Preventive Health

UTIs in kids: What’s normal and what’s not

Urinary tract infections, or UTIs, are fairly common in people of all ages. They can affect children, adults and even seniors.

“A urinary tract infection is the presence of bacteria in the urine that is causing symptoms or some disruption of normal function,” said Linda Schmidgall, APRN. Linda specializes in pediatric urology at OSF HealthCare Children’s Hospital of Illinois.

Some bacteria in the urine is normal, but when it causes an infection, it can cause unpleasant symptoms or lead to more serious health issues.

“If a child is having problems, it indicates that we need to step in and take care of things,” Linda said.

Symptoms of UTI

In very young children

Identifying UTI symptoms can be more difficult in children who have limited vocabulary or are not yet potty trained.

“A younger child can’t tell you it hurts to pee,” Linda said.

Signs your child may have UTI symptoms include:

  • Fussiness
  • Not eating well
  • Change in diaper odor
  • Blood in a wet diaper
  • Fever or other signs of illness that cannot be explained

If your child experiences any of those symptoms, talk with your doctor.

Potty-trained children

Children who are a little bit older are likely to present symptoms that may seem more obvious – though symptoms can vary from child to child.

They might:

  • Complain of pain with urination
  • Make frequent trips to the bathroom
  • Have an increase in accidents or bed-wetting

UTI diagnosis

Your provider will usually collect a urine sample for two tests.

One is called a urinalysis, which could show certain red flags that indicate suspicion of infection. This is usually provided in the office and takes only a few minutes to deliver results.

The second test, called a urine culture, is a test to measure and identify the specific bacteria present. This is important so that your provider can prescribe the treatment that will most effectively treat your infection.

A urine culture is usually performed in a laboratory and make take two to three days to deliver results.

UTI treatment

Because they are caused by bacteria, UTIs are generally treated with antibiotics.

If a child has repeated infections, it could be a sign that an underlying condition is contributing to their infections. In this case, your child may be referred to a specialist, such as a pediatric urologist, for evaluation.

Repeated infections could be caused by a physical condition, such as a birth abnormality called vesicoureteral reflux, that makes a child predisposed to UTIs.

They could also be caused by behavior, such as “holding it” for too long or not fully emptying their bladder when they go to the bathroom.

“When you potty trained your child, you taught them how to hold it,” Linda said. “When you pair that with the normal life of a child, they don’t want to stop what they are doing and go to the bathroom. They want to play with their friends, watch their shows, be in school. They simply are not taking the time to go to the bathroom to relax and fully empty their bladder.”

Constipation can also be associated with UTIs as the source of the bacteria that causes an infection.

A pediatric urology specialist such as Linda will help identify these underlying causes and treat them. Physical issues may in rare cases require surgery or medical intervention. Behavioral issues can often be solved with education and good habits.

“We are going to retrain their bladder and bowels and start over. I have heard other urologists say, ‘We are going back to potty training 101.’ The first thing I do with all of my patients is we put them on a bathroom schedule. It’s getting those kids to recognize what that sensation feels like again instead of ignoring it,” Linda said.

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