Urinary Tract Infection (UTI) In Children

UTI In Children

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UTIs or urinary tract infections aren’t something that children should develop, right? Well, not quite. Children can, and in some cases do, develop urinary traction infections. The American Academy of Pediatrics states that 3 out of 100 girls, and 1 out of 100 boys tend to develop urinary tract infections by the time they are eleven-years-old.

Yes, a urinary tract infection is a possibility, and that is why we at MomJunction have gathered all the details here. This way, you will know everything you need to know about UTI in children and take a well-informed decision.

What Is A Urinary Tract Infection In Children?

Typically, your child (in fact, every human being) has bacteria in his urinary tract, and he flushes them out when he urinates, cleansing the urinary tract. Sometimes, the concentration of bacteria increases and travels from the ureters and urethra to the bladder, triggering a urinary tract infection.

The organs involved in making, storing, and eliminating urine are collectively called the urinary tract. The kidneys make the urine, which travels through the ureters to the bladder. From the age of one, your kid’s bladder can hold about 1.5 ounces of urine. The urine storage capacity increases as your child grows. An adult bladder can store anywhere from 1.5 to 2 quarts of urine. The bladder holds onto the urine until your little one is ready to evacuate.

Usually, urine does not contain any bacterium, and the one-way flow prevents infection. However, sometimes, bacteria find their way into the urine and manage to infect the bladder by traveling through the ureters. This often results in a urinary tract infection.

Types Of Urinary Tract Infection In Children:

As mentioned earlier, urine does not contain any bacterium. However, the skin has bacteria, particularly the skin around the anal region. This can, sometimes, cause bacteria to enter into the urethra, the duct that transports urine from the bladder outside the body. If the bacteria are not flushed out of the body, they multiply causing an infection.

Children (and adults) can get three types of urinary tract infection.

  • In case, your child’s bladder is infected, it is cystitis and causes pain and swelling of the bladder.
  • If your child’s kidneys get infected, it is called pyelonephritis.
  • If the urethras get infected, it is known as urethritis (1).

Kidney infections are quite serious, as they can damage the kidney, particularly in young children.

Causes Of Urinary Tract Infection In Children:

Children who get urinary tract infection often have normal and healthy kidneys and bladders. However, there are some who have abnormalities, making such children more prone to a urinary tract infection.

Some of the causes of urinary tract infection in children include:

1. Vesicoureteral Reflux:

The normal flow of urine is from the kidneys into ureters and finally into the bladder. The one-way flow occurs due to a flap-like valve at the junction of ureter and bladder. In some children, the flap does not function as it should. It causes the urine to flow backward, through the ureters into the kidney. The condition is called vesicoureteral reflux. The bladder, which stores the urine, may have bacteria, and when the urine flow reverses, the pathogens move from the bladder to the kidney, causing pyelonephritis or a kidney infection.

[ Read: Vesicoureteral Reflux In Children ]

2. Urinary Obstruction:

Due to abnormalities in the ducts, the flow of urine can get blocked in the urinary tract. This can result in an infection as the urine accumulates, and leads to a proliferation of bacteria. This obstruction can cause an infection in the ureters or kidneys, but the location of the problem, ureter or kidney, plays a huge part.

3. Dysfunctional Voiding:

Many children hold on to the urine and delay going to the bathroom. They clench the sphincter muscles tight to continue playing or doing what they are engrossed in. When they can no longer hold on, they rush to the bathroom but cannot relax their muscles enough to ensure complete evacuation of the bladder. This causes urine to stay back in the bladder which may result in bacterial growth (mostly E. coli).

4. Straining While Urinating:

Some children tend to strain while urinating. This continuous straining exerts pressure on the bladder, causing the urine to reflux into the ureters, leading to accidental urine leakage, which then causes the E. coli bacteria to multiply and move into the urinary tract.

5. Constipation:

Children who suffer from constipation may be prone to urinary tract infections. When a child is constipated, the stool becomes hard and dry. This stool in the bowel exerts pressure against the urinary tract, blocking the flow of urine. As a result, bacteria thrive and multiply, leading to an infection (2).

Other Causes Of UTI In Children:

Urinary tract infections are more frequent in girls than boys, and children usually get it when they are undergoing toilet training. Boys who are uncircumcised are at a higher risk of developing UTIs, as compared to boys who are circumcised.

