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This topic is about urinary
tract infections in children. For information about these infections in teens
and adults, see the topic
Urinary Tract Infections in Teens and Adults.
urinary tract is the part of the body that makes urine
and carries it out of the body. It includes the
bladder and kidneys and the tubes that connect them. When germs (called
bacteria) get into the urinary tract, they can cause an infection.
Urinary infections in children usually go away quickly if you treat them
right away. But if your child keeps getting infections, your doctor may suggest tests to rule out more serious problems.
Urinary infections can lead to a serious
infection throughout the body called
sepsis. Problems from a urinary infection are more
likely to happen in babies born too soon, in newborns, and in infants who have
something blocking the flow of urine.
that live in the
large intestine and are in stool can get in the
urethra. This is the tube that carries urine from the
bladder to the outside of the body. Then germs can get
into the bladder and
Babies and young children
may not have the most common symptoms, such as pain or burning when they
urinate. Also, they can't tell you what they feel. In a baby or a young child,
Older children are more likely to have common symptoms,
The doctor will
give your child a physical exam and ask about his or her symptoms. Your child
also will have lab tests, such as a
urinalysis and a urine
culture, to check for germs in the urine. It takes 1 to 2 days to get the results of a
urine culture, so many doctors will prescribe medicine to fight the infection
without waiting for the results. This is because a child's symptoms and the
urinalysis may be enough to show an infection.
After your child
gets better, the doctor may have him or her tested to find out if there is a
problem with the urinary tract. For example, urine might flow backward from the
bladder into the kidneys. Problems like this can make a child more likely to
get an infection in the bladder or kidneys.
Your child will take
antibiotics for a urinary tract infection. Give this
medicine to your child as your doctor says. Do not stop it just because your
child feels better. He or she needs to take all the medicine to get better. The
number of days a child will need to take the medicine depends on the illness,
the child's age, and the type of antibiotic.
You can help your
child get better at home. Have your child drink extra fluids to flush out the
germs. Remind your older child to go to the bathroom often and to empty the
bladder each time.
Call the doctor if your child isn't feeling
better within 2 days after starting the medicine. Your doctor may give your
child a different medicine. It is important to treat urinary infections quickly
in children to prevent other serious health problems. Sometimes a baby younger
than 3 months may need to get medicine through a vein (IV) and stay in
the hospital for a while. A child who is too sick to take medicine by mouth or
has trouble fighting infections also may need to stay in the hospital.
Learning about urinary tract infections:
urinary tract infections (UTIs) in children are caused
by bacteria that enter the
urethra and travel up the
urinary tract. Bacteria that normally live in the
large intestine and are present in stool (feces) are
the most common cause of infection. Sometimes bacteria traveling through the
lymph system to the
urinary tract are the cause of kidney or bladder
The ways that bacteria buildup can occur
Problems with the structure or function of the urinary
tract commonly contribute to UTIs in infants and young children. Problems that
limit the body's ability to eliminate urine completely include:
Urinary tract infections (UTIs) in
children may not cause obvious urinary symptoms. Symptoms of a UTI in an infant
or young child may include:
In an older child with a UTI, symptoms are usually easier
to recognize and may include:
A doctor's evaluation can determine whether a UTI or
another condition is causing your child's symptoms.
urinary tract infection (UTI), bacteria usually enter
the urinary tract through the
urethra. They may then travel up the urinary tract and
infect the bladder (cystitis) and the kidneys (pyelonephritis). Most UTIs in children clear up
quickly with proper
The biggest concern
over UTIs in children is that they can cause permanent kidney damage and
scarring. Repeated scarring can lead to
high blood pressure and reduced kidney function,
kidney failure. Infants and young children seem to be
at higher risk for this complication.
The risk of irreversible
kidney damage makes early medical evaluation and treatment of UTIs in infants
and young children very important. Unfortunately, detecting UTIs in infants and
young children can be difficult. Unlike symptoms in older children and adults,
symptoms in the very young can be vague and inconsistent.
short-term complications of UTIs are unusual but do occur. They include an
abscess in the urinary tract, acute kidney failure,
and widespread infection (sepsis), which can be life-threatening.
