Symptoms of a urinary tract infection in toddlers

Urinary tract infection (UTI) in children

Urinary tract infections (UTIs) in children are fairly common, but not usually serious. They can be effectively treated with antibiotics.

A UTI may be classed as either:

an upper UTI – if it's a kidney infection or an infection of the ureters, the tubes connecting the kidneys to the bladder
a lower UTI – if it's a bladder infection (cystitis) or an infection of the urethra, the tube that carries urine from the bladder out of the body

When to seek medical advice

If you think your child is unwell and could have a UTI, contact your GP as soon as possible.

Although UTIs aren't normally a serious type of infection, they should be diagnosed and treated quickly to reduce the risk of complications.

Symptoms of a UTI in children

It can be difficult to tell whether your child has a UTI, as the symptoms can be vague and young children can't easily communicate how they feel.

General signs that may suggest your child is unwell include:

a high temperature (fever)
vomiting
tiredness and lack of energy (lethargy)
irritability
poor feeding
not gaining weight properly
in very young children, yellowing of the skin and whites of the eyes (jaundice)

More specific signs that your child may have a UTI include:

pain or a burning sensation when peeing
needing to pee frequently
deliberately holding in their pee
a change in their normal toilet habits, such as wetting themselves or wetting the bed
pain in their tummy (abdomen), side or lower back
unpleasant-smelling pee
blood in their pee
cloudy pee

Diagnosing UTIs in children

In most cases, your GP can diagnose a UTI by asking about your child's symptoms, examining them, and arranging for a sample of their pee to be tested.

Treatment usually begins soon after a urine sample has been taken, and your child won't need any further tests.

In a few circumstances, further tests may be needed in hospital to check for abnormalities. Your GP may refer you straight to hospital if your child is very young.

Read more about diagnosing UTIs in children

Causes of UTIs in children

Most UTIs in children are caused by bacteria from the digestive system entering the urethra.

There are many ways this can happen, including:

when a child wipes their bottom and soiled toilet paper comes into contact with their genitals – this is more of a problem for girls than boys because girls' bottoms are much nearer the urethra
babies getting small particles of poo in their urethra when they soil their nappies – particularly if they squirm a lot when being changed

There's often no obvious reason why some children develop UTIs and others don't.

However, some children may be more vulnerable to UTIs because of a problem with emptying their bladder, such as:

constipation – this can sometimes cause part of the large intestine to swell, which can put pressure on the bladder and prevent it emptying normally
dysfunctional elimination syndrome – a relatively common childhood condition where a child "holds on" to their pee, even though they have the urge to pee
vesicoureteral reflux – an uncommon condition where urine leaks back up from the bladder into the ureters and kidneys; this occurs as a result of a problem with the valves in the ureters where they enter the bladder

Treating UTIs in children

Most childhood UTIs clear up within 24 to 48 hours of treatment with antibiotics and won't cause any long-term problems.

In many cases, treatment involves your child taking a course of antibiotic tablets at home.

As a precaution, babies under three months old and children with more severe symptoms are usually admitted to hospital for a few days to receive antibiotics directly into a vein (intravenous antibiotics).

Read more about treating UTIs in children

Preventing UTIs in children

It isn't possible to prevent all childhood UTIs, but there are some things you can do to reduce the risk of your child getting one.

The following advice may help:

if possible, exclusively breastfeed your baby for the first six months after they're born – this can help improve your baby's immune system and reduce their risk of constipation
encourage girls to wipe their bottom from front to back – this helps to minimise the chances of bacteria entering the urethra
make sure your child is well hydrated and goes to the toilet regularly – not urinating regularly and "holding in" urine can make it easier for bacteria to infect the urinary tract
avoid nylon and other types of synthetic underwear – these can help promote the growth of bacteria; loose-fitting cotton underwear should be worn instead
avoid using scented soaps or bubble baths – these can increase your child's risk of developing a UTI
take steps to reduce your child's risk of constipation – make sure they drink enough to keep their urine pale and clear during the day, and speak to your GP about medications that can help if constipation is a persistent problem

Some people feel that drinking cranberry juice or taking cranberry supplements can help reduce their risk of UTIs.

However, recent high-quality research into these claims found little evidence to suggest cranberries have a significant impact on your chances of developing a UTI.

Recurrent UTIs in children

A small number of children have recurring UTIs. If your child's had a UTI before, it's important that both of you watch for the return of any associated symptoms.

