Urinary Tract Infection (UTI) in Kids

What is a UTI in kids?

A UTI is a urinary tract infection. The urinary tract gets rid of extra fluids and waste in your child’s body. Bacteria (germs) get into their urinary tract, most commonly through the skin around their rectum and genitals. It causes symptoms that include fever, irritability and painful urination. Adults can also develop urinary tract infections.

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

What is the urinary tract?

Your child’s urinary tract includes their kidneys, ureters (the connecting tubes from the kidneys to the bladder), bladder and urethra (the part that connects to the outside world). Kidneys filter blood and make urine. The urine travels through the ureters to the bladder, which stores the urine. Then, the urine passes through the urethra and out of the body.

What are the types of UTIs in kids?

There are two types of UTIs based on the location of the infection in your child’s urinary tract:

• Lower UTI: An infection in the bladder (cystitis).
• Upper UTI: An infection in one or both kidneys (pyelonephritis).

How common are UTIs in kids?

Urinary tract infections in kids are common. By age 6, studies estimate that approximately 2% of boys and 8% of girls have had at least one UTI.

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

Signs and symptoms of a UTI in babies, infants and toddlers may include:

• Fever.
• Abdominal pain or fullness.
• Strong, foul-smelling pee.
• Weight loss.
• Irritability.
• Vomiting.
• Poor feeding.
• Fatigue.
• Jaundice.
• Diarrhea.

Signs and symptoms of a UTI in older children may include:

• A frequent, urgent need to pee. But despite the urgency, 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 their urine.
• Nausea and/or vomiting.
• Fever and chills.
• Pain in their back or side (below their ribs).
• Fatigue.

Are symptoms the same for a UTI in boys and girls?

Yes, symptoms can be the same for all children. Children with female genitalia may be more at risk of developing a UTI because their urethra, the tube that exits the bladder in their body, is shorter than that of boys.

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

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

What causes a UTI in kids?

Bacteria cause urinary tract infections. These organisms live in your child’s gut, reproductive system and on their skin. The most common bacteria include the following:

• Escherichia coli (E. coli).
• Klebsiella.
• Proteus.
• Enterobacter.
• Citrobacter.
• Staphylococcus saprophyticus.
• Enterococcus.

Normal urine is sterile; it doesn’t contain bacteria or other infectious organisms. It’s made of 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). Microorganisms begin to multiply there. Most infections arise from Escherichia coli (E. coli) bacteria that normally live in your digestive tract and in poop. E. coli causes about 85% of UTIs in kids.

Do diapers and baby wipes cause UTIs in kids?

Studies suggest that super-absorbent diapers can be a risk factor for UTIs in infant girls. While baby wipes themselves don’t cause UTIs in infants, rather the direction in which you use the wipe can contribute to an infection. Wiping from front to back can help prevent UTIs in infants. When you wipe back to front, or from the anus (butthole) towards the urethra, you’re carrying bacteria that normally live around the anus to the urethra, where bacteria shouldn’t live.

Are UTIs in kids contagious?

No. Urinary tract infections aren’t contagious, and they can’t spread to you or anyone else.

What are the risk factors for UTIs in kids?

Risk factors of UTIs in babies, infants, toddlers and children include:

• Wiping from back to front, which contaminates the urethra.
• Wearing super absorbent diapers often.
• Having a weaker immune system.
• Being on antibiotics for a long period of time.
• Organ transplantation.
• Congenital (present at birth) urinary tract abnormalities.
• Having an intact foreskin.

What are the complications of UTIs in kids?

Complications of a UTI in kids include:

• Repeated infections.
• Kidney infections.
• Sepsis.
• Failure to thrive.
• Poor growth or inability to gain weight.

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

• Hypertension.
• Chronic kidney failure.
• Toxemia in pregnancy.

How is a UTI in kids diagnosed?

A healthcare provider will diagnose a UTI in your child after performing a physical exam and testing. During your child’s exam, a provider will take a detailed medical history and they may ask the following questions:

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

What tests diagnose a UTI in kids?

