Is It a UTI? Spotting the Signs in Kids

Podcast Transcript

Dr. Richard So, MD:

Welcome to Little Health, a Cleveland Clinic Children's podcast that helps navigate the complexities of child health one chapter at a time. In each session, we'll explore a specific area of pediatric care and feature a new host with specialized expertise. We'll address parental concerns, answer questions, and offer guidance on raising healthy, happy children. Now, here's today's host.

Dr. Lynn Woo, MD:

Hello, listeners. Welcome to Little Health, the Cleveland Clinic Children's Podcast, where we talk about common health concerns in kids in a way that we hope is practical, reassuring, and easy to understand. I am Lynn Woo, one of the pediatric urologists at the Cleveland Clinic, and hoping to highlight today's topic, which is urinary tract infections, or as we call it, UTIs. It's a very common but worrisome problem that affects one in 30 children. So, UTIs can look really different in babies, toddlers, and older kids, and sometimes the symptoms are obvious and sometimes they're not. And while most UTIs are really treatable, some children have recurrent infections and underlying factors that are important to recognize early in order to avoid long-term urinary tract damage. In this episode, we're gonna talk about what UTIs actually are, common symptoms, what puts some children at higher risk, and when it might make sense to involve a pediatric urologist.

Joining us today is my good friend and colleague, Dr. John, or Jack, as we like to call him, Weaver. He is a board certified pediatric urologist, a surgeon, and researcher at the Cleveland Clinic who works closely with children and families who are dealing with urinary tract problems. Thanks for being here. Dr. Weaver, start out with telling us a litle bit about yourself.

Dr. John Weaver, MD:

Sure. Thank you for having me. Yeah, I'm a pediatric urologist here at the Cleveland Clinic. I grew up in Northeast Ohio, went to Case Western for undergraduate and medical school, and then I did my residency in St. Louis at Washington University, and then my pediatric urology fellowship at the Children's Hospital of Philadelphia in Philadelphia. And I'm really happy to be here to talk about urinary tract infections.

Dr. Lynn Woo, MD:

Well, welcome back to Ohio. I'm very excited to be able to work with you every day. Let's just dive in and start with the basics. Tell me, what is a UTI?

Dr. John Weaver, MD:

So, UTI stands for urinary tract infection. So, let's start with the urinary tract. So, that is, you know, when we talk about the urinary tract, we're talking about the kidneys and the bladder. So, you know, the way I describe it to families is, are is the kidneys make all of the urine and then that urine should drain down into the urinary bladder where, you know, the urine sits until it, you, you pee it out of your urethra. And in, in urinary tract infection is where any part of that urinary tract, either the urethra, the bladder, the kidneys have an infection generally from bacteria, most commonly E. Coli that can get into the urinary tract and cause symptoms and, and issues that, you know, require management from a urologist or any physician.

Dr. Lynn Woo, MD:

How common are UTIs in children and does that risk change with their age or with their gender?

Dr. John Weaver, MD:

Yeah, absolutely. So, urinary tract infections are a pretty common issue that we'd run into. I've seen numbers as much as one to 2% of all children will develop a UTI in their lifetime.

Dr. Lynn Woo, MD:

Does the risk change with age or gender?

Dr. John Weaver, MD:

Absolutely. So, generally, what we consider is, females are at greater risk of urinary tract infections as opposed to males and that's just because of their anatomy. So, their urethra is a little bit shorter where a male has, you know, a long urethra with a penis and then a female has a, a short urethra. So, it's more common for bacteria to be able to get in from the outside world into their urinary tract. So, certainly in general, girls are at higher risk of urinary tract infections than boys. However, there are things that, you know, change that. For example, boys who are uncircumcised and sometimes boys in the first year of their life may be at higher risk than other boys. So, certainly we're, we're always considering each case individually and each patient's individual risk factors, but certainly the general rule is that girls are generally at an increased risk.

