 |
|
UTIs in
Children
-
Dirty Diapers and
Rookie Wipers
-
Signs of
a Problem
-
Typical
Treatment
-
When Things Go the Wrong
Way
-
Bathroom Talk Can Be
a Good Thing
It's one subject mothers just don't
discuss: Urinary tract infections in children. Recognize the
symptoms and adopt good preventative practices early to help your
children avoid potentially dangerous infections.
|
|
It’s a fact of life:
Mothers love to chat about their children. They compare notes on
feeding, toilet training, and everything in between. Aside from
parenting magazines and web sites, swapping child rearing stories,
remedies and baby care tips is how moms learn, how they feel secure
about their parenting skills, and how they bond with other parents.
While veteran mothers will regale a perfect stranger with tales of
stomach flus, leaking breasts and other earthy topics, there’s a
curious silence when it comes to urinary tract infections (UTIs) in
children.
|
|
UTIs are common among very
young boys and girls, but it’s just not something people feel
comfortable bringing out into the open. It may be the fear of being
thought of as “dirty” or unhygienic that keeps this little malady
under wraps. Or it may be that parents, who’ve never heard of
another child getting a UTI, think that their kid is the only one
who has had one. In fact, by age 11, about 3 percent of girls and 1
percent of boys will have seen a doctor for treatment of a urinary
tract infection. Experts guess that the number of childhood
infections is actually higher because some children don’t show
symptoms or can’t describe what they’re feeling, leaving many UTIs
undetected. Unfortunately, an untreated urinary tract infection can
lead to scarring of the kidneys and in rare cases, renal failure, so
parents should be aware of this condition and the accompanying
signs. |
|
Contrary to popular
belief, urine is actually sterile. It contains no germs. But
children’s fingers, underpants and the skin around the genitals can
harbor lots of bacteria that can make their way through the urethra
and into the bladder to cause an infection. If the infection goes
untreated, it can travel to the kidneys where it can do serious and
lasting damage.
Top
|
|
Dirty Diapers and Rookie
Wipers
Urinary tract infections tend to show up
in baby boys before the age of one. According to pediatric
urologist, Dr. Barry Duel, “The biggest risk factor is being
uncircumcised.” He says that an uncircumcised boy has “10 times the
risk” of a UTI as a circumcised baby boy because bacteria can more
easily become trapped under the foreskin and travel up the urethra.
Dr. Duel recommends that parents of uncircumcised boys take extra
care to thoroughly clean and dry the penis with every diaper change.
|
|
Young girls, on the other
hand, are more likely to suffer from a urinary tract infection at
around age 3 when they are toilet training or assuming
responsibility for cleaning themselves after using the bathroom.
When a child doesn’t wipe correctly or thoroughly, bacteria from the
rectum can enter the urethra and result in a UTI. Parents can help
prevent infections by teaching their daughters to wipe from front to
back, as well as supervising young girls even when they insist on
“doing it myself!”
|
|
Another common cause of
UTIs is what’s known as dysfunctional voiding. Dr. Duel explains,
“That’s when children don’t empty their bladders completely and
bacteria builds up. These children are often also chronically
constipated.” Using the potty can be an awkward and scary thing for
a toddler, so many kids are reluctant to go and hold it in as long
as possible. Dr. Duel recommends that parents make sure that they’re
children use the bathroom at least every 4 hours. For serious cases
of dysfunctional voiding, pediatric urologists can use biofeedback
to train a child to recognize the early signs of a full bladder and
visit the potty immediately.
Top
|
|
Signs of a
Problem
Recognizing a UTI in a
young child can be difficult, but here are some tell-tale signs to
watch out for:
 | fever
|
| vomiting
|
| complaints that it hurts to urinate
|
| an overly-frequent urge to urinate but with little output
|
| unexplained wetting accidents
|
| foul smelling or cloudy urine
|
| abdominal and/or lower back pain |
|
|
When pediatricians see a
child for an inexplicable fever, they’ll often ask for a urine
sample to check for a UTI. Young babies who can’t articulate their
symptoms may vomit, have a fever, strange smelling diapers, or
diminished appetite. Doctors can use a catheter to collect a urine
sample from a child who’s not toilet trained to determine if a UTI
is the cause of the problem. “Some kids have ‘silent infections’
with no symptoms,” Dr. Duel warns, “so most pediatricians perform a
standard urine check during well-child visits for potty trained
toddlers.” |
Top
|
Typical Treatment
If it turns out that a child has a urinary
tract infection, antibiotics is the usual treatment. Dosage and
duration depends on the severity of the infection. While most
infections are cleared up with a week or so of the child beginning
the medicine, some children with repeated UTIs remain on low-dose
antibiotics for up to a year at a time as a preventative measure.
Infections of the kidney can cause permanent internal scarring and
threaten the life of a child, so doctors want to make absolutely
sure that they keep recurring infections from taking hold.
Top
|
|
When Things Go the Wrong Way
Sometimes a doctor will order additional
urinary tract tests to determine if an anatomical abnormality is the
cause of a UTI. “Typically we’ll perform an ultrasound of the
bladder and kidneys to look for abnormalities, as well as perform a
Voiding Cystourethrogram (VCUG),” explains Dr. Duel. A VCUG is an
x-ray test that allows specialists to watch the flow of urine from
the bladder to see if the bladder is emptying normally.
|
|
What tests like a VCUG
often reveal is a condition called Vesicoureteral Reflux—an
anatomical quirk that causes some urine to flow backward up to the
kidneys as the bladder fills. Dr. Duel estimates that “about 40% of
kids (boys and girls) with UTIs have Reflux,” and it can cause
recurrent urinary tract infections. Dr. Duel says, “Reflux will
often go away on its own but children with the condition will be
prescribed low-dose antibiotics–sometimes for years at a time. They
also undergo annual VCUG screenings to make sure reflux is improving
and that their kidneys are growing normally.” Children who continue
to get infections despite ongoing medication can have surgery to
correct the anatomical problem that causes some of their urine to
flow in the wrong direction.
Top
|
|
Bathroom Talk Can Be a
Good Thing
Because their bodies and organs are still
growing, small children are at a higher risk than adults for
permanent damage from urinary tract infections. Kidney scarring,
poor kidney function, high blood pressure, and renal failure–which
indicates a kidney transplant or can be fatal–are all lasting
effects of untreated UTIs. For this reason Dr. Duel stresses, “Any
child with unexplained fever should be screened for UTI. And any UTI
should get a radiographic follow-up and the child put on once-a-day
antibiotics until they have a bladder screening.” Parents should not
only talk to their pediatricians if they suspect their child may
have a urinary tract infection, they should talk to each other if
their child had been treated for a UTI. Every bit of information
helps, so spread the word, recognize the signs, and see your doctor
if you have any questions.
Top |
|
|
