Let’s Discuss Bladder Infections in Kids
I receive many urgent calls and emails from patients 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, I received an email from a good friend whose daughter had 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.
My friend was worried about appendicitis. Many parents worry about appendicitis when their child has abdominal pain. It can be challenging to determine if a urinary tract infection or another illness like appendicitis is causing your child’s 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. If you are worried about appendicitis or a UTI, please see your child’s healthcare provider ASAP.
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 or unwilling to empty their bladder. However, a child’s age does not matter when it comes to urinary tract infections. All kids of all ages can get UTIs.
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. Normal urine does not typically cause pain.
A urinary tract infection is more common in girls than boys due to the short distance between the urethra and the anus. Toilet-trained children are less likely to get infections than children still in diapers. However, there is more at risk for urinary tract infections in children with diapers because wearing a soiled diaper for too long could cause an infection – and of course, infants cannot 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
Foul-smelling. bloody or cloudy urine
Symptoms of urinary tract infection include 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
Younger children will be asked to either pee in a sterile container or apply a bag to the genitals to collect urine. However, urine collection bag samples are less accurate as the skin also harbors bacteria contaminating the sample. The collection bag method is mainly used for infants who cannot urinate on command in a cup. This method is suitable for a shy child’s bladder.
Tiny 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 has another health problem.
Urinary tract infection treatment
Most urinary tract infections (UTIs) can be treated with an antibiotic taken for 5-10 days. However, you must make sure to take the total 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 and 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.
Once kids are toilet trained, UTIs are far less common.
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. Again, very young children need parental help.
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. Ensure at least one soft bowel movement per day and that your child empties urine a few times daily.
FAQs – Frequently Asked Questions
What causes a child’s urinary tract infection?
There are many ways kids can get UTIs, but the most common is when bacteria from their skin or poop gets into the urinary tract. These nasty germs multiply in your kid’s kidneys and cause infections anywhere on this crucial plumbing system which filters wastes out of blood to make urine.
What are a child’s symptoms of a kidney infection?
Children with a kidney infection may experience the following symptoms: smelly pee, blood in their urine, wetting the bed or having accidents at school, fever, and feeling sick (they might complain of tummy ache). Not feeding well is another common sign an untreated illness like this one causes that.
What is a normal urinary tract for young children?
The urinary tract is the body’s drainage system for removing urine, which creates a clean environment to house all of our waste and extra fluid.
Do white blood cells in the urine culture have anything to do with urinary tract infection?
Doctors collect a urine sample to rule or out urinary tract infections in children. The urine sample is tested for white blood cells. A positive leukocyte esterase may indicate an infection or inflammation somewhere in the urinary tract. We also look for nitrites and blood in the urine. When these occur, we send the urine to the lab to see if bacteria grow on the Petri dish where urine was placed.
Dina is a wife, mother of 4, and adrenaline junky. She loves to share children’s health information from her professional and personal experience. More About Dr Dina.