Dr. Lynn Woo, MD:

So, I'm hearing that these are infections that can affect your kidney or your bladder that are caused by bacteria like E. Coli and that girls may be at higher risk. How serious are UTIs and can they be dangerous or lead to long-term health problems?

Dr. John Weaver, MD:

So, absolutely. As soon as a child starts showing signs of a UTI, then it's important to go, you know, drop off a urine specimen either at the pediatrician or at our office because if it, if left untreated, UTIs can certainly become high risk and put the urinary tract at risk of, you know, developing issues long-term with the bladder and the kidney. So, it's absolutely important when a child starts showing signs of a UTI to go in and be tested.

Dr. Lynn Woo, MD:

Speaking of those signs, what are the most common symptoms of a UTI starting with babies and toddlers?

Dr. John Weaver, MD:

Yeah. So, I always tell families, you know, the baby's not gonna tell you it burns to urinate. It's something that you have to really watch closely. Generally, a fever is the most common sign of a UTI in a baby and then the baby will just not be acting in himself or herself. The baby will be lethargic, kinda irritable and you have to really monitor for those signs, especially in babies that you know are at increased risk of UTIs. But generally, the fever, uh, especially high grade fevers are, are the most common signs and you have to rule everything else out. You know, they don't have congestion, they don't have signs of an ear infection. If all of those things have been ruled out, then it's good to, you know, go to the pediatrician. They may have to pass a catheter to get a urine specimen and really work it up fully.

Dr. Lynn Woo, MD:

What about for older kids or teenagers? What kind of symptoms might they have?

Dr. John Weaver, MD:

Yeah, so that's a little different. You know, they are gonna, you know, be able to report to you that they're having, you know, pain with urination. They may have some blood in the urine. When the urinary tract infection gets worse, you know, if it's been a few days, they may develop fevers, especially if there's an anatomic abnormality that's obstructing urine. They could develop fevers, which is more serious. So, you need to be really on high alert for the early signs, you know, over- you know, they may develop incontinence. They may be going to the bathroom more frequently. They may have foul odor to the urine. All of those things can kind of present in that population.

Dr. Lynn Woo, MD:

Let's go back to how UTIs happen. You had mentioned bacteria like E. Coli. Where does this come from?

Dr. John Weaver, MD:

That is a great question. So, generally, UTIs occur because there is some underlying issue. So, for example, a lot of our patients have an underlying anatomic issue that's gonna predispose them to UTIs. For example, sta- stasis of urine, urine that's kinda sitting there and, and not draining either because of there's some blockage or obstruction, that can, you know, put children at risk for UTIs. I generally tell families, you know, the more the, the child's drinking, the more they're voiding frequently, the better and the less you want a running river as opposed to a stagnant puddle there. You want urine kinda constantly moving. And so, that certainly puts patients at risk of UTIs when, when the urine is stagnant and not moving. Other things, for example, kidney stones, they can cause blockage and, and again, kinda then stagnant urine becomes at risk of UTIs. Certainly constipation is a big issue in, in our population and, and that's multifactorial how that kind of relates to the development of UTIs, but certainly is one of the biggest risk factors we see in kids, particularly with E. Coli UTIs.

Dr. Lynn Woo, MD:

How is constipation related to UTI?

Dr. John Weaver, MD:

So, that's a very tough question. It, it's related in multiple ways. So, oftentimes, when a kiddo has constipation, they have dysfunctional pelvic floor muscles and they have dysfunctional sphincter control. They may be holding their stool in place and then by, you know, association their sphincter, their urinary sphincter is also connected to the same brain inputs that the anal sphincter is connected to. So, oftentimes, if you have issues with your anal sphincter, you're gonna have issues with your urinary sphincter and you may have a propensity to hold your urine more often and not relax when you empty, and then you may have a high post-void residual. Furthermore, you know, w- what I often say is, you know, there's only so much room in a little kid's pelvis, so if there's a lot of stool in there and it's, it's compressing the bladder, that can cause an overactive bladder picture, some incontinence, and then a lot of issues with urination that ultimately end up leading to UTIs.

