Recurrent UTIs In Children: Doctor Shares Risks And Simple Preventive Measures

Urinary tract infection is an infection in any part of the urinary system, which includes the kidneys, bladder, ureters, and urethra. In most people, the infections happen in the lower urinary tract, which is the bladder and the urethra. While women have a higher risk of experiencing UTIs than men, winter increases the risk all the more. UTIs increase in winter due to poor hydration which causes less bacteria to be flushed out, weaker immunity and less activity which slows waste removal.

Not just women, children too tend to suffer from UTIs. Speaking to NDTV, Dr Ashwin Shekar P, Consultant Pediatric & Transitional Urologist, Asian Institute of Nephrology and Urology Hyderabad, said that it affects up to 8.4 per cent of girls and 1.7 per cent of boys within their first six years of life. "Most children who have one UTI will not have another. However, some children will unfortunately end up having recurrent UTIs. In fact, up to 30% of paediatric patients (aged < 6 years) will have recurrence of UTIs. Recurrent UTIs should be taken seriously, because the risk of long term health issues increases with each subsequent infection."

Symptoms of UTIs in Children

Here are some symptoms of UTI in infants, babies and toddlers.

• Fever
• Belly pain or fullness
• Strong, foul-smelling pee
• Weight loss
• Irritability
• Vomiting
• Poor feeding
• Fatigue
• Yellowish skin or eyes
• Diarrhoea

Here are some symptoms of UTI in older kids.

• A frequent, urgent need to pee, especially if only a small amount comes out when they go
• Daytime accidents or bedwetting after being fully potty trained
• Painful or difficult urination
• Pain or discomfort in their lower belly, back or side
• Pee that smells bad, is cloudy or has blood in it
• Nausea and/or vomiting
• Fever and chills
• Fatigue

UTI Risks in Children

Dr Shekar P shares some of the risk factors that increase the risk of urinary tract infection in children. These include:

• Children who hold urine far too long
• Children who don't relax fully when urinating
• Children who don't empty their bladder completely
• Children who have constipation.

Children suffering from bladder or bowel dysfunction also have an increased risk of UTI. Children with congenital or acquired bladder or kidney problems like urinary tract blockages, dilated urinary tract segments, stones, or elevated bladder pressures are another group at risk of recurrent UTI.

Dr Shekar P adds that a particular congenital (present at birth) condition of concern, called vesicoureteral reflux (where there is backflow of urine from the bladder to kidneys), can contribute to kidney infections. Urine reflux, together with infections from bacteria can lead to pyelonephritis (a urinary tract infection involving the kidney). It can end up in permanent scarring of kidneys. Fortunately, most refluxes improve, or resolve completely when children grow up.

What Happens When Children Have Recurrent UTIs?

Most children who have recurrent UTIs do not develop long-term health issues. However, repeated infections can cause kidney damage, or scarring. Not all children who have infections develop kidney scars. Sometimes, specialised scans are recommended to look for kidney scarring in children with a history of recurrent UTIs. Dr Shekar P said, "In a small percentage of cases, patients may develop chronic kidney disease or high blood pressure hence children who have a history of recurrent UTIs should have blood pressure checks and urine tests for proteins annually."

Managing UTIs in Children

Management of recurrent UTI is individualised and based on identification of underlying cause of his or her UTI, says Dr Shekar P.

In children with bladder and bowel dysfunction, constipation treatment and timed voiding schedules are crucial preventive steps. There is also a role for preventative antibiotics in some patients with recurrent UTIs and high grade urine reflux. Sometimes, urinary tract abnormalities are addressed with surgery. Parents too can follow a few simple steps to prevent UTIs in their child. These include encouraging drinking lots of fluids, timed voiding every 2 to 3 hours to empty bladder, avoiding processed food and increased dietary fibre intake to prevent constipation, keeping the genital area clean and wiping from front to back after a bowel movement or urination in girls.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.