Urinary tract infections are common in children, especially girls. But most UTIs can be prevented through healthy habits.

Healthy Bathroom Habits

Some children do not take time to empty their bladders completely, or they hold urine in their bladders for long periods of time. These behaviors can lead to a UTI, because when urine stays in the body for too long, bacteria can grow. Another problem is that to avoid leaking urine, children may squat and dig their heel into their private parts. This can push “bad bacteria” up into the rest of the urinary tract, possibly leading to infection.

Healthy bathroom habits include:

• Not “holding it” − children should urinate every two to three hours while awake
• Relaxing when urinating − straining is not necessary
• Not rushing through urination
• For girls, wiping from front to back after urinating

Healthy Bowel Movements

Constipation and diarrhea can lead to UTIs.

Constipation often makes it hard for children to empty their bladder all the way, because stool in the colon can block the normal flow of urine. When urine stays in the body for too long, “bad bacteria” can get trapped and have time to grow, which leads to a UTI. You can help promote healthy bowel movements by making sure your child:

• Eats a nutritious, fiber-rich diet. To estimate how many grams of fiber your child should eat daily, take your child’s age and add five.
• Drinks plenty of fluids during the day
• Goes to the bathroom around the same times every day
• Is relaxed when using the bathroom

If your child is constipated, consider placing two stepstools in front of the toilet and having them place one foot on each stool. This can help support the pelvic floor and encourage a bowel movement. Your child’s doctor may recommend stool softeners or laxatives to help ease constipation.

When a child has diarrhea, the risk of getting a UTI can go up, since having diarrhea can make it hard to keep the rectal area nice and clean. This is especially true for girls, since their rectum is only a few inches from the urethra, where urine comes out. Bacteria from the loose stool can travel up the urethra to the bladder and cause infection. If your child has diarrhea, encourage them to eat frequent, small meals of easily digestible foods, such as rice cereal, pasta, breads, cooked beans, mashed potatoes, cooked carrots, applesauce and bananas.

Healthy Diet

Probiotics, or “friendly” bacteria and yeasts, can help promote a healthy urinary tract. Probiotics can include yogurt that contains active cultures, and over-the-counter preparations that contain a bacteria called Lactobacillus acidophilus. Probiotics are available in food or pill form.

Most children do not need medicine to prevent bowel problems or urinary tract infections. Some people believe that drinking cranberry juice can help prevent UTIs, but research does not confirm this.

Avoiding Irritants

Certain products can irritate your child’s bottom. They won’t cause a UTI, but they can add to your child’s discomfort if a UTI occurs.

To minimize irritation:

• Have your child take showers or clear water baths. Avoid bubble baths and oils. Don’t let your child sit in a tub that has residue from shampoo or bath soap.
• Expose your child’s bottom to air when possible.
• Have your child wear cotton underwear and pajama bottoms. Synthetic materials (such as spandex) hold moisture, which can let bacteria grow.
• For children in diapers or pull-ups, create a moisture barrier using petroleum jelly, zinc oxide or lanolin (A&D, Vaseline, Desitin, Balmex).

Keep in mind that if your child’s bottom becomes irritated after swimming or using a hot tub, the chemicals in the water may be the cause.

Minimizing Antibiotic Use

Antibiotics are necessary and can save lives. But in addition to killing harmful bacteria, they kill “friendly” bacteria that protect children from illness, including UTIs. If your child’s doctor (or a provider at an urgent care center) prescribes an antibiotic, be sure to have a conversation about whether it is truly necessary.

Many childhood illnesses are not treatable with antibiotics. These include colds and some ear infections and sore throats. Unless there is a clear benefit in taking an antibiotic, consider “waiting and watching” to see if the condition improves on its own.

Breastfeeding

Breastfeeding until a child is at least 7 months old may help prevent UTIs. Even after you stop breastfeeding, your baby may continue to be protected until the age of 2.

When to Call Your Child's Pediatrician

The following symptoms could be signs that your child has a UTI. Call your child’s pediatrician if:

• Urine becomes red, cloudy, foul-smelling or changes to a dark cola color
• Is difficult or painful for your child to urinate
• There is a strong urge to urinate, yet the bladder is not full
• There is pain in the lower back just below the ribs, or your child has a fever over 101°F
• Your child begins having urine accidents, or has to urinate more often than before
• Your baby is 3 months old or younger with a rectal temperature of 100.4⁰ F or more

Also, call your pediatrician if an irritated, raw bottom does not get better after exposing it to air and creating a moisture barrier with petroleum jelly, zinc oxide or lanolin.

If your child has three or more UTIs in a six-month period, your pediatrician may recommend taking her 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.