Dr. Lynn Woo, MD:

And you had mentioned the importance of keeping things flowing and not letting the urine sit for long times. It sounds like making sure we're not having holding habits, holding back poop, or holding that pee are really important parts of trying to keep the urinary tract healthy.

Dr. John Weaver, MD:

Yeah, that's by far the most important thing. That's the first thing we do, that we address with any child we see. So, you know, a child may have had a history of kidney stones, they may have a history of a little bit of, you know, stasis of urine in their urinary tract, what we call hydronephrosis. But ultimately, the most important thing is good bladder habits. And it's incredibly important and, you know, we, we talk, we work with children on, you know, sometimes we get them a potty watch and it goes off every two hours to remind them, you know, to urinate because kids are busy and they start playing video games and things like that or playing outside. So that's important. Drinking a lot of fluid, I, you know, we, we all, we often give our patients cutoffs, you know, you gotta drink at least 40 ounces a day or 50 ounces a day of water.

You know, these types of things. We tell them, you know, sometimes we do something called double voiding where we have them pee and then we have them sit on the potty and count to 10 and then try to pee again or, or relaxation efforts. You know, a little girl should have her feet on the floor or even turn backwards on the toilet. There, there's little tricks that we do to really help them mo- more efficiently empty their bladder and, and really void well.

Dr. Lynn Woo, MD:

What kind of advice would you give about swimming or bubble baths? Do you think that those are really factors for UTIs or things that parents have to avoid?

Dr. John Weaver, MD:

So that's a great question. Certainly you, you have to take that on a case by case basis and if a family has seen, you know, significant issues with a certain bubble bath or, or, you know, when, when they're going swimming, certainly, you know, we'll take heat of that and focus on that. But most generally, you know, kids should be able to swim in the summer and, uh, you know, as long as it's a safe pool and, and not, you know, a dirty lake or something like that, you know, they should be able to safely, you know, go about swimming and, and not really have issues with UTIs and usually it's something underlying that, that we need to address and they should be able to go back to their normal swimming routine.

Dr. Lynn Woo, MD:

So bubble baths are not inherently dangerous or bad for kids.

Dr. John Weaver, MD:

Certainly there's some cases where, you know, families have noticed that, you know, maybe, you know, when their kid, they have certain very irritable skin and, and certainly, you know, certain products are, are worse on them, but in general, yeah, bubble baths should be safe.

Dr. Lynn Woo, MD:

So going back to the symptoms, once a parent's worried that their child might have a UTI, how do we go about making that diagnosis?

Dr. John Weaver, MD:

So that's a great question. So I kind of alluded to this earlier. It's a tough diagnosis to make, particularly in the young kiddos. And, and ultimately you just have to be hypervigilant and be monitoring your child. And you might, you know, especially if you haven't seen us before, you're not really thinking in the back of your head, is this a UTI? You're thinking more, you know, why is my child have a fever? Why does my child acting not like themselves? And if that's the case, then, you know, you rule everything else out because, you know, you do not want to have to pass a catheter if you don't have to. If there's congestion, if there's clearly everyone in the house is sick, if there's, you know, a history of ear infections, rule those things out. But if it's not getting better, a UTI will not get better on its own.

The fevers are going to persist. It's only going to get worse and that's going to put the kidneys at risk. So ultimately, once you've kind of been vigilant and seen your pediatrician and ruled everything else out, then, you know, passing a catheter is certainly the first step. And then what that, they'll get early results on the urine at that point and, and get a good idea whether or not there's an infection and then they can start antibiotics at that point and then ultimately it takes about a day or two for the actual culture to come back and for us to get results to tell us, you know, what antibiotic will actually treat this infection and what's the best antibiotic for your child. And, you know, we're very good antibiotic stewards and we try not to use antibiotics when they're not needed, but certainly, you know, when a child has a UTI, it's very important to get them on the correct antibiotic as early as possible.

