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Urinary tract infections in children

Would you be able to spot if your child had a urinary tract infection?

Consultant Paediatrician Dr Kishor Tewary from BMI The Priory Hospital discusses the usual causes and symptoms, explains common treatments and also shares advice on preventative methods you can adopt at home.

How common are UTIs in children?

A urinary tract infection (UTI) is one of the most common paediatric illnesses. Around one in 10 girls and one in 30 boys will experience at least one episode before the age of 16. They're more common in girls than boys after the first 6 months.1

What is a urinary tract infection?

A UTI can happen anywhere along your urinary tract, which includes your bladder, urethra and kidneys.2

There are two types of UTI:

  • Upper UTI: an infection in the kidneys or the ureters, which are the tubes connecting your kidneys to your bladder
  • Lower UTI: an infection in the bladder or in the urethra, which is the tube that carries urine from your bladder out of your body

What causes a urinary tract infection in a child?

UTIs most commonly occur due to poor hygiene. A common cause is back-to-front wiping, which brings germs from the back passage into the urinary tract.

Other risk factors include constipation, poor bladder habits (such as holding the urine in for too long), infrequent urination and poor liquid intake.

Less commonly, UTIs can be caused by malformations in the urinary tract.3

How do you know if your child has a UTI?

It can be difficult to tell if your child has a UTI both because symptoms can be vague and because children can't always articulate how they're feeling.

If you are worried your child is unwell, especially if there is no obvious source of infection such as a cough or cold, speak to your GP as soon as possible.

UTIs can cause the following symptoms, which can also be a result of other illnesses:

  • High temperature (fever)
  • Vomiting
  • Tiredness/lethargy
  • Irritability
  • Going off their food or drink
  • Not gaining weight properly
  • Jaundice

Symptoms more specific to UTIs include:

  • Pain or burning when peeing
  • Deliberately holding in urine
  • Needing to urinate frequently
  • Accidents such as bedwetting or wetting the bed that aren't their normal habits
  • Pain in the tummy, side or lower back
  • Bad-smelling urine
  • Blood in the urine
  • Cloudy urine

Although UTIs are not normally serious, it is important to diagnose and treat them quickly to reduce the risk of complications.4

How are urinary tract infections in children diagnosed?

In most cases your doctor will be able to diagnose a UTI by examining your child's symptoms and by testing a sample of their urine.

If you are asked to take a urine sample, pay careful attention to your doctor's advice on how to do so.

How are UTIs treated in children?

A simple UTI can usually be treated with oral antibiotics, often with a course lasting 3-5 days.

An atypical UTI needs longer treatment, and sometimes antibiotics need to be given intravenously.

In some cases, your doctor will decide further investigation is needed. In this case, the treatment plan may consist of scans such as an ultrasound of the kidneys, X-rays (perhaps using dye), and antibiotics.

The route and length of the course of antibiotics prescribed will depend on the type of UTI, the recurrence and the type of germ involved.

If a UTI occurs three times it is classed as recurrent. In this instance you might be recommended long-term antibiotics (prophylaxis) – a low dose taken once the regular course has finished.5 If your child has a recurring UTI, your medical team will keep track of their progress.

How can I prevent my child from developing a UTI?

It's not possible to completely prevent all childhood UTIs, however there are things that you can do at home to reduce your child's risk of developing one.

5 factors that can help to prevent urinary tract infections in children:

1. Make sure they're drinking regularly and drinking enough

Aim to ensure your child drinks between 6-8 glasses of water every day. A good liquid intake replenishes

2. Encourage a regular bladder habit

A regular bladder habit, i.e. peeing every 2-4 hours, is recommended to prevent the growth of unfriendly germs.

Young children often have a tendency to hold urine, especially at school. Holding in your wee can affect the muscle tone in your bladder. Holding stagnant urine in for too long can also encourage the growth of germs, which leads to infection.

A UTI can then travel from the bladder to the kidneys.

Find out more about encouraging healthy habits in your kids

3. Bowel habits matter too

Being constipated can actually affect your bladder, not just your bowel, interfering with your ability to empty it and irritating the musculature.

This can lead to incomplete emptying of the bladder, leaving residual urine in there to stagnate and breed germs or infection, while irritated bladder muscles can affect your regularity and habits.

A regular bowel habit, at least every day, should be encouraged in all children. Stool consistency should be soft, which is achieved by maintaining hydration and making sure your child gets enough fruits and fibre in their diet.

Regular physical activity also helps to keep you regular

If your child is having problems with constipation, speak to your doctor about whether a laxative is appropriate.

4. Promote good genital hygiene

Regular cleaning of the genital area is very important to keep it free of germs, which can lead to infection. As your child gets older, you should be sure to explain and demonstrate how to maintain this.

In girls, the urinary passage is quite close to the anal area. Improper cleaning can lead to germs from the gut migrating to the bladder, which is a common cause of urinary infection. Front-to-back wiping and daily (or at least regular) bathing helps to keep the area clean.

5. ‘Natural' remedies

Various non-pharmacological agents have been suggested as ways to prevent UTIs, but the evidence varies.

There is evidence to suggest that probiotics, found in live yoghurt or specific probiotic drinks, may help prevent infections by encouraging ‘friendly bacteria' to grow in our gut and colon. Some studies have found that drinking cranberry juice can reduce the risk of developing UTIs.

Neither has been proven conclusively, but they do seem to help some people.


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