Urinary Tract Infection (Children’s)

Overview

What is a urinary tract infection (UTI) in toddlers?

A UTI is an infection in your child’s urinary tract which includes their kidneys, the ureters that connect them to the bladder and the urethra where urine exits their body. Bacteria (germs) get into their urinary tract through the skin around their rectum and genitals or through the bloodstream from any part of their body (which is much less common).

Because it may not be obvious when a child has an infection, especially if they’re too young to voice their symptoms, UTIs in children sometimes go unnoticed. Urinary tract infections need to be treated immediately to prevent the infection from spreading and damaging the kidneys.

What are the types of urinary tract infections in toddlers?

UTIs are classified into two categories:

  • Lower UTI: An infection in their bladder.
  • Upper UTI: An infection in their kidney (one kidney, or both).

What is the urinary tract?

The urinary tract gets rid of extra fluids and waste. The kidneys, ureters, bladder and urethra are the organs that make up the tract. The kidneys filter blood and make the urine, the urine travels through the ureters to the bladder which stores the urine and then the urine passes through the urethra and out of the body.

How common are UTIs in Toddlers?

Urinary tract infections in children are common. Before age seven, one of 12 girls and one of 50 boys will have a UTI.

What’s the difference between a urinary tract infection and a bladder infection in toddlers?

An infection in the bladder stays in the bladder, while a UTI can infect the entire urinary system. Many of the symptoms are similar, but a child is more likely to look sicker when they have an infection above the bladder.

Who gets UTIs? Which children and toddlers are at risk?

UTIs are most common in immunosuppressed children (kids who have a weaker immune system) and children who have been on antibiotics for a long period of time for other issues. If your child recently went through an organ transplantation, they are also more vulnerable to a urinary tract infection. Children can also be born with abnormalities of their urinary tract that make them more likely to get an infection.

Adults are also vulnerable to urinary tract infections.

Are UTIs contagious?

No. Urinary tract infections can’t be transmitted to you or anyone else.

Can a UTI cause a fever in my kid?

Yes. A fever is a symptom of a UTI. Fevers are not necessary to diagnose a UTI and are more common with infections outside the bladder.

Can a UTI cause my child back pain?

Yes. A UTI can cause pain in your kid’s back or side. The pain is typically located below their ribs and is worsened when something hits your child’s back then when they are at rest.

Can a UTI cause diarrhea in toddlers?

Yes. Children with a UTI can sometimes get diarrhea.

If I give my child cranberry juice, will that help their UTI?

The rumor that cranberry juice can help resolve a UTI does have some scientific proof. However, the evidence shows that it primarily helps women with repeated UTIs, not children. Drinking fluids will help clear a UTI, so lots of water or other beverages can be very helpful.

Symptoms and Causes

What causes a urinary tract infection (UTI) in toddlers?

Normal urine is sterile (there are no bacteria or other infectious organisms) and contains fluids, salts and waste products. An infection occurs when microorganisms cling to the opening of the urethra (the hollow tube that carries urine from the bladder to the outside of the body) and begin to multiply. Most infections arise from Escherichia coli (E. coli) bacteria that normally live in the digestive tract.

Different bacteria can cause a urinary tract infection. The seven most common bacteria include the following:

  • Escherichia coli (E. coli), found in about 85% of UTIs in children.
  • Klebsiella.
  • Proteus.
  • Enterobacter.
  • Citrobacter.
  • Staphylococcus saprophyticus.
  • Enterococcus.

These organisms live in your child’s gut, reproductive system or on their skin.

What are the signs and symptoms of a UTI in toddlers? What are the UTI signs and symptoms in older kids?

The following are the most common signs and symptoms of a UTI. However, each child may experience these differently. Signs and symptoms in babies may include:

  • Fever.
  • Abdominal pain or fullness.
  • Strong, foul-smelling urine.
  • Poor growth. Failure to thrive.
  • Weight loss or failure to gain weight.
  • Irritability.
  • Vomiting and diarrhea.
  • Poor feeding.
  • Exhaustion.
  • Jaundice.

Signs and symptoms in older children may include:

  • A frequent, urgent need to urinate (having "to go"). Despite the urgency your child feels, often only a small amount of urine comes out.
  • Wetting during the day and/or at night (after being fully potty trained).
  • Painful or difficult urination (dysuria).
  • Discomfort above the pubic bone.
  • Foul-smelling urine.
  • Blood in the urine.
  • Nausea and/or vomiting.
  • Fever, chills.
  • Pain in the back or side (below the ribs).
  • Fatigue.