Tests to diagnose a UTI in kids include:

• Urine analysis or urine culture.
• Imaging tests of your child’s urinary tract.
• Blood tests to look for infection or changes to their kidney function.

How is a UTI in kids treated?

Antibiotics treat a UTI in kids. Common antibiotics include:

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

Your child’s healthcare provider may give them antibiotics that they take by mouth or through a needle into their child’s vein (intravenously). Their provider may also prescribe medications for fever and/or pain and recommend your child drink plenty of fluids.

Who treats UTI in kids?

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

Can I treat a UTI in a child at home?

Your child needs antibiotics to make their UTI go away, so they need to see a healthcare provider. Follow the directions on the label and make sure your child completes their antibiotic treatment entirely, even if they’re feeling better.

At home, you can make sure your child is drinking plenty of fluids to prevent dehydration. They may not want to eat regular meals if they have nausea. Try eating multiple small, bland meals throughout the day instead of three big meals. If your child isn’t able to eat and drink, contact their healthcare provider.

Does cranberry juice treat a UTI in kids?

There’s some evidence that unsweetened cranberry juice can help resolve a UTI. However, the evidence shows that it primarily helps women with repeat UTIs, not children. Drinking fluids will help clear a UTI along with antibiotics, so plenty of water or other beverages can be very helpful.

Are there side effects of the treatment?

Side effects of antibiotics may include:

• An allergic reaction.
• Nausea.
• Diarrhea.
• Stomach pain.

How soon after treatment will my child feel better?

After treatment for a UTI, your child may feel better in a day or two. The infection should be gone in about a week. Even if they feel better, they should continue taking their antibiotics as prescribed.

Can UTI in kids be prevented?

Even with the best hygiene and maintenance, you can’t prevent all UTIs in kids. You can help your child reduce their risk of getting a UTI by:

• Teaching them to wipe front to back.
• Encouraging your child to pee more often if they’re potty trained. Make sure they empty their bladder completely each time.
• Having them wearing cotton underwear that allows for better air circulation.
• Making sure your child drinks plenty of fluids and stays hydrated.

Your child’s healthcare provider can offer more tips to help your child prevent future infections.

What can I expect if my child has a UTI?

A UTI is a temporary infection. Antibiotics treat it and your child should feel better within a couple of days after beginning their treatment. The infection clears up in a week. Complications are rare but possible with a UTI in kids because the condition can take longer to diagnose. Children may not be able to pinpoint their discomfort. A delay in treatment can lead to complications like kidney infections.

If your child has a UTI and gets treatment, they may get the infection again in the future. You can teach your child how to wipe after they go potty (front to back) to reduce their risk of developing the infection in the future.

How long does a UTI in kids last?

A UTI will last about a week after your child begins treatment with antibiotics. They may feel better sooner with treatment.

Does my child need to go to the hospital if they have a UTI?

Hospitalization for a UTI may be necessary if your child:

• Is younger than 2 years old.
• Has a high fever.
• Has back pain.
• Has dehydration (not urinating, having a dry mouth and having no tears when crying).
• Can’t take oral antibiotics.
• Has an infection that spreads to their bloodstream.

When should my child see a healthcare provider?

Urinary tract infections need treatment by a healthcare provider. Call their primary care physician if they:

• Have signs or symptoms of a UTI.
• Aren’t eating or drinking.
• Can’t tolerate medications.
• Are vomiting.
• Have a high fever or pain.
• Have any signs or symptoms that worry you.

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

What questions should I ask my doctor?

• What type of UTI does my child have?
• How often should my child take antibiotics?
• Are there side effects to the antibiotics?
• How can I prevent future UTIs?

What is the difference between a urinary tract infection and a bladder infection in kids?

A bladder infection only affects your child’s bladder. A urinary tract infection can affect all parts of your child’s urinary system — including their bladder, kidneys, ureters and urethra. Symptoms of both types of infections are similar.