Urinary Tract Infection In Children

What is a urinary tract infection?

A urinary tract infection (UTI) is caused by bacteria that get inside your child's urinary tract. Your child's urinary tract includes his kidneys, ureters, bladder, and urethra. Urine is made in the kidneys, and it flows from the ureters to the bladder. Urine leaves the bladder through the urethra. Your child may have a lower UTI, which is an infection in his bladder and urethra.

What increases my child's risk for a UTI?

Your child's urethra is close to his anus. This makes it easier for germs to enter your child's urinary tract. UTIs are more common in girls because the urethra is shorter. This allows bacteria to enter the urinary tract more easily. The following increase your child's risk of a UTI:

  • Problems in the urinary tract: Your child may have problems urinating if he has vesicoureteral reflux (VUR). With VUR, urine flows backward from your child's bladder to his ureters and kidneys. His risk for UTI increases if he has problems with his urinary tract organs. These include an extra ureter or problems with the way his ureter or urethra are formed. Your child's risk is also higher he has had a UTI in the past.

  • Blockages: A blockage can trap germs in the urinary tract. Blockages can be caused by tissue growths or narrowed areas in your child's urinary tract. Stones that form in your child's kidney (kidney stones) also may cause a blockage in his urinary tract.

  • Indwelling devices: Your child's risk for UTI increases if he has an indwelling device, such as a Foley catheter or ureteral stent. Germs may attach to these devices and cause a UTI.

  • Weak immune system: Your child's immune system is his body's defense against infection and disease. A weak immune system cannot fight against the bacteria that cause a UTI. Medical conditions, such as diabetes, may lead to a weak immune system. A newborn baby's immune system is not fully developed, which can increase his risk for a UTI.

  • No circumcision: Baby boys have a higher risk for UTI in the first 6 months of life if they are not circumcised.

  • Constipation: Your child may have problems urinating if has constipation.

  • Sexual activity: UTI risk increases in older children who have sex. If your older child's partner has an infection, then he is more likely to get an infection. Girls who use a diaphragm or spermicide also have a higher UTI risk.

What are the signs and symptoms of a UTI in children younger than 2 years?

  • Fever

  • Vomiting or diarrhea

  • Irritability

  • Poor feeding or slow weight gain

  • Urine that smells bad

  • More wet diapers or fewer wet diapers than is normal for him

  • Jaundice (yellow skin and eyes)

What are the signs and symptoms of a UTI in children older than 2 years?

  • Fever and chills

  • Nausea

  • Abdominal, side, or back pain

  • Urine that smells bad

  • Urgent need to urinate or urinating more often than normal

  • Urinating very little, leaking urine, or bedwetting

  • Pain or a burning feeling when urinating

How is a UTI diagnosed?

Your child's caregiver will ask about your child's signs and symptoms. He will check your child's abdomen, back, and genitals. He may check for discomfort by pressing on your child's abdomen, sides, and back. Your child may also need the following tests:

  • Urine tests: A sample of your child's urine may be collected and sent to a lab to learn what germ is causing his infection. Your child may be able to give a urine sample by urinating into a cup. Your child may need a catheter put into his bladder to get a urine sample. A needle may need to be inserted into your child's abdomen and into his bladder to collect a urine sample.

  • Imaging tests: Your child may need imaging tests if his symptoms do not get better after he starts treatment. Imaging tests are pictures of your child's urinary tract that can show if his infection is in his kidneys. Imaging tests can check for reflux or other problems in your child's urinary tract. Your child may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell your child's caregiver if he has ever had an allergic reaction to contrast dye.

How is a UTI treated?

  • Antibiotics: This medicine is given to fight an infection caused by bacteria. Give your child this medicine exactly as ordered by his healthcare provider. Do not stop giving your child the antibiotics unless directed by his healthcare provider. Never save antibiotics or give your child leftover antibiotics that were given to him for another illness.

  • Acetaminophen: This medicine decreases pain and fever. You can buy acetaminophen without a doctor's order. Ask how much your child should take and how often he should take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

  • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's doctor.

What are the risks of a UTI?

  • Even after your child takes medicine to treat his UTI, the infection may come back. If your child takes antibiotic medicine often or for long periods, he may develop resistance to antibiotics. Resistance means that germs in your child's body become harder to kill.

  • Without treatment, his infection and symptoms may get worse. The infection can spread to your child's blood, which can be life-threatening. The germs may spread to your child's kidneys, causing pyelonephritis. This can be a very serious condition, and your child may need treatment in the hospital. Pyelonephritis could lead to scarring in your child's kidneys and permanent kidney problems. Kidney problems may cause high blood pressure later in life. Kidney problems may also lead to kidney failure.

How can I help prevent my child from getting a UTI?

  • Have your child empty his bladder often: Make sure your child urinates and empties his bladder as soon as he feels he needs to. Teach your child not to hold his urine for long periods of time.

  • Encourage your child to drink plenty of fluids: This may help him urinate more often. Ask how much liquid your child should drink each day and which liquids are best for him.

  • Teach your child to wipe from front to back: Your child should wipe from front to back after she urinates or has a bowel movement to keep germs from entering the urinary tract.

  • Treat your child's constipation: This may lower his UTI risk. Ask your child's caregiver how to treat your child's constipation.

Where can I get more information?

  • American Academy of Pediatrics
    141 Northwest Point Boulevard
    Elk Grove Village , IL 60007-1098
    Phone: 1- 847 - 434-4000
    Web Address: http://www.aap.org

When should I contact my child's caregiver?

Contact your child's caregiver if:

  • Your child has a fever.

  • Your child is not getting better after 1 to 2 days of treatment.

  • You have questions or concerns about your child's condition or care.

When should I seek immediate care for my child?

Seek care immediately or call 911 if:

  • Your child is vomiting so much that he cannot keep his medicine down.

  • Your child has very strong pain in his belly, sides, or back.

  • Your child urinates very little or not at all.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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