does my child have a UTI?

We know talking about UTI’s may seem like an awkward topic to discuss, but they are a common infection for kids.  In fact, nearly 3% of

children develop a UTI each year. That’s why we sat down with Christopher Brown, MD, pediatric urologist at Dayton Children's for a Q&A on the topic.

What is a UTI?

Urinary tract infections, more commonly referred to as UTIs, are common infections during childhood, and may involve any part of the urinary tract from the kidneys to the urethra.  This occurs when bacteria enters the urinary tract and starts to flourish.  UTIs typically show up as a simple bladder infection, but they can progress to severe infections that require hospitalization and potentially may lead to kidney damage.  In the first year of life, boys are more likely to develop a UTI, whereas through the rest of childhood, UTIs are more frequently seen in girls.

What are common symptoms of UTI?

In infants and other children that are not able to express themselves, the most common presentation of a UTI is a fever without an identifiable cause. 

As children get older, they may have the following symptoms:

• pain or burning with urination
• blood in the urine
• increased urinary frequency or urgency
• lethargy, poor appetite
• new daytime or nighttime urinary accidents

How is a UTI diagnosed?

To diagnose a UTI, a sample of urine is required.  The sample  is sent to the laboratory to determine if an infection is present by checking a urinalysis and urine culture.  In toilet-trained children, this is obtained getting a clean-catch urine specimen.  In children not yet toilet trained, the specimen will typically be obtained by either placing a plastic bag over the urethra and catching the urine when they urinate or placing a catheter through the urethra into their bladder.  While it is more invasive, placing a catheter will allow more accurate test results as compared to a bagged specimen.  Typically, the final test results are available within two days.

How to prevent a UTI?

It is very important to keep children well hydrated and teach them good hygiene habits.  If they hold their urine or stool for extended periods of time, this could create an environment in which bacteria can flourish.  Children should be encouraged to urinate every few hours, and have a daily, soft bowel movement.  It’s very important to avoid constipation in order to prevent UTIs.

How are UTIs treated?

Once a UTI is confirmed, it must be treated with a course of antibiotics. For less severe infections, they are treated with up to one week of oral antibiotics.  If the infection reaches the kidney or spreads through the body, children will need a longer course of antibiotics, and may require IV antibiotics or hospitalization.  At times, it may be necessary to take a look at the kidneys and bladder.  A kidney and bladder ultrasound is commonly used, and depending on the results or severity of the infection, additional or more invasive imaging tests may be needed.

When should a child see a specialist?

In some cases, kids may benefit from seeing a specialist for UTIs. These situations include but are not limited to the following:

• When children are not responsive to initial antibiotic therapy
• Children with recurrent or severe UTIs
• If there are any abnormalities on imaging of the kidneys and bladder
• Children with congenital urinary tract anomalies
• Any infant that develops a febrile UTI
• Children with symptoms of UTIs (such as urgency, frequency or urinary accidents) without evidence of a UTI