Urinary tract infections 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.