UTI in children: Signs, causes and prevention tips every parent must know

UTI (Urinary tract infection) is and infection of the urinary tract, usually caused by bacteria.
Urinary tract consists of 3 parts –
Ureters – They carry urine from kidneys to the bladder
Bladder – It stores the urine
Urethra – It carries urine from bladder out of the body
Any part of the Urinary tract can be infected by bacteria. It is more common in children but several lifestyle factors can make a child more prone in developing a UTI.

(Dr. Anjan Kumar T M, Consultant Neonatologist & Paediatrics, Apollo Hospitals, Sheshadripuram, Bangalore)

Fever
Abdominal pain
Dysuria (Pain on passing urine) – Children may pass foul smelling urine which may look cloudy or may have blood
Increased frequency of urination
Urgency (unable to hold on to urine)
Vomiting or abnormal urinary incontinence
A baby with UTI may have symptoms like fever, vomiting and irritability.
Older kids may have fever, pain while peeing, need to pee a lot, or also have lower belly pain.
If the infection travels up the kidneys, it is called pyelonephritis and is a more serious condition. It causes the same symptoms, but the child may look sicker and may have fever with chills, pain in the back or side, severe tiredness, or vomiting.
Other risk factors –
Problem in urinary tract – A malformed kidney or a blockage somewhere in the urinary tract
Vesico ureteric reflux - Abnormal backward flow of urine from the bladder up the ureters and towards the kidneys. (Many kids with UTIs have been found to have it)
Poor toilet and hygiene habits
Family history of UTIs

Urine sample must be obtained when a child is suspected to have UTI, before starting antibiotics. It should be collected in a sterile container and should ideally be a mid-stream urine sample. Culture should always be sent to confirm the diagnosis.

Antibiotics are the mainstay of treatment of UTIs.
After the antibiotic course, urine test may be repeated to be sure that the infection is eradicated. This is important because an incompletely treated UTI can come back of spread.

If UTI is not treated promptly, it can spread to the urinary tract and can lead to kidney damage and can spread into the blood stream and cause sepsis.

Yes, following few daily habits can help in reducing the risk of developing UTI.
Hydration – keeping children well hydrated with 6-8 cups of fluids per day.
Under 5 years – 120 – 150 ml cup
6 years and over – 250-300 ml cups
Pass urine every 2-3 hours during the day. Make a plan and encourage your child to pass urine regularly during the day, both at home and at school.
Prevent constipation – by encouraging regular bowel habits. This can be done by encouraging the child to drink plenty of fluids and by eating a diet rich in fibre, and plenty of exercise. If not, there can be build-up of stool in the large bowel leading to straining and raised pressure, thus blocking urine flow leading to trapping of bacteria and increasing risk of UTI.
Wipe from front to back after passing stools. Girls are more prone to develop UTI due to the proximity of urethra and following the wiping from front to back can prevent the spread of bacteria from stool.
Double voiding of urine – This is passing of urine as normal and counting to 10 and trying to pass urine again. This prevents the residual urine in bladder, which may lead to infection.
Avoid bubble baths and soaps – These can cause irritation to the skin on and around the genitalia. On the other hand, it is important to take showers and regular baths, but avoid adding additives to the water.

You should call your doctor right away if your child has an unexplained fever with chills, and also if there is pain while passing urine or any back pain.
Also if your child is having bad smelling, bloody or discoloured urine or pain below the belly button, and a fever more than 100.4 F (38 C).
Call the doctor if your infant has a fever, feeds poorly, vomits repeatedly, or seems unusually irritable.