When Vanessa Frey's newly potty-trained 2-year-old daughter came to her late one night and said it hurt to pee, Frey knew something was wrong. “I walked into the bathroom and immediately noticed a pungent smell,” she says. Frey took her to the doctor the next day, where they had her daughter pee into a collection device in the toilet. She learned her daughter had a urinary tract infection (UTI), which, says Frey, luckily went away after a course of antibiotics.
About three in 100 children experience a UTI yearly, according to the National Institute of Health. While UTIs in babies and kids are typically easy to treat, it's essential parents recognize the symptoms and seek treatment right away to avoid complications that can lead to a kidney infection and long-term kidney damage.
You may be wondering what causes UTIs and if babies can get UTIs from diapers. Here's why UTIs occur, the symptoms, how they're diagnosed and treated, potential complications, and how to prevent them from recurring.
What Is a UTI?
A urinary tract infection or UTI is a bacterial infection anywhere in the urinary tract. Bladder infections are the most common type of UTI, but an infection can also appear in the urethra, ureter, and kidneys. Children of all ages, including newborns, can develop a UTI.
What Are the Common Causes of UTIs in Kids?
UTIs are most commonly caused by bacteria (germs) that travel from the bowels into the urinary tract. They can also develop when bacteria isn't expelled from the bladder through urination (often when a child holds their pee too long).
“During their first year of life, boys and girls get UTIs at about the same frequency,” explains Antoine Khoury, MD, medical director of urology at Children's Hospital of Orange County (CHOC), a pediatric health care system based in Orange County, California.
After age 1, Dr. Khoury says girls are more likely to develop UTIs because the channel from their bladder to the exterior, or the urethra, is shorter, and it may also be that moist tissue and the folds of their genitals could allow bacteria to colonize the area more easily.
Uncircumcised kids have a greater risk for UTIs than ones who are circumcised, he says. Some studies have shown about a three- to 10-fold decrease in UTI rates after circumcision.
Other risk factors include:
GeneticsPoor toilet hygieneInfrequent urinationConstipationHolding poopNot entirely voiding the bowelsHolding urine (Frey learned that her daughter's infection likely occurred from holding pee, which gives time for bacteria to grow in the bladder.)
About one in three young children under age 2 who have a UTI with a fever have a condition called vesicoureteral reflux (VUR). That means when the bladder contracts, urine flows upward to the ureters and sometimes the kidneys. Most children with VUR don't experience long-term problems.
Can Babies Get a UTI From Diapers?
While wearing diapers doesn't cause UTIs, infants can get them if germs enter the urinary tract from a dirty diaper or if they are wiped from back to front.
UTI Symptoms in Babies
UTIs can be more difficult to recognize in young children because they don't always have the same symptoms as adults. Children under 2 are often unable to articulate what's wrong.
“Infants may lack energy, run a fever, or have no symptoms,” explains Rama Jayanthi, MD, chief of the department of urology at Dayton Children's Hospital and chief of urology at Nationwide Children's Hospital in Dayton, Ohio. But if you have a family history of UTIs or see any of the following symptoms, Dr. Jayanthi says you should take your baby to their health care provider:
Fever (can be the only symptom) TirednessIrritability, crying, or fussinessVomiting or diarrheaPoor appetite or little weight gain
UTI Symptoms in Kids
Older children may experience similar symptoms as adults, including:
Fever (often with rapid onset)Pain when urinatingFoul-smelling urineFrequent urination or sudden need to urinatePain in the lower back or abdomenWetting accidents (when fully potty trained)Blood in the urineTiredness
UTI Diagnosis in Babies and Kids
A urine sample is the only way to diagnose a UTI, says Dr. Jayanthi. Older children can pee into a sterile cup, while health care providers use a catheter (a thin tube inserted into the ureter and up to the bladder) to collect infant samples. The sample is then sent to a lab to see what type of bacteria (if any) grows.
UTI Treatment
UTIs are most commonly treated with antibiotics to kill the bacteria causing the infection. Still, the specific treatment for a child with a UTI will depend on their age, overall health, medical history, and the extent of the infection and symptoms, says Dr. Khoury.
Parents should also give children plenty of liquids and encourage them to empty their bladders frequently. There's no scientific evidence that cranberry juice can treat a UTI in children, so while Dr. Jayanthi says there is no harm in giving cranberry juice, he advises parents to skip sugar-laden juice cocktails in favor of healthier beverages.
UTI Complications
Left untreated, UTIs can develop into a kidney infection, which can be serious and lead to kidney damage when not treated promptly. Frequent UTIs can also lead to kidney scarring.
The American Academy of Pediatrics guidelines state that infants experiencing a UTI accompanied by a fever, and older children who have frequent UTIs, undergo an ultrasound to look for abnormalities in the bladder or kidneys.
How To Prevent UTIs in Kids
Drs. Jayanthi and Khoury offer the following tips to help prevent UTIs:
Change diapers frequently and thoroughly clean genitals, wiping from front to back.Teach potty-trained children to use the bathroom when they need to go. Holding urine in the bladder allows bacteria to grow.Children should fully empty their bowels when using the bathroom. As with urination, teach them not to hold it or hurry off the potty in favor of returning to play.Give children plenty of high-fiber foods and water to help them achieve daily soft bowel movements.Use soap to wash genitals and teach good hygiene, like hand-washing for 20 seconds.Avoid bubble baths. They may irritate the urethra and allow enough time for dirty water to enter the urinary tract.
Despite your best efforts, a UTI may not always be able to be prevented. That's why it's important for parents to look out for signs and take action to treat a UTI promptly.
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