UTI in Children: Signs, Treatment and Prevention Tips

Does your child cry when they pee, need to go all the time, or have accidents after being potty trained? Does your baby have a fever with no clear reason? These can all be signs of a urinary tract infection, also called a UTI.

UTIs are common in young children, especially girls. They can be hard to spot in babies and toddlers because they can't tell you what hurts. Quick treatment matters, because a UTI that is not treated can spread to the kidneys. Here is what parents should know.

What is a urinary tract infection?

A UTI happens when germs, most often bacteria, get into the urinary tract and grow there. The urinary tract has two parts:

• Upper urinary tract: the kidneys and the ureters. Ureters are the tubes that carry pee from the kidneys to the bladder.
• Lower urinary tract: the bladder and the urethra. The urethra is the tube that carries pee out of the body.

A bladder infection is called cystitis. It is the most common type. A kidney infection is called pyelonephritis. It is more serious, and a child with a kidney infection often looks sicker.

What causes UTIs in children?

KidsHealth says most UTIs happen when bacteria from the skin around the bottom and genitals get into the urinary tract. Some things make this more likely:

• Being a girl. Girls have a shorter urethra that is closer to the bottom, so germs can get in more easily.
• Wiping back to front. This can move germs from the bottom toward the urethra.
• Holding pee. Some kids hold it so they can keep playing. The NIDDK says emptying the bladder helps wash out bacteria.
• Constipation. The NIDDK says eating foods with fiber to prevent constipation may help prevent some bladder infections.
• Vesicoureteral reflux (VUR). This is when pee flows backward from the bladder toward the kidneys. KidsHealth says many kids with a UTI are found to have it.
• Other risks. These include a problem in how the urinary tract formed, a family history of UTIs and, for boys under 1 year, not being circumcised.

Signs of a UTI

Signs can look very different in babies than in older kids.

Babies and children under 2

The American Academy of Pediatrics says a fever with no other clear cause may be the only sign in a baby. Other signs can include:

• Fussiness
• Poor feeding or poor weight gain
• Vomiting or diarrhea

Children 2 and older

• Pain, burning or stinging when peeing
• Needing to pee often, even when only a little comes out
• Wetting accidents during the day or night after being potty trained
• Pee that smells bad or looks cloudy or bloody
• Belly pain below the belly button
• Fever

Signs of a kidney infection

KidsHealth says a child with a kidney infection often has a high fever, shaking chills, pain in the side or back, vomiting and a lot of tiredness. This needs quick care.

How doctors check for a UTI

The only way to know for sure is a urine test. Older kids can usually pee into a clean cup. For babies and toddlers in diapers, KidsHealth says doctors usually prefer to collect the pee with a catheter, which is a thin, soft tube. This gives a clean sample. Some children may also need an ultrasound or other imaging to check their kidneys and bladder.

How UTIs are treated

Doctors treat UTIs caused by bacteria with antibiotics. The AAP says UTIs need to be treated as quickly as possible to help lower the chance of kidney damage.

• Give every dose. Keep giving the antibiotic for as many days as the doctor says, even if your child feels better. Stopping too soon can let the infection come back.
• Know what to expect. KidsHealth says pain when peeing should get better within 2 to 3 days of starting antibiotics. Most UTIs are cured within about a week.
• Offer lots of fluids. Water is a great choice. Skip drinks with caffeine, like soda and iced tea, because they can bother the bladder.
• Hospital care. Some kids need antibiotics through an IV in the hospital. KidsHealth says this can happen if a baby is younger than 6 months, if the child looks very sick or has a likely kidney infection, or if they are vomiting and can't keep medicine down.

If your child is worried about seeing the doctor, our Going To The Doctor song can help. It walks kids through a checkup, from the doctor checking their heartbeat to getting medicine that helps them feel great again.

When to call the doctor

Call your child's doctor if you think your child has a UTI. KidsHealth says to call right away if your child has:

• A fever with no clear reason and shaking chills, especially with back pain or pain when peeing
• Pee that smells bad or looks bloody or a strange color
• Low back pain or belly pain below the belly button
• A fever of 100.4°F (38°C) or higher when taken in the bottom, ear or forehead
• A baby with a fever, poor feeding, repeated vomiting or unusual fussiness

The AAP says to talk with your doctor if your baby has a fever with no other symptoms for more than 3 days. For more warning signs, read our post on when to call a doctor.

How to help prevent UTIs

• Change diapers often. This helps stop the spread of germs.
• Teach good wiping. Girls should wipe from front to back after using the toilet.
• Don't hold it. Remind kids to go when they feel the urge and to take their time so the bladder empties all the way.
• Prevent constipation. Offer foods with fiber, like fruits, vegetables and whole grains.
• Skip bubble baths and strong soaps. KidsHealth says these can irritate the area in school age girls.
• Choose cotton underwear. Cotton is a better choice than nylon.
• Offer water through the day. See why water beats sugary drinks in our post on juice for children.

Potty training is a great time to build these habits. Our Potty Song walks kids through each step, from sitting on the potty to wiping with toilet paper, flushing and washing their hands. You can find more fun nursery rhymes on our music page.

Questions Parents Ask About UTIs

Are UTIs contagious?

No. A UTI is caused by germs from your child's own body getting into the urinary tract. It does not spread from person to person.

Can a baby get a UTI?

Yes. Babies and toddlers can get UTIs. A fever with no other clear cause may be the only sign. Babies may also be fussy, feed poorly or vomit. A urine test is the only way to know for sure.

Why is my potty trained child having accidents again?

New wetting accidents during the day or at night can be a sign of a UTI. Other signs are pain when peeing and needing to go often. Call your doctor to check, especially if your child also has a fever or belly pain.

How long does a UTI last in a child?

With antibiotics, pain when peeing usually gets better in 2 to 3 days. Most UTIs are cured in about a week. Always finish all the medicine, even if your child feels better sooner.

Does cranberry juice help with UTIs?

Cranberry juice does not treat a UTI. A Cochrane review found that cranberry products may help prevent UTIs in some children who have had them before. Ask your doctor before using cranberry products, and never use them in place of antibiotics.

Can a UTI hurt my child's kidneys?

If a UTI is not treated, it can spread to the kidneys. The AAP says UTIs in babies and young children have a greater chance of causing kidney damage than UTIs in older kids. This is why quick treatment is so important.

Are bubble baths bad for kids?

Bubble baths and strong soaps can irritate the area around the urethra, especially in girls. KidsHealth suggests school age girls skip them.

This post is for general information only. It is not medical advice. If you have questions about your child's health, please talk to your child's doctor.