A urinary tract infection (UTI) happens when bacteria (germs) gets into the urinary tract. The most common place for a UTI to occur is in the bladder, but infections also occur in the urethra, ureters or kidneys. UTIs are easily treated but can cause problems if left alone.

What is the urinary tract and how do infections occur?

The urinary tract is the body’s drainage system for getting rid of urine (liquid waste). It includes the two kidneys, bladder (the organ where urine is stored), and two ureters and one urethra (tubes).

The blood in the body passes through the kidneys. The kidneys filter the liquid waste products (urine) out of the blood. This urine passes through the ureters and into the bladder. The urine leaves the bladder through the urethra, and passes out of the body through the opening (meatus).

Most UTIs in children occur because bacteria that are normally found in the bowel cause an infection in the urinary tract.

What causes UTIs?

These factors can increase your child’s chance of getting a UTI:

• Poor bathroom habits, such as not changing out of wet underwear or not wiping properly
• “Holding it,” instead of urinating frequently (in toilet trained kids)
• Frequent constipation or diarrhea
• Having some kind of blockage in the urinary tract that limits or stops urine flow
• Irritation in the “perineal” area (where urine comes out of the body). This can be caused by things such as bubble bath, bath soap or tight clothing.
• A condition called vesicoureteral reflux (VUR), in which urine flows backward from the bladder and toward the kidneys

Learn about how to prevent a UTI.

Are UTIs common in children?

UTIs are the second most common type of infection in children (ear infections are the most common). They are more common in girls, although uncircumcised boys are at slightly higher risk than other male babies or older boys.

What are the signs and symptoms of a UTI?

There are two different kinds of UTIs. The most common is called cystitis. It occurs when the infection is in the urethra or bladder. A child who has cystitis may:

• Have a fever (this may be the only symptom in babies)
• Be fussy (common in babies)
• Vomit (common in babies or older children)
• Feel the need to use the bathroom often, yet only pass a very small amount of urine (more common in older children)
• Wet themselves, even after being successfully potty trained
• Have pain or burning with urination (more common in older children)
• Have lower belly or back pain
• Have blood in the urine

The less common type of UTI is called pyelonephritis, which is an infection that occurs in the kidneys. Pyelonephritis can sometimes be treated at home, but in some cases it can become serious and even life threatening. A child who has pyelonephritis may have:

• A fever greater than 101 degrees
• Flu-like symptoms such as shaking, chills, nausea, vomiting or achiness
• Pain in the belly, back, side or groin
• Pain or a burning feeling when urinating
• Urine that is cloudy, red, foul smelling or changes to a dark cola color
• Pus or blood in the urine
• Urgent or frequent urination

If your child experiences symptoms of cystitis or pyelonephritis, call your pediatrician.

How is a child diagnosed with a UTI?

If the pediatrician thinks your child may have a UTI, they will:

• Ask about your child’s symptoms and health history
• Do a physical exam
• Run tests, including a urinalysis (a simple study of a urine sample) and/or urine culture (which detects specific bacteria in urine)

How do you treat UTIs?

The most common treatment for a UTI is antibiotics, which kill the germs that are causing the infection. The pediatrician also may recommend that your child take pain relief medicine as needed, and drink plenty of fluids.

UTIs can cause irritation and raw skin on your child’s private parts. If these symptoms do not improve after exposing the skin to air and creating a moisture barrier with petroleum jelly or, zinc oxide or lanolin, let your pediatrician know.

If my child is being treated for a UTI, what can I do to help?

• Give your child all the medicine the doctor prescribed for the infection. Do not stop the medicine, even if your child is feeling and acting better.
• Give your child lots of fluids to drink so they continue to urinate regularly, every two to three hours for toilet trained children.
• Tell your doctor if your child’s fever, pain or other symptoms continue after taking the medicine for two days.
• If your child is in pain or has a fever, give medicine only as directed by the doctor. Do not give aspirin to children.
• Keep all follow-up appointments.
• Do not allow your child to sit in bathwater that contains bubble bath, shampoo or soap, as this can cause irritation. If your child takes a bath, have them sit in clear water until you’re ready to use these products. Once you are finished, rinse your child off and remove the products from the tub.

What if my child gets frequent UTIs?

Some children get UTIs more often than others. Be sure to tell your pediatrician if symptoms happen again after treatment, or if your child has three or more UTIs in a six-month period.

The pediatrician may recommend taking your child to a pediatric urology practice for an evaluation. Physicians and nurse practitioners at this type of practice specialize in treating children who have problems with their urinary system. These specialists may run additional tests to learn about the cause, and recommend a new treatment plan.

These additional tests may include:

• An ultrasound to view the kidneys, bladder and the tubes connecting them
• A voiding cystourethrogram (sis-toe-u-reeth-ro-gram), or VCUG. This X-ray shows how the bladder is working while the person is urinating.