Signs of UTIs in Children

The connection between bedwetting and UTIs in children

The telltale signs of a urinary tract infection (UTI) are a constant urge to urinate and a burning sensation when you do go. Unfortunately, kids commonly get UTIs, or bladder infections, just like adults.

UTIs in children can occur at any age, from infants to teens. But kids may not be able to describe their discomfort or even tell you at all. And sometimes, they go unnoticed, which can lead to a more severe infection.

“The good news is, most UTIs in children are not serious and can be easily treated,” says Joy Drass, MD, a pediatrician at Geisinger. “But knowing what to look for and when to call the pediatrician can help. Early evaluation leads to faster relief and helps prevent complications.”

Dr. Drass gets to the bottom of UTIs in children, common symptoms and prevention strategies to protect your child from repeat infections.

UTI symptoms in kids

UTI symptoms in kids vary by age and can be subtle in babies and toddlers. Look for changes in urination and general signs of illness, including:

Frequent urination or an urgent need to go, but with little coming out
Crying during urination, likely due to pain or burning sensation
Foul-smelling urine or diapers
Blood in urine, which can appear pink or red
Discomfort in the pelvic area and lower back
Unexplained grumpiness or fever
Bedwetting or daytime accidents in a toilet-trained child

“UTIs irritate the bladder and lead to spasms that kids can’t control while asleep,” says Dr. Drass. “If your child is wetting the bed at night after at least 6 months of being dry, talk to your pediatrician about a possible urinary tract infection.”

Signs of a kidney infection in kids

Most pediatric UTIs affect the lower urinary tract (the bladder and urethra). But left untreated, UTIs can progress into a more serious infection by moving up the urinary system.

“If your child develops a high fever and chills, nausea or vomiting, this is an indication the infection has spread to the kidneys and your child needs prompt medical attention,” says Dr. Drass. “Infants and toddlers are at higher risk because they wear diapers and may not be able to describe UTI symptoms.”

Common causes of UTIs in children

Most UTIs in children occur when bacteria like E. coli from the skin around the genitals or rectum enter the urethra and travel to the bladder.

Baby boys with an uncircumcised penis and girls, thanks to their anatomy, are at a higher risk. Compared to boys, girls have a shorter urethra — the tube that empties urine from the bladder outside the body — which makes it easier for bacteria to reach the bladder. In addition, the opening of the urethra is closer to the anus, where harmful bacteria like E. coli thrive.

Other common causes of UTIs in children include

Constipation, which can compress the bladder and urethra
Holding urine or infrequent bathroom breaks, which allows bacteria to build up
Dehydration
Improper wiping (back to front) or infrequent dirty diaper changes
Bubble baths or other irritants in the genital area
Sexual activity in teens
Recent antibiotic use
Structural abnormalities in the urinary tract like vesicoureteral reflux, where urine can flow backwards up from the bladder

Pediatric UTI treatment

If your child has UTI symptoms, schedule an appointment with their pediatrician. UTIs in kids won’t clear up on their own and you don’t want to risk the infection getting worse.

Pediatric UTI treatment typically means a course of antibiotics, based on your child’s age, severity of symptoms and specific bacteria involved. The infection should clear up in about a week. In the meantime, using a heating pad and making sure your child gets plenty of fluids and rest also can help ease symptoms and discomfort.

“It’s important to complete the entire course of antibiotics, even if your child is feeling better, to make sure the infection is fully cleared,” Dr. Drass says. “If it isn’t, the bacteria can grow and come back to cause a repeat infection.”

Make sure to mention during the visit if your child has recurrent UTIs. The pediatrician might recommend further testing or prevention strategies to reduce the risk of future infections.

Preventing UTIs in children

UTIs in children are common, but don’t despair. Most of them are caused by unhealthy bathroom habits and thankfully can be prevented.

Dr. Drass offers 7 effective strategies to reduce UTIs in children:

Keep kids well hydrated. Drinking plenty of water helps to dilute urine and flush out bacteria from the urinary tract. It also forces kids to urinate more often.
Encourage frequent bathroom breaks. Kids should urinate about 4 to 7 times per day. Urination flushes bacteria from the urinary tract. And make sure kids fully empty their bladders.
Teach kids healthy bathroom habits. Girls should wipe from front to back, especially after bowel movements, to avoid contamination. And boys need to learn good hygiene habits to keep an uncircumcised penis clean and dry.
Change dirty diapers frequently. The longer stool is close to the urethra, the higher the risk of infection.
Avoid bubble baths and perfumed soaps. They can irritate the genital area and urethra and disrupt the natural balance of protective bacteria, which can make infections more likely.
Avoid constipation. Including lots of fiber in your child’s diet and encouraging plenty of fluids and regular toilet time after meals can relieve constipation.
Urinate after sexual activity. For teens who are sexually active, this simple act can help expel bacteria that may have entered the urethra during sexual activity.

“When you teach kids healthy bathroom habits at the start of toilet training, they are learning vital skills that they can take with them into adulthood,” says Dr. Drass. “And it lowers the chances of repeat infections as they grow.”