Urinary tract infection

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When to see the doctor

Go to the doctor if: 

• your child complains of any of the symptoms described below
• the urine is pink, red or brown in colour
• your child has a high, unexplained fever or is generally unwell.

What causes it?

Urinary tract infections (UTI) are caused by germs which infect the urethra (the urinary opening) and sometimes the bladder. Infections are more common where there are abnormalities of the kidneys or urinary tract where the urine collects, thereby encouraging the growth of germs.

What are the symptoms?

Older children usually complain of classic symptoms such as pain or stinging on passing urine, or a frequent urge to run to the toilet. Sometimes they pass small amounts of urine often and have difficulty in getting started. These symptoms can be accompanied by fever, abdominal pain and blood may be present in the urine.

The younger the child the less specific the symptoms; they may have an unexplained fever, irritability and bouts of crying, go off their feeds and even vomit.

Is there a test?

It is impossible to diagnose a UTI on symptoms alone. It is always necessary to back up any suspicions with a urine test, performed before the child has started taking antibiotics prescribed by the doctor. Once a course of antibiotics has commenced, it is impossible to identify the germ in the urine, and this makes treatment more difficult.

If there is a chance that the cause of your child’s UTI is an underlying structural abnormality of the kidneys or urinary tract, such as vesico-ureteric reflux, then further investigations such as a micturating cystourethrogram or a renal ultrasound may be recommended by your doctor and your child may be referred to a paediatric specialist. Most children who have a urinary tract infection need to have these tests to make sure there is no underlying abnormality.

How is it treated?

A short course of antibiotics, given by mouth, is usually effective in treating most UTIs. The urine should be checked again after treatment to make sure the infection has cleared up completely. If tests reveal an underlying abnormality, it may need to be treated – your doctor will explain this to you.

How can I prevent it?

Teach your daughter to wipe from front to back after urinating or opening her bowels, so that germs are not spread forward from the anus. Make sure your child always drinks plenty of fluids. Buy cotton underwear for your child, as it allows a better air flow which helps to keep the area cool, making it difficult for germs to multiply. Encourage frequent emptying of the bladder every three or four hours and before bedtime.

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