Tell your GP about any symptoms as soon as possible so a diagnosis can be confirmed and treatment can begin.

If your child has a problem that increases their risk of UTIs, such as faulty valves that allow urine to flow the wrong way, they may be prescribed low-dose antibiotics as a long-term measure to prevent further infections.

Urinary Tract Infections (UTI) in Children

What is a urinary tract infection (UTI) in children?

A urinary tract infection is inflammation of part of the system that takes urine out of the body. It’s caused by bacteria. The urinary tract includes the two kidneys. They remove liquid waste from the blood in the form of urine. Narrow tubes (ureters) carry urine from the kidneys to the bladder. Urine is stored in the bladder. When the bladder is emptied, the urine travels through a tube called the urethra and passes out of the body. Bacteria can infect any part of this system.

What causes a UTI in a child?

Normal urine contains water, salts, and waste products. It is free of germs such as bacteria, viruses, and fungi. An infection happens when germs enter the urethra, travel up to the bladder, ureters, and kidneys, and begin to grow. Most infections are caused by bacteria from the digestive tract. The most common is Escherichia coli (E. coli) bacteria. These normally live in the colon.

Which children are at risk for a UTI?

A UTI is not common in children younger than age 5. A UTI is much more common in girls. This is because they have a shorter urethra. A UTI is unlikely in boys of any age. But it can occur in boys if part of the urinary tract is blocked. Uncircumcised boys are more at risk for a UTI than circumcised boys. A child with a part or full blockage in the urinary tract is more likely to develop a UTI.

What are the symptoms of a UTI in a child?

Symptoms can occur a bit differently in each child.

Symptoms in babies can include:

Fever
Bad-smelling urine
Irritability
Crying
Fussiness
Vomiting
Poor feeding
Diarrhea

Symptoms in children can include:

Sudden need to urinate
Need to urinate often
Loss of control of urine (incontinence)
Pain while urinating
Trouble urinating
Pain above the pubic bone
Blood in the urine
Bad-smelling urine
Nausea and vomiting
Fever
Chills
Pain in the back or side below the ribs
Tiredness

The symptoms of a UTI can seem like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is a UTI diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. The provider will give your child a physical exam. Your child may also have tests, such as:

Urine testing. This is also known as urinalysis. Your child’s urine is sent to a lab to check for red blood cells, white blood cells, bacteria, protein, and signs of infection. The urine will also be sent for a culture and sensitivity. This is done to figure out what type of bacteria is causing the infection and what medicine is best to treat the infection.
Kidney ultrasound. This is a painless imaging test. It uses sound waves and a computer to make images of blood vessels, tissues, and organs. It can show internal organs as they function and can assess blood flow through vessels. A boy with a UTI or a girl younger than age 5 or 6 may need this test.
Voiding cystourethrogram (VCUG). This is a type of X-ray of the urinary tract. A thin, flexible tube (catheter) is put in the tube that drains urine from the bladder to the outside of the body (the urethra). The bladder is filled with a liquid dye. X-ray images are taken as the bladder fills and empties. The images will show if there is any reverse flow of urine into the ureters and kidneys.

How is a UTI treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Treatment may include:

Antibiotic medicine
A heating pad or medicines to relieve pain
Drinking plenty of water

Your child's healthcare provider may want to see your child back again a few days after treatment starts to see how treatment is working.

Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments.

How can I help prevent a UTI in my child?

You can help prevent UTIs in your child if you:

Make sure your child drinks plenty of fluids
Tell your child to empty his or her bladder fully when urinating
Teach girls to wipe from the front to back after going to the bathroom
Make your child doesn’t get constipated

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

Symptoms that don’t get better, or get worse
New symptoms

Key points about a UTI in children

A urinary tract infection is inflammation of part of the system that takes urine out of the body.
Most infections are caused by bacteria from the digestive tract. The most common is Escherichia coli (E. coli) bacteria. These normally live in the colon.
A UTI is not common in children younger than age 5. A UTI is much more common in girls because they have a shorter urethra.
A UTI is unlikely in boys of any age, unless part of the urinary tract is blocked. Uncircumcised boys are more at risk for a UTI than circumcised boys.
Symptoms vary by age, and can include fever, need to urinate often, pain, and crying.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

Know the reason for the visit and what you want to happen.
Before your visit, write down questions you want answered.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
Ask if your child’s condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if your child does not take the medicine or have the test or procedure.
If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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