These complications are more likely in
premature infants and newborns and in infants with
urinary tract obstructions.
Infants and young children often
get another UTI during the months after their first UTI. If an infection
comes back (recurs), it usually happens within the same year as the first UTI.
Recurrent UTIs in a child can mean that there is a problem with
the structure or function of the urinary tract. Because repeated infections
increase the risk of permanent kidney damage, your child's doctor will evaluate
and monitor any structural or functional problems. In some cases, your child
may need surgery.
Risk factors (things that increase a
child's risk) of
urinary tract infection (UTI) include:
Infants and young children who have UTIs often have
vesicoureteral reflux (VUR).
Urinary tract infections (UTI) in infants and young children need early evaluation and
treatment. Call your doctor to make an appointment within 24 hours if your child has:
Call the doctor if your child isn't feeling better within
48 hours after starting an
Watchful waiting is not
appropriate if you suspect your child has a urinary tract infection. Untreated
UTIs in children can lead to permanent kidney damage,
high blood pressure, and other serious
The following health
professionals can treat UTIs in children:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
If your child has symptoms of a
urinary tract infection (UTI), the doctor's first
evaluation will probably include:
If the doctor suspects that your child has a UTI, a
urinalysis will help point to a diagnosis. A urine culture can confirm the
diagnosis and identify what is causing the infection. But the results usually
are not available for a couple of days. Rather than delay treatment to wait
for the results of the urine culture, the doctor probably will start your child
antibiotics if your child's symptoms, history, and
urinalysis show that a UTI is likely.
A urine sample will be collected.
The doctor may do other tests if your child has a UTI
Other common tests
If an ultrasound shows problems, then a VCUG may be done. VCUG
can identify vesicoureteral reflux, abnormalities of the
urinary tract, and other conditions that may make your
child more prone to kidney infections. If the test finds any of these
conditions, the doctor can watch and give preventive treatment, if needed, to
The doctor may do a
kidney scan (renal scintigram) to evaluate persistent
kidney infection or to evaluate kidney scarring or damage caused by previous
Antibiotic medicine and home care
are effective in treating most
urinary tract infections (UTIs) in infants and
children. The main goal of treatment is to prevent kidney damage and its short-term
and long-term complications by eliminating the infection quickly and
completely. Early evaluation and treatment are very important. Do not delay
calling a doctor if you think your baby or young child may have a UTI.
Infants and young children with
urinary tract infections (UTIs) need early treatment to prevent kidney damage.
Your doctor is likely to base the first treatment decision on your child's
urinalysis results rather than waiting for the results
of a urine culture.
Treatment for most children with UTIs is oral
antibiotics and home care.
If your child is younger
than 3 months, is too nauseated or sick to take oral medicines, or has an
impaired immune system, the doctor may give your child a shot of antibiotics. Or your child may need a brief hospital stay and a
short course of
intravenous (IV) antibiotics. After your
child's fever and other symptoms improve and your child is feeling better, the
doctor may prescribe oral antibiotics.
The number of days a child will need to
take these medicines depends on the illness, the child's age, and the type of
your child's urinary tract infection (UTI) does not improve after treatment
with antibiotics, your child needs further evaluation and may need more
antibiotics. Your child may have a structural problem that is making
the infection hard to treat. Or the cause of the infection may be
different from the types of bacteria that usually cause UTIs.
the infection spreads and affects kidney function or causes widespread
infection (sepsis), your child may be hospitalized. These
complications are rare, but they can be very serious. Children with impaired
immune systems, untreated
urinary tract obstructions, and other conditions that
affect the kidneys or bladder are at higher risk for complications.