Dr. Lynn Woo, MD:

So let's step back. When we need to collect the urine, how do we do that for different kids?

Dr. John Weaver, MD:

In a child who's not potty trained yet, in order to get a clean sample, unfortunately, you do have to pass a catheter. In a baby that may be easier than a kiddo who is a little older and may resist a little more, but generally, you know, that's needed where once the child's potty trained and able to provide a sample, similar to an, how an adult would leave a sample, you clean the genitalia and you give a midstream sample and usually that's sufficient.

Dr. Lynn Woo, MD:

And why is it important to confirm that this is an actual urinary tract infection rather than just giving antibiotics based on symptoms?

Dr. John Weaver, MD:

This is one of the hardest things we deal with in our line. Sometimes they're slam dunks where a child has a fever and clearly a UTI and, and the culture showing UTI and, and those are the easy cases. And there's other cases where, you know, child may be showing some signs, but maybe the early urine results aren't clearly positive and then we're waiting on a culture and the question is, do you start antibiotics? And the reason you wouldn't start antibiotics when you're not completely sure is because you can get resistance. So for example, if you don't have a active infection and you use an antibiotic, let's say Bactrim is one we commonly use and, and that's a good tool that we have in our back pocket to use when you do have an infection. But if we use it when it's not needed, then when you actually do have an infection, your body may be resistant to it. So then we lost one of our best tools by using it too early.

Dr. Lynn Woo, MD:

How quickly should your child's symptoms improve once treatment starts? Why is it important to finish all the antibiotics even if your child's already feeling better?

Dr. John Weaver, MD:

Yeah. So this depends on the severity of the infection. An infection that's pretty early and you catch it pretty early, you can start seeing, you know, improvement within the day, a culture appropriate antibiotic. What I mean by that is an antibiotic that kills the bacteria you are growing, because sometimes you can be put on an antibiotic that the bug that you're growing isn't susceptible to. So the bug will not, the child will not improve on that antibiotic. But if you give them an antibiotic that is the correct antibiotic that will kill the bug that the child has, you should start seeing improvement within a day. If it's a severe infection, it may take a day or two, but antibiotics work very well and, and, you know, you may have some residual inflammation, but generally you start seeing improvement within a day or two.

And, you know, that's a great question in terms of, you know, by day three or four, do you really need to continue this antibiotic if the child's doing great, running around, acting like themselves? And I need to stress that it is important to do that, particularly complex UTIs. For example, if there's an anabotomic abnormality and as I mentioned earlier, stasis of urine where urine's not draining as fast as it should, those infections need at least seven to 10 days of antibiotics. And the reason for that is sometimes even 14 days.

And the reason for that is because if you undertreat it, the infection can come right back after you stop the antibiotic and then the next bout will be more likely to be resistant to that antibiotic and then you've kind of burned one bridge in terms of an antibiotic that you can use. So really important to follow, uh, you know, there's strict guidelines that we set out with the antibiotics so that you don't develop resistance and that, you know, we're, we're good antibiotic stewards and not using them in situations where they're not needed.

Dr. Lynn Woo, MD:

To summarize, what I think I've heard you tell me is we need to get a good urine sample and in children that can't give us one in the cup, a catheter might need to be used to get that urine and then we need to do a formal workup on that urine to see what exactly is growing and confirm that there's an infection. And then once we've determined that there is an infection, you can decide what antibiotics are best and for how long that patient should be taking them and that it's really important to finish that entire course, even if the patient's feeling better pretty early. So most kids who develop UTIs won't necessarily go on to have more infections in the future, but what could it mean if your child's having repeated infections?

