Urinary Tract Infections In Children

Little boy on toiletDr Danielle Esler explains the importance of being able to recognise the signs and symptoms of urinary tract infections in children, and seeking medical attention.

The urinary tract consists of the kidneys (organs that help rid the body of waste), the ureters (tubes that drain the kidneys of urine), bladder (the organ that stores urine) and urethra (the tube connecting the bladder to the body's surface). Urinary tract infection (UTI) occurs when the urinary tract is infected by bacteria, usually as a result of contamination with faeces (for example, from improper wiping after going to the toilet). Infection enters at the urethra, and can move up into the bladder (resulting in cystitis) and spread as far as the kidneys if left untreated.

Infection of the urinary tract in children is not uncommon, so it is important for parents to be able to recognise the symptoms in their child and seek medical assistance.

What Are The Symptoms?
UTI symptoms may be very vague among babies and very young children. Parents may only notice their child seems unwell or irritable, or they may have a fever. Pre-school-age children and older may complain of pain when they pass urine, or tummy pain. Parents may also notice their child has smelly urine, blood in the urine, is passing urine more frequently than usual or a usually continent child may start wetting themselves.

It is important that parents do not mistakenly label these symptoms as thrush. Thrush in children is usually oral, in contrast to the genital thrush seen in women. It is unrelated to childhood UTIs.

If parents notice any of the above symptoms they should take their child to see a doctor.

How Are UTIs Diagnosed?
Tests are needed to confirm or exclude a UTI, such as a dipstick test, which involves a health professional dipping a stick of special paper into urine, and sending urine to a laboratory to determine whether bacteria are present. Sometimes doctors will also order an ultrasound of the urinary tract.

In rare cases, UTIs in children can be due to an abnormality of the urinary tract that causes urine to flow backwards up the tract when the child passes urine (urinary reflux). If your doctor suspects this they will order another test called a micturating cysto-urethrogram. In this instance, a catheter will be placed in your child's urethra and dye injected.

Occasionally children with a UTI become very unwell. It is important to seek prompt medical attention if your child deteriorates, particularly if they are vomiting or complain of back pain. Warning signs for serious illness in babies include lethargy or 'floppiness', decreased wet nappies and not feeding/drinking like they usually would.

How Are UTIs Treated?
UTIs are easily treated with antibiotics. For most children, a course of oral antibiotics will be suitable. However children who are very unwell may require hospital admission so antibiotics can be given through a drip. Sometimes children who experience recurrent UTIs may be prescribed an ongoing regimen of antibiotics to prevent infection.

If a child has a UTI, a doctor may also recommend they drink more than usual to assist the flushing of bacteria out of the urinary tract. As well, paracetamol or other medications may be recommended to help with symptom relief.

Usually children recover from UTIs without any long-term consequences. Occasionally though, particularly if a child has multiple UTIs, the kidneys may be damaged permanently. This is the reason why a doctor should be consulted if your child demonstrates any of the signs or symptoms of a UTI.


Danielle Esler is a registered GP, public-health physician and mother of two boys.





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