Urine Infection (UTI)

uti.jpgA urine infection occurs when bacteria gets into the urine and causes symptoms. It commonly only affects the bladder, but may travel higher into the kidneys. Around 1 in 10 girls and 1 in 30 boys will have a urine infection in childhood.

Symptoms of Urinary Tract Infection

In Babies In Children
High temperature High temperature
Vomiting  Cloudy urine 
Irritable Smelly urine 
Sleepiness  Frequency 
(Passing urine more often)
Difficulty feeding Sore tummy
Looks in discomfort  Back pain 
Generally unwell  Blood in urine (uncommon)

Jaundice 

(Yellowing of the skin)

 
Risk Factors

Most UTI’s are seen in healthy children. Common causes include

  • Not drinking enough fluids
  • Constipation
  • Wiping incorrectly after going to the toilet

Some children are at increased risk of UTI because of conditions which affect the flow of urine. These might include:

  • A blockage at the exit from the bladder
  • Poor bladder emptying
  • Kidney stones
  • Urine going back towards the kidneys

These rare things are found out by scanning your child.

How are urinary tract infections diagnosed?

Diagnosis is by testing a urine sample. The sample needs to be a clean catch to be accurate, i.e directly into a sterile pot.
 

 

If your child 

  • has blue lips
  • becomes pale, mottled and feels abnormally cold to touch
  • is struggling to breathe
  • has a fit/seizure
  • becomes extremely agitated (crying inconsolably despite distraction, confused or very lethargic (difficult to wake)
  • develops a rash that does not disappear with pressure (the ‘glass test’)
  • is under 3 months of age with a temperature of 38°C or above (unless the fever is 48 hours following a vaccination and no other red or amber features)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any one of these features

  • Appears to be getting worse or you are worried
  • Restless or irritable
  • Increased difficulty breathing
  • Temperature of 39°C despite paracetamol and/or ibuprofen
  • Continues to have a fever of 38 °C or above for more than 5 days
  • Reduced fluid intake by half usual amount
  • Passed urine less than twice in 12 hours
  • Has extreme shivering or complains of muscle pains
  • Recurrent UTI, concerns regarding pus discharge

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

If none of the features in the red or amber boxes above are present

The most important advice is to keep your child well hydrated.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

Treatments

When your child has a urinary tract infection, the doctor will prescribe antibiotics. When taking antibiotics it is important to complete the full course. If symptoms such as burning when passing urine, going to the toilet more often or blood in the urine don’t improve after 2 days, you should seek medical advice.

Caring for your child at home

If your child does not have any red or amber symptoms in the traffic light advice then you can care for your child at home. If your child is already taking medicines or inhalers, you should carry on using these.

Give lots to drink to help flush the infection out. 

If your child is not feeding as normal, offer smaller feeds more frequently. If your child is breastfed, continue to feed on demand.

If your child is in pain or distressed and over 3 months old, you can give them liquid paracetamol or ibuprofen. At home, we do not recommend giving paracetamol and ibuprofen at the same time. If your child has not improved after two to three hours you may want to give them the other medicine. Never exceed the dose on the packaging.

What happens next

In most cases, your child will recover fully and will not have any more UTIs. Once a urine infection is diagnosed and treated, the infection usually clears quickly. Many children who just have a single UTI which gets better quickly will not need any further tests.

If your child has an infection when they are very young, the infection is caused by an unusual bacteria, they have recurrent infections or they don’t get better quickly with antibiotics they may need further tests. An ultrasound of the kidneys is the 
most common test.

It is important that you and your child watch for any symptoms of a repeat infection and go back to your GP to check a urine specimen if there is any doubt. If further tests are needed, your doctor will discuss and arrange them if necessary. The type of scan will depend on your child’s specific circumstances.

Rarely scans show up problems which require follow up and antibiotics for longer. Very rarely a procedure is required to put the problem right if any blockages are found on the scan

Why is it important to identify and treat UTIs quickly?

Most children will recover completely and have no long-term problems. A small number of children may develop scarring on their kidneys which can cause high blood pressure in later life.

Preventing Urine Infections

As well as the antibiotics, there are also some things you can do to help the infection to get better and also prevent another infection.

1. Avoid Constipation. You can do this by giving your child a high fibre diet to include wholemeal bread, whole wheat cereals and fresh fruit and vegetables. Ensure your child drinks a lot and has regular exercise. If this is an issue for your child, please talk to your health visitor or GP.

2. In young girls the tube to the bladder is very close to the back passage, wiping should be done from front to back.

3. It is better to take a shower rather than a bath. Cleanliness is very important to help prevent infection.

4. Avoid irritating soaps and bubble baths, use plain water only to wash the bottom.

5. Emptying the bladder properly is very important. Encourage your child to use the toilet regularly and empty the bladder every 2-3 hours.

6. Always encourage your child to drink as much as possible during the day, and the empty the bladder properly last thing at night

7. Underwear should not be tight, they prevent air from circulating freely and encourage the warm, moist environment which favours infection. Soft cotton briefs, changed daily are ideal. 

8. Swimming is excellent exercise but chlorine in the pool is very irritant for girls, so rinse their bottom thoroughly with water in the shower afterwards.

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance

Page last updated on: 10th May 2023