Dr. John Weaver, MD:

This is our population generally that we see. So pediatricians will often, if, if there's one UTI, they'll often, you know, treat it and if the kiddo does better and doesn't have another, you know, we may never see that patient. But generally what we see is these complex patients who are having recurrent infections. There's a lot of workup that we can do to kind of better evaluate why this is happening. For example, we do ultrasounds, which is where totally non-invasive tests put jelly on the belly is what we call it, no lubricating jelly on the belly and then you put the ultrasound probe on the belly and you evaluate the kidneys, the bladder, and the whole urinary tract. And that will help us identify, is there an underlying abnormality of the urinary tract that's leading to these infections? Is there a blockage? Is there a stone?

Is there an active infection? So these are things that we, you know, need to do in order to better evaluate, you know, why the kiddo is having these recurrent infections. Again, you know, it may be, you know, just under treatment of the initial UTI, it may be b- bad bladder habits, which we see very commonly, especially around the time of potty training as the kiddos learning, you know, how to more efficiently void and how to fully relax their pelvic floor muscles. So we have a whole armamentarium of tools that we can use to treat all of these issues. It's very common in our population to have these recurrent infections, but generally we are able to find a solution and have a really good treatment regimen.

Dr. Lynn Woo, MD:

So you mentioned ultrasound and I think a lot of our listeners are familiar with that, but what other tests might a pediatric urologist recommend for a child who's having recurrent UTIs or as you said, complex or really serious UTIs with a lot of additional symptoms?

Dr. John Weaver, MD:

There are a lot of different tests we can do to better evaluate the urinary tract and, and figure out why someone's having a UTIs. We try to only do this when they're absolutely necessary. So one test is avoiding cystourethrogram. Sometimes we'll do that even in babies who haven't had a UTIs just based on their ultrasound findings. And the voiding cystourethrogram does require a catheter placement and then the bladder is filled up with fluid that includes contrast. So then we are able to take x-rays and see, you know, the bladder, we're able to evaluate when the child voids and we're able to see, you know, what their urinary tract looks likes when the patient's peeing. We're able to see is there reflux? Is there a urine that's going from the bladder up to the kidneys? That's abnormal. In the normal urinary tract, urine should go one way.

It should go down from the kidneys into the bladder and out. It should never go back up to the kidneys. So this test will tell us that. And in older kids, that can be a somewhat traumatic experience in terms of avoiding the VCUG. So we really work closely with the families to ensure that the child is totally relaxed during the study and that, you know, we make the experience as best as possible for all involved. So that's VCUGs. There's other tests, for example, renal scans. So renal scans, that is oftentimes when we're evaluating is there obstruction in the urinary tract. So what that involves is a IV is placed and then a radioactive substance is given through the IV and then we follow that substance through the urinary tract and identify drainage times, or how long does it take for the substance to drain similar to how long it would take urine to drain out of the urinary tract.

And that study, again, we work very closely with families because it does often require a catheter as well and it requires an IV placement. So we work closely with the families to, you know, only do that when absolutely necessary and only when we think we're really gonna get a lot of useful information from it. Uh, there are other tests I won't get into as much detail, but MRIs oftentimes in the very young children that require sedation, there's also, uh, urodynamics where we actually can get pressure readings on the bladder and that's generally for kiddos who may have a neurologic component to their bladder issues. Very commonly we do this in spina bifida patients almost annually and that's an area where I really do a lot of research in I think we have a really good team here to do urodynamics. So, you know, these are the different studies that might be needed beyond just a simple catheterization.

Dr. Lynn Woo, MD:

So thanks for sharing all that with us. It sounds like there are a lot of studies. You're not saying that every child necessarily needs these, right?

Dr. John Weaver, MD:

Absolutely not. No. And one of our main jobs in pediatric urology is to ensure that we are only doing these studies when they are absolutely necessary and talking with families in detail about them. And, and as I mentioned, a lot of my research is based on, you know, tr- trying to better understand how often are we able to maybe avoid doing these studies when we previously may have done them in the past. And we're trying to understand, you know, exactly, you know, what patients need them so that we're not doing unnecessary studies that may be causing undue trauma to the family.

