Urinary tract infections

What causes urine infections?

Urine infections are usually caused by germs from the bowel entering the bladder. Some less common reasons for it can include abnormality of the bladder or kidney itself. Children who are constipated are more at risk of getting urine infections.

The best way to prevent any infections is to clean the nappy area thoroughly and regularly. Make sure that you wipe from front to back. It is also important to make sure small children are taught to wipe this way when potty training starts.

What are the symptoms of a urine infection?

Each child is different and symptoms may vary depending on the age of the child, but some common ones may include:

• high temperature
• increased drowsiness or sleepiness
• poor feeding
• not drinking
• middle to lower back pain
• cloudy, stronger smelling urine
• an older child may need to pass urine more frequently or complain of a burning sensation when passing urine

How is a urine infection diagnosed?

A urine infection is diagnosed by collecting a clean urine sample and sending it to be looked at under a microscope.

If this examination suggests there is an infection, the sample is kept for a further 48 hours to see exactly which germ is causing the infection and which antibiotics will be the most effective in treating the infection.

A diptest is usually done (except in very young babies) before sending the sample to the lab. This can often give a strong indication of whether there is a urine infection or not, and may help the doctor make treatment decisions whilst awaiting the final results.

How is a urine sample collected?

Children in nappies

For children who are not toilet trained, you will be asked to thoroughly clean the nappy area with baby wipes or soap and water. The urine sample will then need to be caught in a waiting container.

Toilet trained children

These children will be asked to pass urine in the normal way on the toilet. The urine will then be caught in a special container.

It often takes a long time to catch a urine sample, please be patient and encourage your child. Providing your child with drinks may help.

How is a urine infection treated?

Urine infections are treated with a course of antibiotics.

Can I do anything to help my child whilst they have the infection?

Yes.

What next?

After the infection has been treated with a full course of antibiotics, in most children this will be the end of treatment. In a small number of more at risk children the doctor may wish to continue to treat your child with antibiotics that are given once a day, usually at bedtime. This is done in order to prevent your child from developing a further infection. It is important that the once a day treatment is not stopped. You will need to continue this until you visit the out patients department for the test results.

Further appointments

Most children will not need any more urine samples to check the infection has cleared, and will not need any more appointments.

However, babies under 6 months and children who have had more than one urine infection or complicated infections will be seen in paediatric clinic and have an ultrasound scan to ensure that no damage has been done to the bladder and kidneys. Young children are especially susceptible to damage from infection as their bladder and kidneys are still immature.

An ultrasound scan

This is the first of 2 simple tests a doctor may want your child to have. It is done in the X-ray department and looks in detail at the kidneys and bladder. The machine is the same as the one used in baby scans and involves a small sensor, covered in clear jelly being rubbed over the child’s tummy and back. It does not hurt and only takes a few minutes. You will be able to stay with your child throughout the scan and they will be awake the whole time.

A DMSA scans

A much smaller number of children will go on to have a DMSA scan.

This investigation involves a small plastic tube being inserted into the vein in the back of the hand, during the morning. A special fluid containing a small amount of radioactivity will then be put into this tube and this will travel to the kidneys over the next few hours. The injection does not harm your child and there are no side effects. During the afternoon your child will have a series of x-rays which normally take around 45 minutes. You may stay with your child throughout the procedure and they may eat and drink normally during the day. If your doctor thinks your child may need a scan like this, you will be sent more detailed information nearer the time.