Why Does My Child Keep Getting Urinary Tract Infections and How Can I Prevent Them?

A urinary tract infection (UTI) happens when bacteria (germs) get into the bladder or kidneys. UTIs can be painful and scary for children and their caregivers. UTIs are common in children, especially in girls, and can usually be treated easily if found early.

What Puts a Child at Risk for UTIs?

Some children are more likely to get UTIs. Risk factors include:

• Female Sex: Girls have a shorter urethra (tube through which pee exits the body), so germs can enter the urinary tract more easily.
• Holding urine too long: Not going to the bathroom often can let germs grow in the bladder.
• Not emptying the bladder completely: Some children don’t get all the urine out when they pee. This causes germs to sit and grow in the bladder.
• Constipation/stool retention: Full bowels can press on the bladder and stop urine from flowing well.
• Poor wiping habits: Wiping back to front can bring germs from the anus (where poop exits the body) to the urethra.
• Not drinking enough fluids: Drinking less fluid means your child will make less urine. Less urine means bacteria are not flushed out of the body.
• Structural changes in the urinary tract: Some children are born with differences that affect urine flow.
• Previous UTIs: Children who have had one UTI are more likely to have another.

Signs and Symptoms of UTIs

Symptoms can be different depending on the child’s age. To learn more about UTIs in babies, read this article.

In older children who are potty-trained, UTIs usually cause pain or burning with peeing, needing to pee more often or more urgently than usual, more pee accidents than normal, or cloudy or dark urine. Belly or back pain or fever may indicate that a UTI has spread from the bladder up to the kidneys.

Redness, pain or rash on the outside of the genitals does NOT indicate a UTI but more irritation from moisture, allergies to scents or dyes, or a different type of infection.

Why is my child having symptoms of UTI, but their urine culture is negative?

To have a UTI, a positive urine culture AND symptoms of a UTI must BOTH occur. Some children will have bacteria in their urine when checked, but this usually does not indicate a UTI unless symptoms are present Additionally, symptoms similar to UTI can occur with other conditions like constipation or dehydration. It is important to always have a urine culture checked when UTI is suspected.

How to Help Prevent UTIs

You can lower your child’s risk with simple habits:

• Encourage regular bathroom breaks (every 2–3 hours)
• Teach proper wiping: front to back.
• Make sure your child drinks plenty of water; a good gauge of how much water to drink every day is ½ your child’s weight in pounds in ounces (e.g., if your child weighs 50 pounds, she should be drinking 25 ounces of water daily).
• Make sure poops are regular and soft – daily and “mashed potato” consistency!
• Avoid bubble baths or harsh soaps that may irritate the area.
• Have your child wear loose cotton underwear and change underwear when wet.
• Put feet flat on the floor or a stool as well as spreading legs wide with urination when sitting to encourage fully emptying the bladder.

When Should Your Child See a Urologist?

Most UTIs can be treated by your child’s primary doctor. A referral to a urologist (a urinary tract specialist) may be needed if your child:

• Has repeated UTIs
• Has a UTI along with high fever or kidney infection
• Does not improve with antibiotic treatment
• Has an abnormal kidney and bladder ultrasound or known urinary tract condition
• Has trouble emptying the bladder

In these cases, thorough review of peeing and pooping habits will occur and additional testing like ultrasound of the kidneys and bladder may be recommended.

UTIs are common but treatable and usually don’t cause long-term problems when treated early. Healthy bathroom habits and good hygiene can go a long way in keeping your child’s urinary tract healthy.