Dr. Lynn Woo, MD:

So once you've done your full evaluation and if you do find a specific problem with the urinary tract, can you speak in general about what treatments might be needed?

Dr. John Weaver, MD:

Yeah. So, you know, treatments for recurring urinary tract infections, you know, it's a mixed bag and, and there's, there's a lot of different possibilities. For example, as I mentioned earlier, a lot of times conservative treatment is, is the first option for a lot of kiddos. But if there is an anatomic abnormality that's this source, then there's certain things we can do. For example, if there's kidney stones, if the kidney stone is already passed, then, you know, we work with our nephrology colleagues closely and put the patient on a diet regimen or increase their fluid intake to prevent future kidney stones. But if there is a blockage in the urinary tract, for example, sometimes those do require surgery. Luckily, we're very good and have very good results in correcting blockages in the urinary tract. You know, there's open surgical options, there's laparoscopic minimally invasive options. Here we use, oftentimes use the robot to do those and the patients often do great after those surgeries and will often not need a further surgery and the goal of surgery is generally to get them free of UTIs going forward.

Dr. Lynn Woo, MD:

What are some key steps parents and caregivers can take right now to decrease the risk of UTIs in their kids?

Dr. John Weaver, MD:

That's tough because, you know, a baby is different than a kid who's in their potty training years versus a kiddo who's a little bit older and they're teenagers. But, you know, there's general habits that you can follow, you know, fluid intake, you know, ensuring high volumes of, of water throughout the day, frequent voiding and then, you know, whatever you know about your child in terms of, you know, what predisposes them to UTIs, you know, is it an issue with holding their urine too long? I hear this all the time, kiddos don't like to void at school. They don't like to use the bathrooms there. So ta- having a discussion with your child saying, you know, it's not okay to go eight hours without peeing. You have to, you know, do it. You, you have to go at least every three hours, especially if you're at home and, and playing, you have to come in and, and pee.

And even kiddos who may have a subtle abnormality anatomically, as long as they follow good bladder habits, they may be able to avoid urinary tract infections. And, and that's our goal is really to get kids UTI free with the least invasive options.

Dr. Lynn Woo, MD:

When should families consider seeking out a pediatric urologist? What are the main warning signs that a family should look for to guide them on, you know, additional consultation or referral to a specialist like yourself?

Dr. John Weaver, MD:

Well, luckily, the American Academy of Pediatrics has pretty strict guidelines for pediatricians in terms of, you know, when a patient comes in with UTIs or, or other voiding issues, when they should refer to us. However, I would say, you know, I would not hesitate. We're happy to see patients at any time. If there's any, uh, ever any concerns, you know, if you've seen the pediatrician, you still have questions. We are happy to see your child for consultation, talk with your child, talk with the family, maybe just put you at ease and then if the child's doing great, maybe, you know, send them back to the pediatrician, but know we're available at any time. So we're always available. However, there are certain things, you know, fever, you know, a UTI with a fever and then an ultrasound shows an abnormality. That patient should absolutely be seeing us.

Prenatal ultrasounds that shows some dilation of the kidneys. Generally, we need to be consulted early on so that we can kind of risk classify the patients and then ultimately, you know, determine whether or not the patient can be discharged back to their pediatrician or needs to continue to follow with us because prenatal hydronephrosis is the most common abnormality seen on prenatal ultrasound. So that's a huge part of our practice is just working up children after birth and, and kind of determining their risk.

There's cases in which the UTI diagnosis isn't completely clear and sometimes there can be symptoms that mimic a UTI but aren't actually a UTI. For example, if a child has odd smelling urine but their urine culture is, is showing no growth or not actually growing bacteria, that may be secondary to something other than a UTI. If they're having new onset accidents, that while that is a possibility a UTI, you know, that could be something else. You know, they may be holding their urine longer or just changing their bladder habits or, you know, something going on psychologically that has changed their voiding habits.

