URINARY TRACT INFECTION IN BABIES AND PRE-SCHOOL CHILDREN - Information Leaflet

URINARY TRACT INFECTION
IN BABIES AND PRE-SCHOOL
CHILDREN
Information Leaflet

Your Health. Our Priority.

www.stockport.nhs.uk         Paediatrics, Tree House | Stepping Hill Hospital

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What is the Urinary Tract?
The urinary tract consists of the kidneys and the tubes which carry urine to the bladder
(ureters), the bladder and the urethra (see diagram). Urine is made in the kidneys, drains down
the ureters into the bladder. When the bladder squeezes urine is pushed out through the
urethra.

What is a Urinary Tract Infection (UTI)?
Urinary tract infection occurs when germs (bacteria) get into the urinary tract and can be found
in the urine. This happens more often in girls than boys because the urethra in girls is very short
and its opening is close to the anus, allowing germs that are usually present in the bowel to get
into the urine up the urethra.

Why do children get urine infections?
There are lots of reasons, although in the majority of children we do not identify a particular
cause. Sometimes there are problems with the plumbing of the urinary tract, which means urine
stays in the system longer than it should and allows germs to collect.

What are the symptoms and signs of a UTI?
In the very young baby, the symptoms of a urinary tract infection are non-specific and may
include:
 Poor feeding
 Floppiness
 Jaundice
 Vomiting

www.stockport.nhs.uk                              Paediatrics, Tree House | Stepping Hill Hospital

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   Generally off colour
   Mottled skin
   Unusually high or low temperature

In older children the symptoms may be more obviously related to the urinary tract and might
include:
 Pain or burning on passing urine
 High temperature
 Tummy or loin (lower back) pain

How is a UTI diagnosed?
To diagnose a UTI a specimen of urine must be collected. This can often be difficult in babies
and young children because a ‘clean’ catch specimen must be obtained.

The urine sample is stick tested on the ward, which can tell us whether a UTI is probable. It is
then sent to the pathology lab where the numbers of white cells are counted to confirm the
presence of germs. The urine is then cultured to grow the germ in the urine and to test which
antibiotic is best to treat it. This takes 24 - 48hours.

How is a specimen of urine collected?
If we suspect your child/baby has a UTI we will usually collect two separate urine specimens.

This will involve washing the nappy area/perineum thoroughly with soap and water or baby
wipes and drying well.

Baby: A clean catch can be obtained by positioning a container under your baby to catch the
urine. If a specimen has not been collected after an hour the skin will be cleaned again and the
container replaced.

Toddler: a container can be placed in a potty

Older children: if possible a mid stream urine will be collected by holding the container under
the child while they pass urine on the toilet.

A minimum of a teaspoon (5mls) is required.

Occasionally a sterile adhesive bag maybe used if the specimen is difficult to obtain.

www.stockport.nhs.uk                              Paediatrics, Tree House | Stepping Hill Hospital

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How is a UTI treated?
A urine infection is treated with antibiotics which can be started before the urine has been
cultured. These are usually given by mouth but if your child is very unwell or vomiting the course
can be started intravenously (through a small plastic tube inserted into a vein). It is important
your child completes the course. Untreated infections can cause damage to the urinary tract
and kidneys.

When the antibiotic course is completed you will need to collect another urine sample one week
later to check the infection has gone. We will give you the necessary equipment and the sample
can be dropped off at you GP or at the pathology labs in the hospital.

After the treatment course of antibiotic is completed, some babies will need to take a low dose
of antibiotic at bedtime to keep the urine free of infection until some outpatient tests have been
carried out. It is important you keep going with this until you have been seen by the
paediatrician in the outpatient department. Your GP will provide a repeat prescription.

What happens next?
In babies and some younger children if a urinary tract infection is confirmed, tests may need to
be done as an out-patient to exclude any abnormality of the urinary tract and that the infection
has not caused any damage. You will be given a leaflet explaining the tests and will be sent
appointments for these in 8-10 weeks.

If no abnormalities are found the paediatrician may stop the night time antibiotic. Only stop the
antibiotics when advised to.

Can my child have another UTI?
It is possible to have another UTI. If your child becomes unwell with the same symptoms then
you will need to take him/her to your GP as soon as possible. Take a sample of urine if
possible.

To help prevent another UTI, avoid using scented soaps or bubble bath in the bath. Once out of
nappies your child should wear cotton underwear and encourage girls to wipe themselves from
front to back to help avoid bacteria entering the urethra. Encourage your child to drink plenty
during the day and eat a healthy high fibre diet to prevent constipation which can lead to
repeated UTI.

www.stockport.nhs.uk                              Paediatrics, Tree House | Stepping Hill Hospital

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Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: 0161 419 5678
Information Leaflet. Email: PCS@stockport.nhs.uk.

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Leaflet number         PAED54
Publication date       May 2013
Review date            December 2015
Department             Paediatrics, Tree House
Location               Stepping Hill Hospital

www.stockport.nhs.uk                           Paediatrics, Tree House | Stepping Hill Hospital