Urinary tract infection

Causes

Urinary tract infections (UTIs) are caused by bacteria 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 urine collects, as these can encourage bacteria growth.

Symptoms

Older children usually complain of classic symptoms, such as pain or stinging when passing urine, or a frequent urge to run to the toilet. Sometimes your child might pass small amounts of urine frequently, and have trouble starting urination. These symptoms can be accompanied by fever and abdominal pain, and there might be blood in the urine.

The younger your child, the less specific the symptoms. Your child might have an unexplained fever, irritability and bouts of crying, go off his feeds or vomit.

When to see your doctor

You should see the doctor if:

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

Tests

A UTI can’t be diagnosed on symptoms alone – a urine test is always necessary, and should be performed before your child starts taking antibiotics. Once a course of antibiotics has started it’s impossible to identify the bacteria in the urine, making treatment more difficult.

If your doctor suspects the cause of your child’s UTI is an underlying abnormality of the kidneys or urinary tract, such as vesico-ureteric reflux, your child will be referred for further investigations, such as a renal ultrasound.

Your child might also be referred to a paediatric renal specialist.

Most children who have a urinary tract infection need an ultrasound to make sure there’s no underlying abnormality.

Treatment

A short course of antibiotics, given by mouth, is usually effective in treating most UTIs. Your doctor will check your child’s urine again after treatment to make sure the infection has cleared up.

If any tests reveal an underlying abnormality, your doctor will explain this to you and advise you about treatment options.

Prevention

If your child has a structural abnormality, your specialist might recommend long-term antibiotic therapy.

Doing the following can help avoid urinary tract infections:

• Teach your daughter to wipe from front to back after urinating or opening her bowels, so she doesn’t spread bacteria forward from her anus.
• Make sure your child always drinks plenty of fluids, particularly water.
• Dress your child in cotton underwear, as it lets air flow better – this helps keep the area cool, making it harder for germs to multiply.
• Encourage your child to use the bathroom frequently, emptying his bladder every three or four hours and before bedtime.

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