But that doesn't necessarily always point to a UTI and, and we just absolutely, as I mentioned earlier, we need to be good antibiotic stewards and, and ensure that when we are treating with antibiotics, it is a true UTI and, and we aren't simply treating symptoms, we're treating a true infection, which is, you know, a really big part of our job. Other things, you know, bedwetting sometimes, you know, if bedwetting gets worse, you know, the concern is, you know, is it a UTI, which sometimes it absolutely could be, but, you know, we really have to do the full workup before starting antibiotics for those patients.

Dr. Lynn Woo, MD:

Dr. Weaver, how would you advise families that purchase test strips from the drugstore and want to test their child's urine or call because they're concerned that the test, test strips are coming up with abnormal results? Is that enough to diagnose a UTI?

Dr. John Weaver, MD:

I think that's a great starting point in terms of if in families being vigilant and, and working up a UTI and if they're concerned, you know, starting with that. But ultimately, you know, that's not the end all be all in terms of whether or not there's a UTI present. Sometimes those tests can be inaccurate and the best thing is for the patient to then, you know, use that information to either contact our office or pediatricians, get a true urine sample from the office so that we can then send that off for a urine culture to determine whether a true infection is present.

Dr. Lynn Woo, MD:

Got it. What about supplements or other vitamins or things parents can give to help with UTIs? Is there really anything scientifically proven that's not an antibiotic that can lower someone's risk of getting a urinary tract infection?

Dr. John Weaver, MD:

Yeah. For example, cranberry extracts, this isn't, you know, cranberry juice or, you know, the, the juice that you would, you know, drink that's, you know, very, you know, high in sugar. We're talking about cranberry extracts here is something that has been tested thoroughly in the urology community and we actually have guidelines referring to it and studies have been kind of inconsistent in terms of the benefits of cranberry extract on decreasing urinary tract infections. However, there doesn't appear to be any harm to taking cranberry extract. So the general party line in terms of urologists in cranberry extract is, you know, it is fine to do it. If you see benefit, that's fantastic, but the data doesn't really show right now that there would be a major benefit.

Dr. Lynn Woo, MD:

So I'm hearing the jury's kind of out on cranberry extract. It probably doesn't help but probably won't hurt. I think one of the take homes that I've heard from you though is really focusing on those other good habits about drinking plenty of water, making sure you use the restroom regularly to empty out that bladder and avoiding constipation or backups in the system with either pee or poop.

Dr. John Weaver, MD:

Yeah, those are proven and, um, those are generally where we start and, and we can see a significant improvement in patients if they're following those recommendations.

Dr. Lynn Woo, MD:

Thank you so much. Before we wrap up, we wanna leave parents with a few takeaways. UTIs are common in kids and in most cases really treatable and many kids may have a single infection and then never go on to have another one. But it sounds like from what Dr. Weaver's explained to us today, if a child's having recurrent infections or ongoing urinary symptoms or signs of serious illness like high fevers that come with their UTIs, it's probably important for us to dig a little deeper and identifying contributing factors early can help prevent future problems and we wanna work closely with our pediatrician colleagues and with parents and caregivers to understand exactly the why behind the UTIs and help find long-term solutions, hopefully focusing on, like you said, non-invasive treatments, non-surgical options, although certainly some kids may ultimately have issues that require surgical correction. So Dr. Weaver, thank you so much for helping us break down this topic in a clear and reassuring way.

To our listeners, if you're concerned about UTIs, please talk to your child's pediatrician. If you're ever told a referral to a pediatric urologist might help, know it's about getting some extra support, evaluation, and expertise for your child. So I'm Lynn Woo. This has been Little Health Podcast. If you would like an appointment with Dr. Weaver or another member of our pediatric urology team, please call 216.444.5600. That's 216.444.5600.

Dr. John Weaver, MD:

Thank you.

Dr. Richard So, MD:

Thanks for listening to Little Health. We hope you enjoyed this episode. To keep the Little Health Tips coming, subscribe wherever you get your podcasts or visit clevelandclinicchildrens.org/littlehealth.