Just when you thought your potty-training work was complete, your toddler now reports that it hurts to go — and your gut tells you the problem could be a urinary tract infection. A UTI occurs when bacteria enter any part of the urinary system, including the bladder, kidneys or one of the two tubes that carry urine through and out of the body, either the ureter or the urethra.[1]
Since little kids are still mastering bathroom wiping and hand washing, UTIs can be common, with about 3 percent of girls and 1 percent of boys developing one by the time they're 11 years old. But fortunately, these infections are treated rather quickly. Learn more about UTI symptoms in kids, as well as the causes and treatments, so your tot can get back to pain-free peeing.[2]
UTI symptoms in kids
Girls tend to get more UTIs than boys, and signs of a UTI can vary among children. That said, the symptoms you might spot are similar for both boys and girls and may include the following:[3]
- Complaining or crying about going to the bathroom
- A return of bedwetting or accidents after potty training
- Pain in the lower belly, lower back or above the pubic bone
- Strong-smelling urine
- Urine that looks cloudy or rusty red
- A frequent need to go, yet very little urine is released
- Fever and chills (potentially the only sign in kids 2 years old and younger)
- Signs of illness, like vomiting, diarrhea, weight loss, fatigue, loss of appetite and irritability
What causes childhood UTIs?
Here are the risk factors to keep in mind when you're wondering whether your tot has a UTI, as well as some of the most common causes of childhood UTIs:[4]
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- Female anatomy. Because a girl's urethra is shorter and closer to the anus, fecal matter and other germs can more easily enter the urinary tract, causing an infection.
- Less-than-ideal hygiene. Both boys and girls who are new to using the potty may fail to wipe in the right direction, or they may not wipe at all (sigh).
- Circumcision status. Boys who are uncircumcised have a slightly higher risk of developing a UTI before the age of 1.
- Genetics. If you or your partner have had UTIs, there's a better chance your kids will too.
- Urinary tract problem. A kidney that's not formed correctly or a blockage in the tract can interrupt the normal flow of urine.
- An abnormal flow. Reflux or a backward flow of urine due to an anatomical abnormality can also cause a UTI.
- Holding it. If your child is potty-training or getting used to a new bathroom at preschool, she may avoid using the toilet. But holding in pee (and poop) can up the risk of UTIs because urine stays in the bladder for longer and bacteria has more time to multiply.
Toddler UTI treatments
Prescribed antibiotics, either liquid or pills, can quickly treat UTIs in toddlers and young children, though it's important to finish the entire course. While your child's symptoms should improve after a couple of days, continue to give the medication as directed by the pediatrician. A UTI that's not fully treated may return or spread.
If your tot is in lots of pain, the doctor may prescribe a medicine that numbs the urinary tract lining; this drug actually turns the pee orange!
Most UTIs should clear up in about a week or so, though along the way you can offer plenty of fluids to keep your child hydrated. Just skip those with caffeine, like soda and iced tea drinks, which may irritate the bladder (and amp up your toddler anyway).
Treatment for severe UTIs may happen in the hospital, where an injection or IV can quickly deliver the medicine. Babies under 6 months of age or kids with high fevers or kidney infections may require this type of in-patient treatment. Children who are dehydrated or vomiting and can't take medicine orally or those with a UTI that's spread to the blood will also need a hospital stay.
When to call the doctor
UTIs don't go away on their own, so it's very important to call the pediatrician right away if you suspect one. Not only do you want to get rid of the infection so your child is comfortable and pain-free, but also to prevent the spread of infection and eliminate any chance of kidney damage.
Call the doctor if you notice fever with shaking chills along with back pain or bad-smelling urine. And contact the doctor right away if your child can't keep the prescribed medication down, is eating or drinking less, vomits, has severe pain or is increasingly fussy or lethargic. UTIs aren't life-threatening, but they can lead to more pain and complications if left untreated.
How are toddler UTIs diagnosed?
Doctors typically diagnose urinary tract infections based on parent-reported symptoms and a sample of urine.
Bigger kids can pee in a cup, though diaper-age tots will probably need a catheter, which is a thin tube that obtains a clean urine sample when it's inserted into the urethra. Alternatively, a cup placed on the baby can catch urine.
An analysis or urine culture is then performed to identify the type of bacteria that's causing the UTI.
How to prevent UTIs in toddlers
Prevent future UTIs in your little one in the future by doing the following:[5]
Teach proper wiping
Your newly trained toddler will certainly want to go potty solo. But urge him or her to wipe front to back so as not to drag bacteria from the bottom to the urethra. And also caution against wiping too hard as it can irritate the genital area, making it easier for bacteria to enter the urinary tract.
Stick to cotton
Keep your tot in loose fitting, cotton briefs during the day to prevent moisture in the area that can foster bacteria growth. At night, if letting your little one sleep au naturel is too nerve-wracking, try offering a pair of training pants, but make sure you change them fast if there's an accident (especially a poopy one).
Push the fluids
When tots aren't well hydrated, they don't make enough urine to flush out any bacteria in the urinary tract. If your tot does get a UTI, offer plenty of water as well as low- or no-sugar cranberry juice as it contains compounds that prevent bacteria from sticking to bladder and urethra walls.[6]
But skip the OJ since citrus irritates the bladder and worsens symptoms, as do caffeinated and carbonated drinks (which your toddler shouldn't be drinking anyway).
Visit the loo — a lot
Toddlers at play don't like to take breaks. But make sure your little one tries to pee at least every four hours. Urine that sits around in the bladder becomes a breeding ground for bacteria, and regular bathroom trips can flush it out. Encourage regular pooping too. (Kids who are constipated tend not to pee much.)
Banish bubbles
Bubble baths are a blast, but they're not so great for little kids because the bubbles and other perfumed soaps can irritate their genitals and skin near the urethra, making it painful to pee.
Even if you've banned bubbles from toddler bath time, save the soaping and shampooing for last so your water sprite isn't sitting in soapy water for more than a few minutes. Once tub time is over, encourage your tot to pee.
Change after swimming
Wearing the same wet bathing suit for hours can also end up chafing the genitals. The fix: Have a dry set of clothes on hand after each trip to the lake, pool or ocean.
UTIs are common childhood occurrences, so try not to fret if your child develops one. By following the pediatrician's care advice and completing the medication that's prescribed, your little one should be back to normal in the bathroom department in no time.
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