness, a fever with no apparent cause, odd smelling urine, loss of appetite, or vomiting. Older children may also have pain or burning while urinating, more frequent urination, and pain on either side of the back. Unfortunately, your baby can’t tell you about these discomforts, so it is important to be aware of the other symptoms you can see yourself.
To correctly diagnose a UTI, your doctor will need a urine sample. This is easier in an older child who can be told to urinate into a container, but samples can also be collected from babies fairly easily. Your doctor will most likely insert a small tube, or catheter, into your baby’s urethra so that sterile urine can be collected from the bladder. Alternatively, the doctor may place a collection bag over your baby’s genitals with an adhesive or a catheter to collect urine. However, this method is often unreliable because normal bacteria from the skin can get into the urine, causing a positive test result and confusing the picture. In rare cases, the doctor may choose to insert a needle into the bladder to collect a sample.
The sample is then examined under a microscope. If there is an infection, bacteria and white blood cells will likely be visible. A culture of the urine will also be done, which takes 1-2 days.
After a UTI is diagnosed, antibiotics will typically be prescribed. Your doctor may start your child on antibiotics and then decide to change the type of antibiotic after the results of the urine culture come in. Don’t be concerned. This just means your doctor has a clearer picture of the type of bacteria causing the infection, so it’s easier to prescribe the most effective antibiotics to kill it. Be sure to administer the antibiotics exactly as directed for the full course so the infection doesn’t come back.
After the infection is cleared up, your doctor will likely run a few more tests, including an ultrasound of the kidneys, to make sure there are no abnormalities in the urinary tract. Abnormalities can mean more infections, and frequent infections can cause damage to the bladder or kidneys.
Reviewed by Dr. Sara Connolly, May 2020
Takeaways
- UTIs affect about 3% of children in the US every year.
- A small child may not show or tell you the usual symptoms of a UTI, so you will have to watch for symptoms like fever, strange smelling urine and fussiness.
- In most cases, a UTI isn’t serious and is easily treated.
- Usually UTIs are caused by bacteria. Babies who have abnormalities in the urinary tract are at a higher risk of developing UTIs.
Catheters are very painful. More painful is watching your two year old get one because he is in pain and in the middle of potty training and afraid of urinating in a cup 🙁 I took him to the bathroom and even if I begged he wouldn’t do it so they had to do it the other way. It was horrible to watch and listen but gladly it was not a UTI..
Unfortunately there is no way to tell just by examining a sick child that they have a UTI. Thankfully the catheter is quick and does not cause any permanent or lasting trauma, although they may be a little sore afterwards. But I’m sure when it is your own child it is terrible to go through!