The ABCs of UTIs

Identifying and Treating Urinary Tract Infections

By Michele St. Martin

Urinary tract infections (UTIs) rank just behind unexpected wetting as the top urinary problem in children. In fact, according to the National Institutes of Health (NIH), more children may have UTIs than statistics show. Researchers believe that the number of UTIs may be underreported because younger children are unable to describe their symptoms. In infants and young toddlers, these symptoms may be so vague that parents don't even suspect a problem.

A urinary tract infection is an infection of the bladder or kidneys. The most common UTI is bladder infection (cystitis); kidney infections (pyelonephritis) occur much less often but generally are more severe. Untreated kidney infections can lead to permanent damage or even the loss of a kidney.

According to the NIH, one of the major causes of a UTI in children is bacteria getting into the urinary tract (usually from the skin around the rectum or genitals), thus the advice to "wipe front to back" after a child uses the toilet. Even if your young child insists "I can do it myself," you may want to help out after bowel movements until you're sure that the child really has the hang of it.

The other major cause of UTIs is an abnormality somewhere in the urinary tract. In the case of these abnormalities, UTIs may recur frequently. Other children get UTIs because they are predisposed to them in the same way that some children are to colds or ear infections. And still others may get UTIs from a certain type of bacteria that has a special ability to cause urinary tract infections.

While very young children cannot communicate to their parents that they are experiencing the symptoms of urinary tract infections, Dr. Gregory E. Dean, associate professor of urology and pediatrics at Temple University Children's Medical Center, says signs of an infection may include fever or poor feeding habits.

Children who are old enough to tell their parents they're not feeling well may name a variety of symptoms. According to Dr. Dean and Dr. Craig B. Langman, professor of pediatrics and head of kidney diseases at Northwestern University, some of the most common symptoms include:

• Difficulty starting to urinate
• Pain and burning during urination
• Frequent urination
• Cloudy urine
• Blood in the urine or on underwear
• Foul-smelling urine
• Back pain or fever
• Increased frequency of urination (though the quantity of urine may not increase)

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