When Your Child Has a Urinary Tract Infection (UTI)
A urinary tract infection (UTI) is a bacterial infection in the urinary tract. The urinary tract is made up of the kidneys, ureters, bladder, and urethra. Children often get UTIs that affect the bladder. UTIs can be uncomfortable and painful. But with treatment, most children recover with no lasting effects.
What is the urinary tract?
The following body parts make up the urinary tract:
Kidneys filter waste from the blood and make urine.
Ureters carry urine from the kidneys to the bladder.
The bladder stores urine.
The urethra carries urine from the bladder to the outside of the body.
What causes a urinary tract infection?
Most UTIs are caused by bacteria that enter the urinary tract through the urethra. The urinary tracts of boys and girls are slightly different. The urethra is shorter in girls. This makes it easier for bacteria to enter. As a result, girls are more likely than boys to get UTIs.
What are the symptoms of a urinary tract infection?
If your child has a UTI affecting the bladder (cystitis), symptoms can include:
Urgent need to urinate
Blood in the urine
Daytime wetting or nighttime bedwetting when previously continent
If your child has a UTI affecting the kidneys (pyelonephritis), symptoms are similar to those of a bladder infection. They can also include:
Nausea and vomiting
How is a urinary tract infection diagnosed?
The doctor asks about your child’s symptoms and health history. Your child is examined.
A lab test, such as a urinalysis, is done. For this test, a urine sample is needed to check for bacteria and other signs of infection. The urine is also sent for a culture, a test that identifies what bacteria is growing in the urine. It can take 1 to 3 days to get results of a urine culture. If a UTI is suspected, the doctor will likely start treatment even before lab results come back.
If your child has severe symptoms, other tests may be done. You’ll be told more about this, if needed.
How is a urinary tract infection treated?
Symptoms of a UTI generally go away within 24 to 72 hours of starting treatment.
The doctor will prescribe antibiotics for your child. Make sure your child takes ALL of the medication even if he or she starts feeling better.
You can do the following at home to relieve your child’s symptoms:
Give your child over-the-counter (OTC) medications, such as ibuprofen or acetaminophen, to manage pain and fever. Do not give ibuprofen to an infant who is less than 6 months of age, or to a child who is dehydrated or constantly vomiting. Do not give aspirin to a child with a fever. This can put your child at risk of a serious illness called Reye’s syndrome.
Ask your doctor about other medications that can be prescribed to relieve painful urination.
Give your child plenty of fluids to drink. Cranberry juice may help relieve some pain symptoms.
When you should call your healthcare provider
Call the doctor if your child has any of the following:
Symptoms that do not improve within 48 hours of starting treatment
Fever (see Fever and children, below)
A fever that goes away but returns after starting treatment
Increased abdominal or back pain
Signs of dehydration (very dark or little urine, excessive thirst, dry mouth, dizziness)
Vomiting or inability to tolerate prescribed antibiotics
Child begins acting sicker
If a urine culture was done, make sure to get the results from the healthcare provider. Make an appointment to follow up about a week after your child has finished antibiotics.
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
How is a urinary tract infection prevented?
Encourage your child to drink plenty of fluids.
Encourage your child to empty the bladder all the way when urinating.
Teach girls to wipe from the front to back when using the bathroom.
Don't use bubble bath.
Don't allow your child to become constipated.
If your child has a UTI, he or she may need ultrasound imaging of the kidneys and bladder. This helps the doctor rule out possible anatomical problems that could cause a UTI. If problems are found, or if your child has recurrent UTIs, additional imaging tests may be helpful.
March 21, 2017
Subcommittee on Urinary Tract Infection. Urinary Tract Infection: Guideline for Diagnosis and Management of the Initial UTI in Febrile Infants and Children 2 to 24 Months, Pediatrics (2011); 128(3): pp. 595-610, Urinary Tract in Children, Up To Date
Adler, Liora, C., MD,Bass, Paul F., III, MD, MPH,Image reviewed by StayWell medical illustration team.,Turley, Ray, BSN, MSN