  • Bubble baths and tight-fitting clothes can make girls more susceptible to urinary tract infections.
  • If your little one has a nervous or brain disorder, such as spinal cord injury, hydrocephalus or myelomeningocele, it can make it more difficult for a child to empty their bladder.
  • When you toilet train your child, supervise how he wipes his bottom. Children who wipe from back to front risk transferring bacteria from the rectal region to the penile or vaginal region. From here, the bacteria enter the urethra and then make their way to the bladder and kidney. Hence, an improper method of cleaning after using the bathroom can increase your child’s risk contracting a urinary tract infection (3).

[ Read: E Coli In Children ]

Signs And Symptoms Of UTI In Children:

The UTI symptoms in children, vary and depend on the location of the infection and age of the child. Some of the symptoms that you may notice based on age are as follows:

1. Children Between The Ages 0 And 2 Months:

Newborn infants who develop urinary tract infection may have the following symptoms:

  • Failure to thrive
  • Irritability
  • Vomiting
  • Not feeding properly
  • Fever
  • Jaundice

2. Children Between The Age 2 Months and 2 Years:

Children aged two months to two years tend to manifest the following symptoms of UTI:

  • Pain in the abdomen
  • Fever
  • Vomiting
  • Poor feeding
  • Strong odor of the urine
  • Irritability

3. Children Between The Ages 2 And 6 Years:

Children aged two to six years can have the following signs:

  • Fever
  • Pain in the abdomen
  • Vomiting
  • Enuresis, which is involuntary urination, especially at night
  • Strong smelling urine
  • Frequent urge to urinate

4. Adolescents And Children More Than 6 Years Of Age:

Children over six years and adolescents may display the following symptoms of a urinary tract infection:

  • Pain in the back
  • Pain in the flank region
  • Fever
  • Vomiting
  • Pain in the abdomen
  • Urge to urinate frequently
  • Enuresis
  • Incontinence
  • Strong smelling urine

Diagnostic Tests For Urinary Tract Infection In Children:

If you notice any signs of a urinary tract infection in your kid, it is imperative you take him to a doctor. While a urinary infection is not fatal or life-threatening, an untreated infection could cause irreversible kidney damage.

A doctor performs the following diagnostic tests to diagnose urinary tract infections in children:

1. Child’s Medical History:

The doctor will ask you about your child’s medical history and also inquire about the medications he is taking. Be sure to let your doctor know the prescription, non-prescription and supplements that your kid may be taking.

2. Physical Examination:

The doctor will conduct a physical examination and also palpate the abdominal region and flanks to check for tenderness. The examination allows the doctor to exclude an injury to the kidneys.

3. Urinalysis:

Doctor will request for a urine sample that will help detect the infection and also identify the type of bacteria causing the UTI. You would have to collect the sample midstream in a sample bottle. The pathologist analyzes the sample under the microscope and also cultures it to identify the bacterium causing the UTI.

4. Blood Test:

The doctor will draw some blood to test it in the laboratory for infection. The doctor recommends this test if your child appears visibly ill. The pathologist performs a complete blood count and basic metabolic panel with the assumption that your child has a kidney infection. In case your child is severely ill due to the infection, the doctor may also request for blood culture.

5. Renal Function:

The renal function test checks your child’s blood for serum creatinine and blood urea nitrogen. If the levels are high, it indicates your child has a severe infection. Using the renal function test, doctors can diagnose kidney infection as well as early kidney damage caused by the infection.

[ Read: Renal Tubular Acidosis In Children ]

Other Diagnostic Tests For Urinary Tract Infection In Children:

The doctor may request other diagnostic tests if he suspects there is an abnormality in the urinary tract; your child does not improve after starting the treatment, or there are signs of a kidney injury.

1. Renal Ultrasound:

The doctor may recommend a renal ultrasound to check the structure of the kidneys and identify obstructions, scarring, damage and structural abnormalities. Usually, the ultrasound is used for children who suffer from recurrent urinary tract infections.

2. Cystourethrogram:

This is a type of X-ray that allows the doctor to click images of your child’s bladder and urethra while he is urinating. It helps identify abnormalities in the urinary tract and other conditions that make your little one susceptible to UTIs.

