Urinary Tract Infection In Children

As your bundle of joy arrives, you will be full of happiness and excitement to know what this journey has in store for you. Accompanied by many new experiences, you would want to give your child the best in terms of nutrition, facilities, healthcare, hygiene and lifestyle. Every milestone and interaction with your child is a memorable moment, and every illness a cause of anxiety. With delicate immune systems, children are vulnerable to many health problems, one of which is UTI, a common paediatric infection.

What Is Urinary Tract Infection (UTI)?

A Urinary Tract Infection(UTI) is a bacterial infection which occurs in the urinary tract. Usually a sterile environment, infection occurs in the urinary tract when bacteria travels from the skin surrounding the genitals or rectum through the urine or bloodstream.

An infection in the upper urinary tract consisting of the kidneys and ureters is called upper UTI and an infection in the lower urinary tract consisting of bladder and urethra is called lower UTI. The kidneys produce urine which is transported to the bladder. The ureters transport the urine to the bladder where it is stored until it is expelled out of the body through the urethra. An infection in the bladder is termed as cystitis and in the kidney(s) is termed as pyelonephritis.

Is Urinary Tract Infection In Babies And Children Common?

Childhood UTI is common and more likely to occur in girls than in boys in the first year. Premature babies, newborn infants who have something blocking the urine flow and children with birth defects of the urinary system are more likely to develop UTI. According to doctors, UTI in babies below the age of 2 are more likely to suffer serious damage and therefore UTI should be diagnosed and treated as early as possible. Cystitis and pyelonephritis can also occur in children and cystitis in children is more common than pyelonephritis.

 What Causes Urinary Tract Infection in Children?

Girls are more prone to UTI due to the close proximity of rectum to the urethra. Causes of UTI in children are:

• Stool coming into contact with the urethra, especially in girls when wiping from back to front.
• Stool from the soiled nappy coming into contact with the urethra.
• Bubble-baths pose a threat of UTI as they are an easy medium for bacteria to travel.
• Tight fitting clothes are another cause of a UTI.

Sometimes children are more vulnerable to a UTI due to problems in emptying their bladder. Some of these causes are:

• Constipation can sometimes lead to swelling of a part of the large intestine which can put pressure on the bladder and thus prevent it from emptying.
• Dysfunctional elimination syndrome, is a condition where the child holds on even when there is an urge to clear the bladder. Any bacteria if present, is expelled out of the urinary tract while urinating and not doing so helps bacteria to grow.
• Vesicoureteral reflex (VUR) is a condition present at birth where urine flows back to the ureter and kidneys from the bladder. This is caused due to a defect of the valves present in the ureters where it enters the bladder.

Signs and Symptoms of UTI

Sometimes only characterised by fever, early detection and treatment will ensure your child and you will be distress free. Watch for these symptoms to make sure your child is safe from UTI.

Symptoms in Babies and Young Children

Babies and children who have not learned to communicate may be diagnosed if you notice the following symptoms:

• A fever with no other symptoms and which has no other known cause
• Urine that smells odd
• Vomiting
• No interest in food

• Cloudy or bloody urine
• Persistent irritability or fussiness
• Crying while urinating indicating pain or uneasiness
• Diarrhoea

Symptoms in Children

• Complaining of pain or a burning sensation while urinating (Dysuria)
• Need to urinate more often (Urinary urgency)
• Pain in the lower belly
• Accidents due to loss of bladder control (Enuresis)
• Foul-smelling, red, pink or cloudy urine
• Flank (region below rib cage and above waist) or back pain on one or both sides

Risk Factors for Developing UTI In a Child

Some children are more prone to UTI’s than others. Here are a few risk factors to watch out for:

• Uncircumcised male infants are at a higher risk as bacteria can thrive under foreskin which is difficult to clean.
• A child who does not urinate frequently is at a higher risk as this allows bacteria to thrive in the urinary tract which would otherwise be expelled with the urine.
• Malfunctioning of the immune system or urinary system
• Lack of proper toilet hygiene

Diagnosis of UTI in Young Children and Kids

Once the above symptoms have been identified, it is important to have them diagnosed by a doctor without any further delay. The paediatrician will do a physical examination of the child and ask you to describe the symptoms. Further, if the doctor suspects UTI, a urine sample will be collected to check for any infection and inflammation (urinalysis) and for a urine culture.

For babies, collecting a sterile urine sample is a challenge. This is because there are bacteria on your child’s skin which will contaminate the urine sample and may give a false reading. A catheter is used in these cases to obtain samples after cleaning the genitals with a sterile solution. The catheter or tube is inserted into the urethra to obtain sample right from the bladder. Though the baby may cry, this a safe procedure.

The doctor will prescribe medicines based on physical examination and urinalysis before the result of the urine culture is obtained as it takes 1 or 2 days for the test result.

Once the child has recovered, the doctor recommends these tests to check for any blockages or Vesicoureteral reflex (VUR):

• Ultrasound to check the kidneys and bladder
• Voiding cystourethrogram (VCUG): This is a 20-minute procedure in which X-rays of the urinary system are taken before and after inserting a catheter into the bladder and injecting dye into it. This helps to detect if the urine is flowing back into the kidneys from the bladder.
• Nuclear scans: A similar procedure as in VCUG is followed using radioactive liquids rather than dye.

Treatment For Uti In Young Babies And Children

Babies below 3 months of age, may need to be admitted to the hospital and administered medicine through a vein (IV). They may also need to stay in the hospital for a while.

To treat your baby or child older than 3 months, you will be prescribed antibiotics in liquid form. The dosage will depend on the illness, your child’s age and the type of antibiotic. It is mandatory to complete the course of the medication so that your child recovers completely. In case the medication is not completed, there are chances of the infection returning.

Moreover, for child UTI pain relief, it is important to keep your child well hydrated so that germs are flushed out. If your child resists food or fluids, hospitalisation may be required and medicines will need to be administered through the vein (IV).

If the UTI persists after 2-3 days, contact your doctor for alternate treatment.

In case of blockage, a surgery may be required to correct it. As for VUR, the child may outgrow it by the age of 6 or surgery may be required. In either case, long-term antibiotics are prescribed to avoid recurring episodes of UTI.

Are There Any Home Remedies to Treat UTI In Children?

Though some of these home remedies have no scientific proof, they have proven to soothe the symptoms in children

Urine infection in children natural treatment:

• Fluids: Fluid intake helps to flush out germs by frequent urination.
• Cranberry or blueberry juice: These juices do not let the bacteria survive in the urinary tract and thus help to push them out.
• Pineapple: Bromelain in pineapple has anti-inflammatory properties that help to reduce symptoms of UTI.

Prevention of UTI In a Child

As you now know all about UTI, let us now see how this painful situation for your child can be prevented.

• Hydration: This is the key to avoiding UTI.
• Breastfeeding: Exclusively breastfeeding your baby for at least 6 months proves to boost your baby’s immunity. It also helps avoid constipation.
• Healthy diet: Make sure you include plenty of fruits, vegetables and whole grains in the child’s diet. Avoid caffeine and carbonated drinks in your child’s diet.
• Hygiene: Teach your child how to keep themselves clean after using the toilet. Ensure your daughter wipes from front to back.
• Avoid bubble baths and tight-fitting clothes.

Having learned all about UTI in children, you now know what to expect and do to prevent it. Although home remedies help to soothe and prevent UTI, it is important to get in touch with your doctor as soon as you detect the symptoms. An early cure is highly beneficial to your child’s health.