Urinary Tract Infection

Urinary tract infection is a common illness among children. It occurs more frequently in girls than in boys. This is because the urethra isvery short in girls, thereby allowing bacteria to easily enter into the urinary tract. The urinary tract consists of kidneys that removes the waste from the blood, ureters that carry urine from the kidneys to the bladder, urinary bladder where urine is stored and the urethra which carries the urine from the bladder to the outside of the body. Bacteria enters into the urinary tract through urethra which is contaminated with stools. Bacteria may also be carried to the kidneys from another part of the body through the bloodstream and infect other areas of the urinary tract. The bacteria may cause infection in any of the three areas of the urinary tract. The infection may be in the urethra, the bladder or in the kidneys. The most commonly infected area is the bladder.

Symptoms

Infection in the bladder usually manifests with symptoms like lower abdominal pain, pain during urination, frequent urination, blood in the urine and fever. Infection in the kidneys is shown by symptoms like more general abdominal pain, back pain and high fever. Chronic urinary tract infection is suspected if your child shows vague symptoms. Therefore in such cases, you must consult your paediatrician immediately and a urinalysis also should be performed. For many babies, an inexplicable fever is the only symptom and only a urine analysis will reveal the presence of infection.

Diagnosis and Treatment

Urinalysis is the clear-cut method to diagnose this infection. Once a diagnosis of a UTI has been made the doctor will also ask for a urine culture. This test will help the doctor know exactly which micro-organism is causing the infection and to which antibiotics it will respond. For very young babies the urine for a culture may have to be collected by putting a needle or tube (catheter) into the bladder and removing some urine. For older babies and children it is recommended to first clean the genitals with plain water and then collect a mid-stream sample, ie. allow the first few drops of urine to escape and then start collecting. Do be very careful to not allow your fingers or any part of the child’s body to touch the urine or the inside of the container – this is very important to ensure accurate results.

Once your child is found to have a UTI, the doctor will prescribe an antibiotic for ten days or two weeks. After a course of the antibiotic, another sample of urine will be taken to test for the effectiveness of the prescribed antibiotic. Even if your child feels relieved after a few days of medication, you have to continue it for the full course. Otherwise, the bacteria may grow again, causing further infection and more serious damage to the urinary tract. Treatment of urinary tract infections are easy. But if they are not treated, they may lead to permanent kidney damage and even kidney failure.

Prevention

Certain measures can be taken to minimize the risk of your child being infected in the urinary tract. If your child has the problem of constipation, she is likely to be affected by urinary tract infection. So, to prevent both constipation and urinary tract infection, give your child a lot of fluids. The fluids will help your child to urinate more frequently, which cleanses her urinary tract. For older children, who have started taking solid foods, give lot of fruits, vegetables and whole grains to prevent the infection. Breast feeding for a long period, up to at least 1 year protects the child against the infection. It is true even for babies up to 2 years. For a girl child, take care that her genitals are not irritated during bath time, with the kind of soap you use, and the way you handle the area like bubbling it with too much of soap. Wipe from front to back after a bowel movement or while changing her diaper, to prevent infection. Change your baby’s diaper frequently and immediately when it becomes wet, to avoid her genitals staying wet for a considerable time. Do not allow your child to sit over the faeces, for there is the risk of urethra being contaminated. Train your child to empty the bladder regularly, which helps in flushing out the bacteria.

Vesicoureteric reflux

Some children affected by urinary tract infections face a condition called vesicoureteric reflux. It is a condition where the flow of urine is in the reverse direction. Normal flow of urine is from the kidneys to the bladder through the ureters. This normal flow is regulated by the muscles of the bladder and ureters and by the pressure of the urine in the bladder. But when the child faces this reflux condition, flow of urine is from the bladder back to the kidneys. When such reflux occurs, an abnormal amount of urine remains in the bladder, where the bacteria multiply and reach the kidneys and cause damage to the kidneys.

If the reflux is mild, there is a strong possibility of it improving with age and can also be managed with preventive antibiotics. In severe cases, surgery may be recommended by the doctor.