Recurrent UTIs increase the risk of long-term kidney damage and
high blood pressure. The doctor may prescribe
preventive antibiotic therapy after treatment for a first UTI if your child has
a structural problem, such as vesicoureteral reflux, that increases the risk of
repeat infections, or if your child has a few UTIs in a 6- to 12-month
Urinary tract infections (UTIs) are hard to prevent in children who seem to get them
easily. The doctor may prescribe
antibiotics to prevent repeat infection while waiting
for test results after your child's first UTI. If test results show
abnormalities of the urinary tract that raise the risk for repeat infections,
the doctor may recommend long-term antibiotic treatment.
evidence suggests that
breast-feeding may help prevent UTIs during the first
6 months of life.footnote 1, footnote 2
After learning to use the toilet, some children may not empty their
bladders often enough. Without regular bladder emptying, which flushes out the
germs in urine, children may be more likely to get a UTI. Encourage a schedule
of bladder emptying to help lower this risk. Offer your child drinks (such as
water) throughout the day. Drinking enough fluids fills the bladder and can
help your child empty the bladder more often.
also put a child at risk of a UTI. Regular toileting habits and a
nonconstipating diet are the best ways to prevent constipation. For more
information, see the topics
Constipation, Age 11 and Younger and
Constipation, Age 12 and Older.
diagnosis and early treatment are the most important steps in preventing
UTI-caused kidney damage. Periodic urine cultures during the first year after a
child's first UTI and for children at risk for recurrent UTIs can help detect
infections before they do serious damage.
Starting home treatment at the first
signs of a
urinary tract infection (UTI) in your child may
prevent the problem from getting worse and help clear up your child's
Note: Remember that home treatment
is not a substitute for professional care and evaluation. If you think your
child may have a UTI, a doctor should see him or her right away.
antibiotic medicine usually is effective in treating
urinary tract infections (UTIs). In many cases, if the
urinalysis suggest a UTI, the doctor will start
medicine without waiting for the results of a
The doctor may give
intravenous (IV) antibiotics if your baby is:
The doctor will stop the IV medicine and begin oral
medicine treatment after your child is stabilized and feeling better.
To prevent kidney damage
that can result from recurrent infection, the doctor may prescribe long-term
treatment with antibiotics for children who are at risk for repeat
infections. The doctor may consider preventive antibiotics:
Preventive treatment may last from several months to
several years. Experts disagree about the best approach. Some doctors believe
that long-term use of low-dose antibiotics can safely prevent UTIs in
children, especially in children who have vesicoureteral reflux. Whether long-term antibiotics prevent kidney damage needs more study. Some doctors are more hesitant about prescribing antibiotics for
long-term use because of increasing concern about the growth of
Antibiotics are used to kill the bacteria that cause
Give your child the antibiotics
as directed. Do not stop using them just because your child feels better. Your
child needs to take the full course of medicine. Your child may begin to feel
better soon after starting the medicine. But if you stop giving your child the
medicine too soon, the infection may return or get worse. Also, not taking the
full course of medicine encourages the development of bacteria that are
resistant to antibiotics. This makes antibiotics less effective and future
bacterial infections harder to treat.
Surgery is not used to treat
urinary tract infections (UTIs) in children.
is a problem with the structure of the urinary tract that is causing frequent,
severe infections and increasing the child's risk of long-term complications,
the doctor may consider surgery to correct the problem. For instance, children
vesicoureteral reflux may benefit from surgery. For
more information, see the topic
Vesicoureteral Reflux (VUR).
There is no other treatment for
urinary tract infections (UTIs) in children at this
Shortliffe LMD (2012). Infection and inflammation of the pediatric genitourinary tract. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 4, pp. 3085–3122. Philadelphia: Saunders.
Elder JS (2011). Urinary tract infections. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 1829–1834. Philadelphia: Saunders Elsevier.
Other Works Consulted
Hannula A, et al. (2012). Long-term follow-up of patients after childhood urinary tract infection. Archives of Pediatric and Adolescent Medicine, 166(12): 1117–1122. Also available online: http://archpedi.jamanetwork.com/article.aspx?articleid=1378179.
ByHealthwise StaffPrimary Medical ReviewerJohn Pope, MD - PediatricsSpecialist Medical ReviewerAvery L. Seifert, MD - Urology
Current as ofSeptember 9, 2014
Current as of:
September 9, 2014
John Pope, MD - Pediatrics & Avery L. Seifert, MD - Urology
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