Tiny Troubles: Urinary Tract Infections in Children

It is crucial to treat urinary tract infections (UTI) in children to prevent them from developing into more serious complications. It is also important to evaluate for causes that may lead to recurring UTIs. Dr Lim Kwang Hsien, a consultant paediatrician from Mount Alvernia Hospital explains more on how UTIs affect children, the importance of early detection, and what parents can do to reduce the risk of it happening.

What is a urinary tract infection?

The urinary tract is a system that carries urine out of the body. It starts from the kidneys down the ureter into the bladder, and finally through the urethra. A UTI is an infection of any part of this system, and is usually caused by a bacterial infection. The infection happens when bacteria enter the urethra, commonly from the skin around the groin, and travel up the urinary tract and begin to grow.

Children, like adults, are also prone to getting a UTI. In fact, “UTIs are one of the most common bacterial infections in children”, says Dr Lim.

How does UTI happen in children?

The majority of UTI cases in children are caused by hygiene issues.

However, some children with UTIs have underlying abnormalities of the kidneys or urinary tract present at birth that cause them to have urinary tract infections more easily.

Dr Lim advises that it is important to diagnose and treat UTIs as early as possible to prevent long term kidney damage. In young infants, there may be a risk of the bacteria spreading from the kidneys into the bloodstream. This can lead to life-threatening conditions that can cause organ failures and even death.

When discovered early, UTIs can be easily treated with the right course of antibiotics. Some children, especially younger infants, may need to be admitted for intravenous antibiotics.

Not diagnosing UTIs and leaving them untreated can also mean missing any underlying congenital anomalies of the kidneys or urinary tract that need to be corrected to prevent recurrent UTIs.

Hence, Dr Lim emphasises, “All babies diagnosed with UTIs should undergo further medical examinations to ensure that they do not have an underlying kidney condition that will predispose them to recurrent UTIs.”

How can parents identify UTI symptoms early?

Identifying UTIs in children is not always straightforward, especially in infants and toddlers who may show no obvious symptoms.

Oftentimes, infants and toddlers will present with fever with no associated urinal symptoms, but accompanied by the following non-specific signs:

• Fussy behavior
• Feed refusals
• Crying during urination

Older children may have the following symptoms

• Verbalising pain during urination
• Accidental urine leaks
• Difficulty in controlling urination
• Foul-smelling urine
• Lower back pain

Recognising these symptoms is of utmost importance as it serves as a crucial signal for parents to take swift action and seek timely medical attention to prevent potential complications associated with UTIs.

Tips to prevent UTIs in children

• Frequent diaper changes.
  For infants and toddlers on diapers, change their diapers frequently and keep their genital areas clean during diaper changes
• Teach proper cleaning techniques.
  For older girls, teach them how to clean their genital areas from front to back, not back to front, to prevent bacteria on the anal area from being transferred to the urethra.
• Minimise bubble baths and avoid long tub baths.
  Bath products may contain irritants that can disrupt the natural balance of bacteria in the genital area, increasing the child’s susceptibility to UTIs. Prolonged exposure to water in the tub also contributes to a moist environment that could facilitate bacterial growth.
• Consider circumcision for boys.
  This is especially important if they have a history of UTIs, as the foreskin can trap and create a potential breeding ground for bacteria.
• Avoid and treat constipation.
  Constipation may obstruct proper urine flow. Urine left in the bladder can be the perfect place for bacteria to grow and cause infection.

Article contributed by Dr Lim Kwang Hsien accredited doctor from Mount Alvernia Hospital.

This article is taken from our MyAlvernia Magazine Issue #52. Click here to read the issue on our website.