Introduction
Urinary tract infections (UTIs) are very common infections that happen in the urinary system. The parts of the urinary system that are commonly infected are:
- the kidneys – the organs that filter waste from the blood, turning it into urine (wee)
- the bladder – where urine is stored
- the urethra – the tube that takes urine out of the body.
UTIs are caused when germs enter the urinary system through the urethra and grow. Females are at higher risk of developing UTIs because their urethra is shorter and sits closer to the anus.
UTIs are very common in babies and children, but if left untreated can develop into bigger infections that cause serious illness.
Signs and symptoms
Spotting a UTI in your child will depend on how old they are, and what symptoms they are showing.
Take your child to your local doctor as soon as possible if they show signs of a UTI.
Present to your nearest emergency department if your child becomes very lethargic, develops pain in their back and has a persistent fever as this can be a sign of a more serious infection.
Babies and children under three years old
Because babies and toddlers are unable to communicate how they are feeling, and often wear nappies, symptoms of a UTI may look like:
- irritability
- loss of appetite
- vomiting
- drowsiness
- poor weight gain
- fever
- blood in the nappy.
Children over 3 years old
Children over 3 years old may show signs like:
- complaining of pain or stinging when urinating
- an “urge” to urinate or do a wee more often than usual
- wetting their pants when toilet trained
- difficulty starting a wee, and only getting a little bit out each time
- pink, red or brown colour to urine
- stomach pains
- fever.
Diagnosis
UTIs are diagnosed by testing your child’s wee. The doctor will ask you to collect a sample of urine from your child. You will need to help your child to do a wee into a sterile (clean) jar, provided by the doctor.
It can be difficult to get a sample of urine from babies as they wear nappies and cannot control when they urinate. The doctor may ask you to try “catch” some wee while their nappy is off, or they may insert a catheter (thin tube) into the urethra to collect urine from the bladder.
Your child may need to have an ultrasound of the bladder and kidneys if they are:
- experiencing repeated or unusual UTIs
- a boy
- under three months old.
This is to make sure the bladder and kidneys are not also infected.
Treatment
Babies under three months old will need to have their UTI treated in hospital, with antibiotics delivered by an intravenous cannula (IV drip).
Children older than three months are usually given oral (taken by mouth) antibiotics to take at home. It is very important that your child takes their antibiotic every day until the packet is finished, even if they start to feel better.
Your child’s doctor can also prescribe medicine to help relieve pain if your child feels stinging when they urinate.
Management
Care at home
UTIs are uncomfortable, but usually clear up quickly with proper treatment. If your child is experiencing pain or the urge to go to the toilet more often than usual, you can keep them at home to rest and recover. Your child should drink plenty of fluids while they recover to help keep the urinary system healthy.
Prevention
UTIs are very common, and some children may experience UTIs that come back many times.
It can be difficult to prevent UTIs in babies, so focus should be on good nappy hygiene. This includes changing nappies as soon as you can after your child does a poo and making sure to wipe front to back. You should also avoid any creams, powders or wipes that have “fragrance” on the ingredients list as these can irritate the urethra.
Some general tips for preventing UTIs in children include:
- teaching your child to wipe from vulva to anus after going to the toilet
- making sure your child is drinking lots of fluids throughout the day to keep the bladder healthy and avoid constipation
- encouraging your child to do a wee when they feel the “urge” and not holding on too long, or going more often than needed “just in case”
- avoiding products that can irritate the urethra, like bubble bath, powders, and soaps.
Teenagers who are sexually active can prevent UTIs by:
- washing hands before and after sex
- showering before and after sex
- urinating after sex.
They can also speak to their local doctor or sexual health clinic if they are experiencing repeated UTIs.