Introduction

Urinary tract infections (UTIs)in children are fairly common, but not usually serious. They can be effectively treated with antibiotics.

AUTI may be classed as either:

• an upper UTI if it's a Pyelonephritis or an infection of the ureters, the tubes connecting the kidneys to the bladder
• a lower UTI if it's a bladder infection (cystitis) oran infection of the urethra , the tube that carries urine from the bladder out of the body

When to seek medical advice

If you think your child is unwell and could have a UTI, contact your GP as soon as possible.

Although UTIs aren'tnormally a serious type of infection, they should bediagnosed and treatedquickly to reduce the risk of complications.

This topic covers:

Symptoms

Diagnosis

Causes

Treatment

Prevention

Recurrent UTIs in children

Symptoms of a UTI in children

It can be difficult to tell whetheryour child has a UTI,as the symptoms can be vague and young children can't easily communicate how they feel.

General signs that may suggest your child is unwell include:

• a high temperature (fever)
• vomiting
• tiredness and lack of energy (lethargy)
• irritability
• poor feeding
• not gaining weight properly
• in very young children, yellowing of the skin and whites of the eyes (jaundice)

More specific signs that your child may have a UTI include:

• pain or a burning sensation when peeing
• needing to pee frequently
• deliberately holding in their pee
• a change in their normal toilet habits, such as wetting themselves or wetting the bed
• pain in their tummy (abdomen), side or lower back
• unpleasant-smelling pee
• blood in their pee
• cloudy pee

Diagnosing UTIs in children

In most cases, your GPcan diagnose a UTI by asking aboutyour child'ssymptoms, examining them, and arranging for asample of theirpee to be tested.

Treatmentusually beginssoon after a urine sample has been taken, and your child won't need any further tests.

Ina fewcircumstances, further testsmay be needed in hospital to check for abnormalities.Your GP may refer you straight to hospital if your child is very young.

There are many ways this can happen, including:

• when a child wipes their bottom and soiled toilet paper comes into contact with their genitals this is more of a problem for girls than boys becausegirls' bottoms are much nearerthe urethra
• babies getting small particles of poo in their urethra when they soil their nappies particularly if they squirm a lot when being changed

There's often noobvious reason why some children develop UTIs and others don't.

However, some children may be more vulnerable to UTIs because of a problem with emptying theirbladder, such as:

• constipation this can sometimes cause part of thelarge intestine to swell, which can put pressure on the bladder and prevent it emptying normally
• dysfunctionalelimination syndrome a relatively common childhood condition where a child "holds on" to their pee, even though they have the urge topee
• vesicoureteral reflux an uncommon condition where urine leaks back up from the bladder into the ureters and kidneys; this occurs as a result of a problem with the valves in the ureters where they enter the bladder

Treating UTIs in children

Mostchildhood UTIs clear up within 24 to 48 hours of treatment with antibiotics and won't cause any long-term problems.

In many cases,treatment involves your child taking a course of antibiotic tablets at home.

As a precaution,babies underthree months old and children withmore severe symptoms are usually admitted to hospital for a few days to receive antibiotics directly into a vein (intravenous antibiotics).

However, recent high-quality research into these claims found little evidence to suggest cranberries have a significant impact on your chances of developing a UTI.

Recurrent UTIs in children

A small number of children have recurring UTIs. If your child's had a UTI before, it's important that both of you watchfor the return of any associated symptoms.

Tell your GP about any symptomsas soon as possible so a diagnosis can be confirmed and treatment can begin.

Ifyour childhas a problem that increases their risk of UTIs, such as faulty valves that allow urine to flow the wrong way,they may be prescribed low-dose antibiotics as a long-term measure to prevent further infections.