Understanding urinary tract infections in children

Written by: Dr Kishor Tewary
Edited by: Nicholas Howley

Why do children get urinary tract infections – and can they be treated? We spoke to Dr Kishor Tewary, an experienced consultant paediatrician with a special interest in urology and nephrology.

Are children more prone to urinary tract infections than adults?

Children are more prone for UTI than adults – and this is mainly because of a few anatomical factors and a few physiological factors:

  • UTI is more common in boys less than six months because of malformations of kidneys or vesicoureteral reflux, which are common in males at that age.
  • After six months the girls take over because the urethra is quite short and in proximity with the back passage. When there is a lack of hygiene – such as back to front wiping – the germs can easily be brought into the front passage and cause a UTI.

Can urinary tract infections be treated?

Urinary tract infections absolutely can be treated – so it’s important to visit the doctor if you suspect your child has one.

To diagnose a UTI child may go through three types of investigation:

  • An ultrasound of the kidneys
  • A type of nuclear imaging called a DMSA scan, which picks up kidney scarring
  • An MCUG (micturating cystourethrogram), where we put a dye through a catheter in the bladder and check if there is any urinary reflux going back towards the kidneys

Treatment usually involves antibiotics. This can be given orally or intravenously, from three days up to two weeks, depending on three factors:

  • the age of the child – treatments depends on whether your child is 0-6 months, 6 months – 3 years, or over 3 years old
  • where the UTI is located – a UTI towards the kidneys is treated differently to one that is in and below the bladder
  • the type of UTI a simple UTI is caused by a germ called E. coli which responds to antibiotics within 48 hours of initiation, a recurrent UTI involves two or more episodes of urinary infections, and an atypical UTI is anything else

How can I prevent a UTI in my child?

The most important precautions you can take are to make sure your child has:

  • a regular liquid intake
  • regular bladder habits – they empty bladder every two to four hours
  • good hygiene – showers/bath every day to make sure that the front part is clean

Finally, it’s important to avoid constipation – because that can cause residual urine in the bladder and that can breed the germs. With these simple steps your child should be able to avoid most urinary tract infections.

By Dr Kishor Tewary

Dr Kishor Tewary is an experienced consultant paediatrician, with a special interest in paediatric urology and nephrology, treating conditions such as bedwetting, urinary incontinence, urinary tract infections and hydronephrosis. He also treats a wide range of general paediatric conditions including abdominal pain, gastric reflux and asthma. Dr Kishor Tewary is based across the Midlands, in both Birmingham and Solihull.

Dr Tewary qualified in 1987 and went on to gain paediatric training with the NHS, becoming a consultant and Fellow of the Royal College of Paediatrics and Child Health in 2007. He continues to further his clinical knowledge, and attends many conferences internationally, most recently presenting at the International Congress of Paediatrics in Athens. Dr Tewary has had many years of experience as a paediatrician, and as a result, he understands children and their parents very well, ensuring the whole family is involved in the process.

Dr Tewary is regularly involved in educational activities, and has also recently featured on ITV speaking on the issue of Children and sleep disorders.

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