Urinary tract infections (UTIs) are common in children and occur when bacteria enter the urethra and bladder. UTIs can cause discomfort and, if left untreated, can lead to more serious kidney infections. Recognizing the symptoms, seeking prompt medical care, and implementing preventive measures are essential for managing UTIs in children.
Types of UTIs in Children
There are two main types of UTIs in children:
- Lower UTIs (Cystitis): Infections of the urethra and bladder. This is the most common type of UTI in children.
- Upper UTIs (Pyelonephritis): Infections of the ureters and kidneys. This type of UTI is more serious and can lead to kidney damage if not treated promptly.
Symptoms
Symptoms of UTIs in children can vary depending on the child’s age and the location of the infection.
Lower UTI Symptoms:
- Painful Urination: A burning sensation or discomfort during urination (dysuria).
- Frequent Urination: An increased urge to urinate, even when the bladder is not full.
- Urgency: A sudden, compelling need to urinate.
- Bedwetting: New or increased bedwetting in a child who is already toilet-trained.
- Abdominal Pain: Pain or discomfort in the lower abdomen.
- Cloudy or Foul-Smelling Urine: Changes in the appearance or odor of urine.
- Blood in the Urine (Hematuria): Urine may appear pink, red, or brown.
- Fever: Sometimes, a low-grade fever may be present.
Upper UTI (Pyelonephritis) Symptoms:
- High Fever: A temperature of 101°F (38.3°C) or higher.
- Flank Pain: Pain in the side or back, below the ribs.
- Abdominal Pain: Pain in the abdomen.
- Nausea and Vomiting: Due to the severity of the infection.
- Irritability or Lethargy: The child may appear very tired, irritable, or unwell.
Symptoms in Infants:
Infants may not exhibit the typical symptoms of a UTI. Instead, they may present with:
- Fever:
- Irritability:
- Poor Feeding:
- Lethargy:
- Vomiting:
- Jaundice: Yellowing of the skin and eyes.
When to Seek Medical Attention
Seek medical attention promptly if your child exhibits symptoms of a UTI, especially if they have a fever, flank pain, or appear very ill. Infants with any signs of a possible UTI should be seen by a doctor immediately.
Diagnosis
Diagnosis typically involves:
- Medical History and Physical Examination: Evaluation of symptoms and risk factors.
- Urine Sample: A urine sample is collected to test for the presence of bacteria, white blood cells, and red blood cells.
- Urine Culture: A test to identify the specific type of bacteria causing the infection and determine the most effective antibiotic.
In some cases, additional tests may be needed, such as:
- Ultrasound: To visualize the kidneys and bladder.
- Voiding Cystourethrogram (VCUG): An X-ray test to evaluate the structure and function of the bladder and urethra.
- Dimercaptosuccinic Acid (DMSA) Scan: A nuclear medicine scan to assess kidney damage.
Treatment
Treatment for UTIs in children typically involves antibiotics to kill the bacteria causing the infection. Common antibiotics used to treat UTIs in children include:
- Amoxicillin:
- Cephalexin (Keflex):
- Cefixime (Suprax):
- Trimethoprim-Sulfamethoxazole (Bactrim, Septra):
- Nitrofurantoin (Macrobid, Macrodantin):
The choice of antibiotic depends on the type of bacteria identified in the urine culture and local antibiotic resistance patterns. It’s important to complete the full course of antibiotics as prescribed, even if symptoms improve before the medication is finished.
For pain relief, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help alleviate discomfort.
Prevention
Several strategies can help prevent UTIs in children:
- Encourage Frequent Urination: Remind children to urinate regularly and not hold their urine for extended periods.
- Proper Hygiene: Teach children to wipe from front to back after using the toilet to prevent bacteria from the anal area from entering the urethra.
- Avoid Bubble Baths and Harsh Soaps: These can irritate the urethra and increase the risk of infection.
- Cotton Underwear: Choose cotton underwear over synthetic fabrics to promote airflow and reduce moisture.
- Treat Constipation: Constipation can put pressure on the bladder and make it difficult to empty completely.
- Encourage Hydration: Ensure children drink plenty of fluids to help flush bacteria out of the urinary tract.
- Address Underlying Conditions: If the child has an underlying condition that increases their risk of UTIs, such as vesicoureteral reflux (VUR), work with a healthcare provider to manage the condition.
Takeaway
UTIs are a common childhood illness that can cause discomfort and potential complications. Early diagnosis and appropriate treatment are essential for preventing kidney damage and other long-term health problems. By understanding the symptoms, seeking prompt medical care, and implementing preventive measures, parents can help their children manage and reduce their risk of UTIs.