Understanding and preventing UTIs in children

Kinderling News & Features

Most adult women know what a urinary tract infection (UTI) is, but did you know it’s common for young boys and girls to get them too? Heba Shaheed is a pelvic health physiotherapist, and she told Kinderling Conversation how to identify and treat a UTI should it appear.

What is a UTI and how do kids get them?

“A UTI is basically where germs grow and multiply along the urinary tract,” explains Heba. “These germs normally live on your skin and they’re passed from person to person, but sometimes they get into your bladder and urethra (that’s the pipe where you wee from).

“Normally your bladder’s able to get rid of them but when these germs multiply they can irritate that urethra and urinary tract.”

If it’s particularly bad, the kidneys can also have the infection, too.

Germs can be picked up anywhere, but often they can be on the toilet seat from a person who sat there before.

What are the symptoms?

Symptoms include burning, cloudy and even bloody urine, pain in lower part of the body, fevers and irritability. Kids might have feeding problems, lose their appetites and some kids even have day time and night time wetting, related to a UTI.

“They can even get things like vomiting and really bad back pain, especially when their kidneys are involved,” says Heba. “That’s when you know [it’s in] the kidneys, because they’re getting this back pain that’s kind of strange.”

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With UTIs in children especially, she advises identifying the root cause.

“We know it could be the germs, but what’s happening? Are they holding onto their bladder all day as well? When they’re sitting on the toilet, are they trying to hover? Are their feet supported? Are they actually relaxing, or are they rushing to get out?”

Are UTIs preventable?

Yes, and Heba has a bunch of techniques for avoiding them in kids. It’s all about maintaining healthy bladder and pelvic habits.

Wiping

A simple thing like wiping front to back, especially with girls, is a crucial part of a good toilet regime. “Girls have a bit of a higher risk of UTIs. Wiping front to back can be the one thing that prevents them from developing UTIs,” Heba details.

Using toilet paper every time and making sure it’s completely dry is really important.

Genetics

Some people are just born more prone to UTIs, Heba explains. “Some children just have a smaller urethra and it’s easier for those germs and bacteria to get in.”

Relaxation

Some people think it’s better to hover above the toilet seat to avoid germs, but Heba says the opposite is the case! “It’s actually better to sit on the toilet so that you let everything leave your body. When you hover, you actually hold things in,” she says. “You want to completely relax your muscles.”

“At home, having a foot stool underneath [your child’s] feet, so their feet are well supported, helps [them to not hold] onto those pelvic floor muscles.”

The stool will also help number twos too, ensuring their knees are above their hips. The whole bowel will empty and be completely empty and clean down there.

Constipation can also have an impact on UTIs - kids with wetting and UTI issues often also have constipation issues. Watch that and make sure you’re addressing all these issues.

Timing

Kids often hold on until the very last minute before going to to the toilet, but Heba says this can increase the likelihood of UTIs.

“We have to teach them and train them,” says Heba. “‘Say, ‘look don’t wait until you’re completely busting to go, if you feel like your bladder’s full, then go to the bathroom, sit on the toilet and relax until you’re empty. Don’t rush.’”

It’s hard to get kids to calm down sometimes, so Heba recommends a few strategies. Try a game on the toilet wall, or using an hourglass timer for when they can get off the toilet.  These strategies help establish good bladder habits.

Underwear

Heba says that every person has a different environment downstairs, so you need to be aware how your child’s body reacts to different clothes and listen to what they’re verbally telling you.

She adds: “Always wear dry, clean underwear. Don’t sit in wet swimmers, get changed as thrush can start to develop too.”

How is it treated?

For diagnosis and treatment, go to your doctor. Infections sometimes require low dose antibiotics.

“Cranberry juice has been shown to be effective in UTIs [with children], but the strength of cranberry needs to be super strong for it to have a good effect. It actually helps to prevent UTIs in women as well,” Heba says.

When a child is having recurrent UTIs, this is when a pelvic health paediatric physiotherapist comes in handy. They can teach you and your child all the things to prevent them coming back, such as timed weeing and drinking programs, plus proper bladder and bowel habits.