3. Renal Scintigram:

If your child gets urinary tract infections frequently, the renal scintigram, which is a type of kidney scan, allows the doctor to identify damage or scarring caused by previous episodes of infection.

Treatment & Solutions For UTI In Children:

Early diagnosis and treatment of a urinary tract infection can prevent kidney damage. Usually, based on the symptoms of UTI in children and urinalysis, the doctor will start the treatment. He will not wait for the other results to come.

Treatment for UTI in children may include the following:

1. Antibiotics:

Since urinary tract infections occur due to bacteria, antibiotics are the first line of treatment to eliminate the infection quickly and completely. If your little one is old and well enough to swallow, the doctor will prescribe oral antibiotics. However, if your child is too sick or young to take the medication orally, he will receive a shot or brief hospitalization where he will receive the medication intravenously. Once your little one feels better, he will be put on oral medication.

Make sure your child completes the course of the medication even if the symptoms of the UTI disappear. Otherwise, there is a risk of the infection returning with vengeance or turning immune to the medication.

2. OTC Painkiller:

If your child has pain due to the infection, the doctor will prescribe an over-the-counter painkiller such as acetaminophen. Do your give your child aspirin, as it could lead to Reye’s Syndrome which causes liver and brain damage.

4. Hot Water Bottle:

To ease the discomfort in the abdomen or back, the doctor may advise you to place a heating pad. If you don’t have one, use a hot water bottle. It will alleviate the pain and ease the discomfort the infection is causing your little one (4).

Treatment For Recurrent Urinary Tract Infection In Children:

Some children are prone to repeated infections of the kidney or urethra. Hence, it is important you keep a close watch on your child to spot the signs of a urinary tract infection early. Then contact your pediatrician so that the infection can be diagnosed early and the subsequent treatment can commence.

Children who are prone to repeated UTIs are often given low doses of antibiotics for long-term use to prevent the infection from recurring (5).

Risk And Complications Of Urinary Tract Infections In Children:

As stated earlier, your child’s urinary tract infection is not life-threatening. However, it can result in complications if the infection is not diagnosed and treated, and these complications can be life-threatening. In most developed nations where medical treatment is easily available, mortality due to a UTI is relatively rare.

Some of the complications that can occur if you don’t seek medical intervention for your little one’s UTI include:

1. Sepsis:

The primary concern of a urinary tract infection is sepsis. This refers to the spread of infection to the blood and tissues of the body. When a child gets sepsis, his blood pressure plummets. This results in limited blood flow to the organs. Due to lack of oxygen and nutrients, the child experiences organ failure, resulting in death.

Signs of sepsis include:

  • High-grade fever or low body temperature
  • Rapid heartbeat
  • Confusion and delirium
  • Rapid breathing
  • Chills
  • Significantly reduced urine output

While a child of any age can get sepsis, it is more prevalent in infants. This infection of the blood is treated aggressively with antibiotics, medications to support the child’s blood pressure and fluids.

[ Read: Sepsis In Children ]

2. Focal Kidney Inflammation:

Some children are at a risk of developing a renal abscess or focal inflammation of the kidney. This results in renal scarring that does not allow the child’s kidneys to function optimally. As a result, your little may get prone to kidney problems and frequent UTIs.

3. Hypertension:

Kidneys play an important role in maintaining blood pressure and electrolyte balance in the body. If the kidneys sustain irreversible damage, your little one may develop hypertension or elevated blood pressure. This problem will require medication and changes in lifestyle habits.

4. End Stage Renal Disease:

End stage renal disease means your child’s kidneys are not functioning. Your child will be put on dialysis. He also risks anemia brought on by the disease. He will be put on recombinant human erythropoietin and iron supplements to keep proper iron levels. Also, your child is at a high risk of developing rickets or suffering from bone resorption or osteitis fibrosa. Bone disease becomes severe as the functioning of the kidney deteriorates.

5. Dehydration:

Dehydration is one of the serious complications of a urinary tract infection in children. Since urine output is low, your child stays away from drinking fluids, resulting in dehydration. Severe dehydration can be fatal.

Prevention Tips For Urinary Tract Infection In Children:

There are ways to prevent a UTI in your child. By following these tips, you can minimize the chances of your child contracting a urinary tract infection.