What makes a UTI in toddlers worse?

It’s more difficult to diagnose because symptoms are less specific, and waiting too long to get treatment may lead to a kidney infection.

Is a UTI in a toddler a sign of bladder or kidney problems?

Not necessarily. Most children who get UTIs don’t have other urinary tract problems.

Diagnosis and Tests

How is a urinary tract infection diagnosed? How do healthcare providers test for a UTI in toddlers?

After interviewing you about your child’s history and performing a physical examination, the healthcare provider may order the following tests:

  • Urine tests like the leukocyte esterase and a urine culture to test for the presence of bacteria or white blood cells.
  • Blood tests looking for infection or kidney function.
  • Ultrasound or CT of the kidneys and bladder.
  • Voiding cystourethrogram (VCUG), which evaluates the bladder and urethra to detect vesicoureteral reflux (when urine backs up to the kidneys instead of flowing out through the urethra).

What questions might my toddler’s healthcare provider ask to diagnose a UTI?

  • What are your child’s symptoms?
  • How long has your child had these symptoms?
  • Does your child have a history of urological problems?
  • Is there a history of urological problems in the family?
  • What medications is your child taking?

Management and Treatment

What’s the treatment for UTIs in children?

Treating a urinary tract infection requires antibiotics that can either be delivered intravenously (through a needle into your child’s veins) or orally (they swallow the pills or liquid). Their healthcare provider may also prescribe medications for their fever and/or pain. Common antibiotics include:

  • Amoxicillin/clavulanate (Augmentin®).
  • Cefixime (Suprax®).
  • Cefpodoxime.
  • Cefprozil (Cefzil®).
  • Cephalexin (Keflex®).
  • Trimethoprim/sulfamethoxazole (Bactrim®, Septra®).

Who will treat my child’s UTI? Should my kid see a specialist?

Your child’s primary care physician will likely be able to treat your child’s UTI. If there are any complications, you may be referred to an urologist or nephrologist (healthcare providers who specialize in the urinary tract).

How soon after treatment will my child feel better? How long does it take to recover from a urinary tract infection?

They may feel better in a day or two and the infection should be gone in about a week.

Prevention

Can I prevent a UTI in my child?

Do your best to keep your child’s urinary skin areas very clean, and teach them to do the same. This is particularly important for girls. Teach them to wipe front to back to avoid contaminating the urethra from the anus.

Outlook / Prognosis

What’s the outlook for children with urinary tract infections?

This is a temporary infection with little risk of complications. With treatment, your child’s UTI should only last about a week. However, they can get an infection again even if they have a normal urinary tract.

Are there any long-term complications of a UTI in toddlers?

About 3% of children who get a urinary tract infection may have kidney problems in the future, including scarring. Complications of renal scarring include:

  • Hypertension.
  • Chronic renal (kidney) failure.
  • Toxemia in pregnancy.

Living With

When may my child need to be hospitalized for a UTI?

Your child may need to be hospitalized for the following reasons:

  • If they’re a young infant or child.
  • If they have a high fever.
  • If they have back pain.
  • If they’re dehydrated (signs of dehydration are not urinating, having a dry mouth and having no tears when crying).
  • If he or she is unable to tolerate oral antibiotics.
  • When there is a concern that the infection has spread to their bloodstream.

When should I contact my child’s healthcare provider?

Urinary tract infections need to be taken care of right away. Call a healthcare provider if your child:

  • Shows a decrease in feeding or drinking.
  • Isn’t tolerating home medications.
  • Is vomiting.
  • Experiences an increase in fever or pain.
  • Becomes more irritable or inactive.
  • Has any signs or symptoms that worry you.

Quickly getting treatment for your child’s UTI decreases the risk of kidney problems and the risk that the infection could spread.

A note from Cleveland Clinic

Although a urinary tract infection isn’t a life-threatening condition, it may result in a hospital stay or lead to complications that can affect your child’s quality of life. Be sure to have them checked out by their healthcare provider as soon as they show symptoms. Always make sure that your child takes all of their prescribed medication. Even if they seem better, you should still have them take the medication until the treatment is complete.

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