Urine infection in kids and how to treat it

"I think [my daughter] (aged 4) has a urine infection. She's constantly needing to pee but says when she goes not much comes out but she still feels like she needs to go.

"She doesn't have a temperature or feel unwell, isn't in pain.

"Do you think it's OK to leave it 'til Monday to see a doc or should I be going to out of hours?"

UTIs are actually quite common in children and, while they can be really uncomfortable, and painful, the good news is they tend to clear up with a course of antibiotics.

Doctors split them into 2 types:

• lower UTIs - which involve the bladder and urethra (tube carrying urine from the bladder out)
• upper UTIs - which involve either the kidney or ureter (tubes connecting each kidney to the bladder).

We put a few questions to our consultant GP, Dr Philippa Kaye, on the causes, symptoms and treatment of UTI in kids.

What causes urinary tract infection in children?

Your child's urinary system is normally sterile, but sometimes germs that live in the bowel travel up the urethra (the tube through which urine passes from the bladder to the outside).

UTIs, especially in girls, can often be due to wiping from back to front on going to the toilet, ie, wiping from the anus towards the vagina and urethra and therefore pulling bacteria along with the paper as they wipe.

In younger children they can occur because they move around a lot when having their nappies changed.

Even just sitting in a dirty nappy allowing bacteria to transfer to the urethra can cause a UTI.

Little boys are less likely than girls to develop a UTI because their urethras are longer, so germs have further to travel.

UTIs are also more common in children who are constipated, or who have a condition where some of the urine leaks back up from the bladder into the kidneys.

Philippa points out that your mum or grandma who probably told you not to hold onto your urine is right: as infections are also more common in kids who hold on and don't pass urine even though they need to.

What are the symptoms of a urine infection in children?

The symptoms of a UTI can be a bit vague in young children who don't always communicate what's going on, but Philippa advises they might include:

• a fever
• decreased appetite
• they may feel a bit miserable and tired
• they may be going to the toilet to pass urine more frequently than usual
• they may start wetting themselves when they have previously been dry
• they may complain of burning or stinging on passing urine or abdominal pain
• there may be blood in the urine.

Your doctor can test the urine with a dipstick to indicate if there is an infection and may then send it off to the lab to confirm it.

It is then treated with a short course of antibiotics and most children recover without any problems.

"If your baby is under 6 months old, or if your child has multiple urine infections or an unusual bacteria is causing the infection they will be referred for an ultrasound scan to check the kidneys and may be referred to a paediatrician," Philippa adds.

Can you treat UTI in kids at home?

Not usually. If your child has any of the urinary symptoms above — going to the toilet more often, wetting when previously dry, burning or stinging on urinating, abdominal pain or blood in their urine you'll need to see a doctor.

If the symptoms are more non-specific, such as fever, it is reasonable to wait a couple of days to see if a cough or cold appears, but if the fever is prolonged and you don't know why then you should still see your doctor.

How to collect a wee sample if you need one

Tricky as it may be(!), it's important that if you're asked for a wee sample at the doctors (you'll probably need to get a collection pot from them first) you collect it carefully with as little opportunity as possible for it to become contaminated.

With your baby, you'll either place an absorbent pad in her nappy, or your GP or practice nurse will stick an adhesive bag around the baby’s perineum (nappy area) to collect the sample. Make sure your baby's nappy area is as clean as possible before this is done.

With toddlers who are potty trained, you can collect a sample from the potty. The potty needs to be pre-cleaned with detergent and hot water (but not bleach, which can kill the bacteria that are being looked for).

Encourage older children to ‘aim’ into a suitable collecting pot. Again, cleanliness in this area is important.

Also, try to collect urine during the middle of the flow, not the first or last parts of the wee (just like a pregnancy test). Your GP may do an initial test on the sample in the surgery, as this will give him an idea of the likelihood of a UTI.

Is there anything you can do to prevent your child from getting a UTI?

As well as getting them to wee when they need to go, rather than holding it, make sure they are drinking plenty of water, treat any constipation and teach them to wipe from front to back always — for both wees and poos!

Dr Philippa Kaye is a London GP who has written several books on pregnancy and childcare including The First Five Years. Visit her official website and follow her on X @drphilippakaye

Images: Getty Images

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