Urinary tract infections are unfortunately an all-too-common occurrence for many families and children.
UTIs are a common occurrence in all children but are more common in children who are still in nappies, and also more common in girls as compared to boys. UTIs occur when bacteria enter the urinary tract and then grow in the bladder, kidneys or urethra (the little tube that urine is passed out of). Infections in the bladder are called cystitis (often presents with the symptoms below), and ones that travel all the way up to the kidneys are called pyelonephritis and are usually more serious. The bacteria that cause UTIs can also make their way into the blood stream (bacteraemia) and this can certainly make children very unwell indeed.
Signs of a UTI
- Pain, stinging or burning when passing urine
- Having the urge to go to the toilet to wee more frequently than usual
- Tummy pain (especially below the belly button)
- Day or night time wetting (even if the child is toilet trained)
- Stinky urine
UTIs are generally easy to treat, but if they go undiagnosed and untreated, they can lead to serious (and sometimes
irreparable) damage of the kidney.
Risk factors of a UTI include:
- A family history of UTIs
- A structural abnormality of the urinary tract (like cystic kidneys, or a narrowing of any part of the urinary tract) or kindey reflux (where there is abnormal backwards flow of urine from the bladder up the ureters towards the kidneys)
- A history of poor toileting hygiene
How do we test for a UTI?
A sample of urine needs to be collected for testing. This sample needs to be a “clean catch” and “mid stream” specimen for older children into a sterile jar (to avoid collecting bacteria that live on the skin or near the opening of the urinary tract) or sometimes a catheter specimen (where a tiny tube is inserted up into the bladder to collect “clean” urine) for babies and children who are not yet toilet trained.
Treatment for UTIs
The definitive treatment for a UTI is an antibiotic. The infection needs to be treated for the symptoms to go away. A urinary alkaliniser eg Ural (ie a medicine that takes the acidity out of the urine) can be given for some symptom (pain) relief. It is important that the child continues to drink plenty of fluids.
If your child is showing signs of a more serious infection:
- If the child has a high fever and/or looks very ill
- The child is less than 6 months old
- The child has flank/lower back pain
- The child is dehydrated and/or vomiting, or is unable to take their medicine or fluids by mouth
Then it is important to take the child to hospital for medical attention and antibiotics/fluids via a drip (intravenously). This is especially important in children who we know have a structural kidney abnormality or vesico-ureteric reflux (an abnormal backflow of urine from the bladder upwards through the ureters towards the kidneys) because recurrent UTIs can result in permanent kidney damage or even renal failure later in life.
In babies/toddlers – frequent nappy changes
In children (especially girls) – good toilet hygiene habits are essential. Making sure they know to wipe from front to back (and not back to front) so that they don’t carry germs from the anus to the urethra
Cotton (breathable) rather than synthetic underwear
Trying to avoid soaps and bubble bath (that can irritate the skin)
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