An Overview of Urinary Tract Infections in Toddlers

A urinary tract infection (UTI) is an infection in any part of the urinary system, which includes the kidneys, ureters, bladder, and urethra. While you've probably heard of adults getting UTIs, children, including toddlers and infants, can also get them.

Overview

UTIs don’t resolve on their own. These infections need medical attention and prescription medication, but the good news is that they’re usually pretty easy to treat. The most important thing is to get timely diagnosis and treatment, because if left untreated, UTIs can cause damage to the kidneys or lead to more serious infections.

Causes

UTIs are often caused by normal bacteria that are found in the bowel. While the urinary tract typically fights off any bacteria it comes into contact with, sometimes the bacteria will cause an infection.

In babies and toddlers, sometimes the bacteria can spread from feces to the bladder because of wearing diapers or having poor wiping skills. An infection can also signal an issue with the structure of the urinary tract. If you have a family history of UTIs, your toddler might be more prone to them.

Signs and Symptoms

Signs and symptoms of a UTI in a toddler might look different than in adults, especially if they aren’t able to verbally express themselves yet. Sometimes, there aren’t any symptoms at all, especially if your toddler is younger than 2 years old.

However, research shows that unexplained fever is the most common symptom of UTIs in children from birth to age 2. Other symptoms of UTIs in children can include:

• Cloudy, dark, bloody, or bad-smelling urine
• Diarrhea or vomiting
• Fever
• Frequent trips to the bathroom
• Irritability or fussiness
• Lack of appetite
• Lower back or belly pain
• Pain or burning with urination
• Urinary accidents (in toddlers who are already potty trained)

Girls are more prone to UTIs than boys because their urethra is shorter and closer to the anus—and closer to bacteria there. Boys who are not circumcised are also a bit more likely to get a UTI than boys who are circumcised.

Diagnosis

If you suspect your toddler might have a UTI, take them to the pediatrician as soon as possible. Prompt diagnosis and treatment are important to avoid more serious infections.

When you go to the doctor, they will ask questions about your child’s medical history and present symptoms, and do a physical exam.

While all of that will be helpful, the only definitive way to tell if your toddler has a UTI is a urine culture. If your toddler isn’t potty trained, they will use a catheter to get a small amount of urine. This involves inserting a very thin tube into the urethra and up into the bladder.

Treatment

The principal treatment for a UTI is antibiotics, which kill the bacteria causing the infection. If the child is experiencing significant pain, a medication that numbs the urinary tract lining may also be prescribed.

It’s important that your child takes the antibiotics for however long the doctor prescribes them. While on the antibiotics, make sure your child is drinking lots of fluids, but avoid caffeine. After a few days or after the course of medicine, your doctor might want to repeat the urinalysis to make sure the infection is gone.

In severe cases of UTIs, or in infants younger than 6 months old, sometimes hospitalization is necessary. Hospitalization can ensure close monitoring and appropriate medication and treatment, especially if a child is dehydrated, a kidney infection is suspected, or the infection is thought to have spread.

Prevention

For toddlers, changing diapers frequently can help reduce the risk of UTIs, because it limits the spread of bacteria that can contribute to infections. If your child is potty trained, teach them proper hygiene, especially for girls, including the importance of wiping front to back.

Wearing cotton underwear and avoiding bubble baths can also help reduce bacterial growth and irritation. It’s also important to let kids know not to “hold it in” when they have to urinate. When urine stays in the bladder for a long time, it creates an environment conducive to bacterial growth.

When to Call the Doctor

If you’ve given the full course of antibiotics and your toddler is still symptomatic, call your doctor. They might want to retest the urine and/or do other tests to see if there’s an underlying medical issue causing the symptoms.

While UTIs can be painful, prompt diagnosis and treatment will help to alleviate symptoms. Usually, after starting antibiotics, symptoms start to abate within two to three days. Most UTIs are cured within a week of starting treatment.