1. Breastfeeding:

Research shows breastfeeding neonates can prevent urinary tract infections in the first six months of your baby’s life.

2. No Holding Back:

Teach your child not to hold when he wants to urinate. Holding the urine increases the risk of bacterial infection, as the bacteria multiply quickly in concentrated urine. It is sometimes good to create a toilet schedule for your little one so that he goes to the toilet and empties his bladder.

3. Increase Fluid Intake:

Many children do not consume enough fluids and hence, don’t feel the urge to go to the toilet. Make sure your child drinks a lot of water throughout the day. Do not let him consume carbonated beverages, as it results in dehydration and reduces urine output. Drinking more fluids also helps in flushing out bacteria and toxins that may be present in the urinary tract.

4. Fiber-Rich Diet:

Constipation also can result in urinary tract infection. The hard and dry stools put pressure on the urinary tract, obstructing the flow of urine. So make sure you feed your child lots of fresh fruits and veggies to prevent constipation.

5. Change Diapers Frequently:

If your child uses diapers, make it a point to change them frequently. Wet diapers become a breeding ground for bacteria that can make their way through the skin into the urethras and then into the bladder and kidneys.

6. Proper Toilet Training:

When your child is undergoing toilet training, teach him to wipe from front to rear. This is especially true for girls, as it prevents the bacteria from the anal region spreading to the urethra.

7. Avoid Bubble Baths:

This prevention method is especially for girls. Bubble baths may let bacteria enter the urethra, leading to a urinary tract infection.

8. Tight-Fitting Underwear And Clothing:

Do not let your little one wear tight-fitting clothing or underwear. This increases the risk of bacteria making their way into the urethra.

9. Personal Hygiene:

As your child learns to get independent, teach him the importance of keeping the genital region clean. Make it a point to wash the area well when giving your little one a bath. This minimizes the risk of bacteria making their way through the urethra into the bladder and kidneys.

[ Read: Personal Hygiene Tips For Kids ]

Home Remedies For Urinary Tract Infection In Children:

Before you start home remedies for UTI in children, get the go-ahead from your child’s nephrologist.

1. Water:

If your child has a urinary tract infection, water is one of the best home remedies. Under normal circumstances, your child should consume about eight to 10 glasses of water a day. Giving him a little more will help flush out the kidneys and bladders which, in turn, cleans out the infection-causing bacteria.

2. Cranberry Juice:

Cranberry juice has antiseptic properties and can treat not only urinary tract infection but also prevent one. Let your child drink two to three glasses of cranberry juice every day if he has a UTI. It will facilitate faster healing. The proanthocyanidins present in the juice prevent bacterial growth.

3. Pineapple:

Pineapple has anti-inflammatory properties, thanks to the bromelain present in the fruit. The fruit or juice helps with the inflammation, thereby reducing pain. You can give your child pineapple juice or the flesh to eat. Make sure you give him fresh pineapple, as the canned ones may have preservatives.

4. Blueberries:

The antibacterial and antioxidizing properties of blueberries can help combat your child’s urinary infection. Do not sweeten the berries with sugar, as sugar offers bacteria the perfect environment to proliferate. Let him have fresh berries or juice them.

5. Barley Water:

Barley water can flush out the bacteria from the urinary tract as it is a diuretic. Boil a teaspoon of barley powder in two to three glasses of water. Allow the concoction to cool before giving it to your child to drink. Encourage him to drink several glasses of barley water during the day for optimal results.

6. Baking Soda:

Anecdotal stories show baking soda helps to ease urinary infection in the initial stages. Mix one teaspoon of baking soda in a glass of water and let your child drink it twice a day. Baking soda helps neutralize the urine and restore acid-base balance. It aids in a quick recovery.

In Conclusion:

If you notice signs of a urinary tract infection in your kid, take him to a qualified pediatric nephrologist. Even though the infection is not serious, it can result in complication if it is not treated with antibiotics. It can result in scarring, poor kidney function, and elevated blood pressure. In the worst case scenario, your child may develop sepsis, which can be fatal.

Has your child ever had a urinary tract infection? How did the doctor diagnose and treat the infection? Did you use any home remedy to hasten your angel’s recovery? We would love to hear from you, so please comment below.

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