Urinary infections – could your child have one?

A sick baby with no obvious symptoms may well have a hidden infection. Here's how to flush it out...

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It has an unattractive name (urinary tract infection) and an even less attractive abbreviation (UTI), but these wee infections can be a hidden upset.

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

What are the symptoms?

The younger your child, the more likely her symptoms will be ‘non-specific’ and potentially more serious.

In a baby, look out for your little one being unwell but with no apparent source of infection. Newborn babies with a UTI may have prolonged jaundice, poor feeding and weight gain. Older babies may be unwell, with poor feeding, vomiting or diarrhoea.

If your child is unwell with vomiting and fever, this may be a sign of UTI, and older children may have more noticeable urinary symptoms, such as soreness when urinating, or weeing a dark, foul-smelling urine.

Also, if your little one was previously dry at night and is now wetting the bed again, or has difficulty ‘holding on’ during the day, a UTI may be the cause. She may also complain of tummy-ache and have a high temperature.

When should I call the doctor?

A urinary tract infection can only be diagnosed accurately through tests done by the doctor. As UTIs are potentially serious infections, you should visit your GP for an assessment if you’re concerned. In fact, if your child is displaying the symptoms described above, you should see your GP.

The doctor will do a thorough examination and will require a urine sample. This can be a lengthy procedure with a little one, so don’t be surprised if you’re asked to either wait at the surgery until this has been done, or bring a sample back in later.

How to collect a wee sample

Tricky as it may be(!), it’s important that you collect the sample 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, which your GP will give you. 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.

How is a urinary infection treated?

A sample of your child’s urine will be sent to a laboratory to be examined under a microscope and to be ‘cultured’ to see if organisms are growing in it. If your GP is suspicious at this point that your child has a UTI, then antibiotics will be given.

The treatment may be adjusted when the laboratory tests come back, but will be continued for a total of (usually) 7 days. A baby who is clearly ill, or in whom the GP suspects a UTI, will be referred to hospital for treatment.

What if it’s serious?

Nearly all children diagnosed with a UTI will be referred to a paediatrician for later investigations and follow-up checks.

Investigations are necessary because a percentage of children with UTIs have an underlying kidney abnormality, and it’s important these are detected to prevent problems in later life. Ultrasound and other scans may be recommended to look for these problems, as some of these conditions can lead to kidney damage.

If this is the case, some children will be regularly monitored until the condition has fully improved. In a very small number of little ones, surgery may be needed.

As the kidneys are part of the mechanism that controls our blood pressure and removes waste products from the body, some children may need lifelong follow-up.

How can I help?

After a urinary infection has been treated, most babies and children will appear to be better. But if you have been given a follow-up hospital appointment, do make sure you go, as it’s important to rule out any serious problems.

Can drinking cranberry juice prevent UTIs?

There’s no evidence to suggest that drinking cranberry juice has a role in preventing UTIs in children, but you should encourage your little one to have a healthy diet and lifestyle, and try to avoid becoming  constipated, as this can increase the chance of developing a UTI again.

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Also teach good toilet hygiene. Make sure your child knows to wash her hands after wees and poos, and show little girls how to wipe their bottoms – from front to back, to reduce the risk of infection from bowel germs.

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