Dr. Lisa Thornton, a
mother of three, writes the Health Matters monthly
column for Chicago Parent as is the voice behind "The Doctor is In," a Chicago Parent
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A urinary tract infection (UTI) is pretty unusual
in a child, but they occur about four times as often in little
girls as in little boys. In fact, they are so uncommon in boys that
a single infection will typically require further exploration to be
sure there isn't a more serious problem.
Urine is constantly being produced by the kidneys and
drips down two tubes into the balloon-like bladder. It is kept from
leaking out with the help of a "sphincter," a strong muscle at the
opening of the bladder. When the child feels the urge to void, she
will voluntarily relax the sphincter and urine will flow
In its normal, healthy state, the bladder doesn't contain
any germs. When germs get into the bladder, they cause a UTI called
cystitis. Sometimes the germs can move from the bladder to the
kidneys and cause a kidney infection, which is more serious and is
often accompanied by a fever.
UTIs are more common in little girls who take bubble
baths, wear tight-fitting clothes and wipe from back to front
(which carries germs from the anus toward the urinary system). They
also are seen in children who hold their urine. In some of these
children, the sphincter becomes less responsive, which can lead to
A UTI can cause pain in the lower abdomen, burning during
urination, foul-smelling or cloudy urine, the need to pee more
often and trouble "holding it." In very young children, the
symptoms of a UTI aren't always easy to detect. Sometimes the only
symptoms in a baby are nausea, vomiting, irritability, low-grade
fever, and decreased appetite, but there are many other more common
infections that should be considered first.
The only way to know for sure if a child has a UTI is to
test a sample of urine, which is looked at immediately to give an
early diagnosis, but then is sent to a lab where the germs can be
grown in a culture medium. This can take a couple of days. In the
meantime, the doctor may put the child on an antibiotic. UTIs are
usually very responsive to antibiotics and the child will feel
better in a day or two, but it's important to take all of the
medication as directed or germs left behind can cause another
To avoid a UTI, children should be encouraged to wipe
front to back, avoid tight clothing, avoid frequent bubble baths,
and urinate when they need to. In other words, don't "hold
Dr. Lisa Thornton, a mother of three, is director of pediatric rehabilitation at Schwab Rehabilitation Hospital and LaRabida Children’s Hospital. She also is assistant professor of pediatrics at the University of Chicago.
See more of Dr. Thornton's stories here.
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