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When Your Child Has a Urinary Tract Infection (UTI)

 A urinary tract infection (UTI) is a bacterial infection in the urinary tract. The urinary tract is made up of the kidneys, ureters, bladder, and urethra. Children often get UTIs that affect the bladder. This s called cystitis. They also can get UTIs that affect the kidneys. When the kidneys are affected it's called pyelonephritis. UTIs can be uncomfortable and painful. But with treatment, most children recover with no lasting effects.

What is the urinary tract?

The following body parts make up the urinary tract:

  • Kidneys filter waste from the blood and make urine.

  • Ureters carry urine from the kidneys to the bladder.

  • The bladder stores urine.

  • The urethra carries urine from the bladder to the outside of the body.

    Outline of girl's lower body showing kidneys, ureters, bladder, and urethra. Closeup of outline of boy's lower body showing bladder, urethra, and penis.

What causes a UTI?

Most UTIs are caused by bacteria that enter the urinary tract through the urethra. The urinary tracts of boys and girls are slightly different. The urethra is shorter in girls. This makes it easier for bacteria to enter. As a result, girls are more likely than boys to get UTIs. Other causes of UTI include:

  • Incomplete emptying of the bladder

  • Genitourinary reflux

  • Birth defects of the genitourinary system

  • Poor hygiene

  • Constipation

  • Tight foreskin on the penis

Sometimes the cause of a UTI is unknown.

What are the symptoms of a UTI?

  • If your child has a UTI affecting the bladder (cystitis), symptoms can include:

    • Pain when peeing

    • Frequent peeing

    • Urgent need to pee

    • Blood in the urine

    • Daytime wetting or nighttime bedwetting when this wasn't a problem before

  • If your child has a UTI affecting the kidneys (pyelonephritis), symptoms are a lot like those of a bladder infection. They can also include:

    • Fever

    • Belly (abdominal) pain

    • Upset stomach (nausea) and vomiting

    • Cloudy urine

    • Strong-smelling urine

How is a UTI diagnosed?

  • The healthcare provider asks about your child’s symptoms and health history. Your child is examined.

  • A lab test, such as a urinalysis, is done. For this test, a urine sample is needed. It is checked for bacteria and other signs of infection. The urine is also sent for a culture. This is a test that identifies what bacteria is growing in the urine. It can take 1 to 3 days to get results of a urine culture. If the provider thinks your child has a UTI, the provider will likely start treatment even before the results of the urine culture come back.

  • If your child has severe symptoms, other tests may be done. You’ll be told more about this, if needed.

How is a UTI treated?

  • Symptoms of a UTI generally go away within 24 to 72 hours of starting treatment.

  • The healthcare provider will prescribe antibiotics for your child. Make sure your child takes  all of the medicine, even if they start feeling better. 

  • You can do these things at home to ease your child’s symptoms:

    • Give your child over-the-counter (OTC) medicines, such as ibuprofen or acetaminophen, to manage pain and fever. Don't give ibuprofen to a baby who is younger than 6 months old, or to a child who is dehydrated or constantly vomiting. Don’t give aspirin (or medicine that contains aspirin) to a child younger than age 19 unless directed by your child’s provider. Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious disorder. It most often affects the brain and the liver.

    • Ask your provider about other medicines that can be prescribed to ease pain when peeing.

    • Give your child plenty of fluids to drink. Cranberry juice may help ease some pain symptoms.

  • If a urine culture was done, make sure to get the results from the healthcare provider. Make an appointment to follow up about 1 week after your child has finished antibiotics.

When to call the healthcare provider

Call the healthcare provider if your child has any of these:

  • Symptoms that don't get better within  48 hours of starting treatment

  • Fever (see "Fever and children" below)

  • A fever that goes away but returns after starting treatment

  • Increased belly or back pain

  • Signs of dehydration, such as very dark or little urine, excessive thirst, dry mouth, or dizziness

  • Vomiting or inability to tolerate prescribed antibiotics

  • Child starts acting sicker

How is a UTI prevented?

  • Encourage your child to drink plenty of fluids.

  • Encourage your child to empty the bladder all the way when peeing.

  • Teach girls to wipe from front to back when using the bathroom.

  • Don't use bubble bath.

  • Don't allow your child to become constipated.

  • If your child has a UTI, they may need ultrasound imaging of the kidneys and bladder. This helps the healthcare provider rule out possible anatomical problems that could cause a UTI. If problems are found, or if your child has repeated UTIs, more imaging tests may be helpful.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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