Let’s Discuss Bladder Infections in Kids
I receive many urgent texts and emails from friends each week with frantic questions about their kids’ health. With search engines like Google at our fingertips, it can be easy to go down a rabbit hole of ailments and symptoms and jump quickly to the worst-case scenario. Often, different illnesses have similar symptoms, which can increase worry in parents without having a doctors’ diagnosis.
This morning the email I received was from a good friend whose daughter was having pain during urination, red-tinged urine, and back and abdominal pain. Several different illnesses can cause these symptoms, and it’s essential to understand the possibilities. Many parents worry about appendicitis; for example, it can be challenging to comprehend if a urinary tract infection or appendicitis causes symptoms. But in this case, it was apparent that the culprit was a urinary infection — one that had spread from the bladder to the kidneys (pyelonephritis).
Appendicitis often includes nausea, vomiting, fever, and loss of appetite – which my friend’s daughter was not experiencing. One thing to look for to determine if the pain is in your appendix is new or worsening pain in the lower right part of your abdomen.
Urinary tract infections are prevalent
Urinary tract infections are prevalent in kids — especially if you have an infant in diapers or an older child that holds in their urine for more extended periods (like in the classroom or during extracurricular activities). This is especially true for a constipated toddler who is less able to communicate the issue.
What causes a urinary tract infection?
Urinary tract infections occur when bacteria enter the urethra and multiply in the bladder. The infection can keep moving upward into the kidneys, which usually causes more intense symptoms, like chills, fever, back pain, nausea, and vomiting.
A urinary tract infection is more common in girls than boys due to the short distance between the urethra and the anus. Children still in diapers are also more at risk for urinary tract infections because wearing a soiled diaper for too long could cause an infection – and of course, infants cannot clearly communicate discomfort.
Symptoms of a bladder infection
- Pain during urination
- Feeling a sudden urge to pee
- Peeing more frequently
- Blood present in the urine
- Less controllable urination
- Abdominal pain
- Foul-smelling urine
Symptoms of urinary tract infection including a kidney infection
- As above, plus flank or back pain
- More likely to have a fever
- Aches and pains
- Chills and shaking episodes (rigors)
Urinary tract infection diagnosis
Your child will be asked to either pee in a sterile container, or a bag may be applied to the genitals to collect urine. The bag method is less accurate, though, as the skin also harbors bacteria that can contaminate the sample. The collection bag method is mainly used for infants who cannot urinate on command in a cup.
Small babies may have a urine sample collected with a catheter, or less commonly through a needle entering the abdomen outside the bladder (suprapubic catheterization). This method may be used when someone has urinary leakage, urinary retention, has had a specific surgery that makes the catheter necessary, or another health problem.
Urinary tract infection treatment
Most urinary tract infections (UTIs) can be treated with a urinary tract infection antibiotic taken for 5-10 days. You must make sure to take the full dose of antibiotics, even if symptoms subside. Severe infections such as pyelonephritis, or infections in very young babies, may be treated with intravenous antibiotics for a brief time, switched to oral antibiotics when the infection improves.
Recurrent urinary tract infections
Children with recurrent infections may require prophylactic (preventative) antibiotics to prevent further infections while investigations and diagnoses are completed. Some children have vesicoureteric reflux, where the urine splashes up from the bladder to the ureters and sometimes into the kidneys. This can cause damage over time to the kidneys. To investigate this, your doctor may order a kidney ultrasound and a test called a VCUG to see if urine is moving upward.
Urinary tract infection prevention
- Teach your child proper toilet hygiene; wiping from front to back, and cleaning the genitalia as often as necessary after using the bath and toilet.
- Encourage your child to void when the urge arises. Delaying the emptying of the bladder can lead to infections.
- Treat constipation, which can block the flow of urine out of the bladder when stool compresses it.