URINARY TRACT INFECTION IN BABIES AND PRE-SCHOOL CHILDREN

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1 URINARY TRACT INFECTION IN BABIES AND PRE-SCHOOL CHILDREN Information Leaflet Your Health. Our Priority.

2 Page 2 of 5 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 Generally off colour Mottled skin Unusually high or low temperature

3 Page 3 of 5 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 clean 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. Rarely, if a child is very unwell or the specimen is difficult to collect, a catheter specimen maybe collected. 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.

4 Page 4 of 5 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 approximately 6 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 gut germs 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. Contact us Brambles Acorn Rainforest Outpatient department

5 Page 5 of 5 If you would like this leaflet in a different format, for example, in large print, or on audiotape, or for people with learning disabilities, please contact: Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: [email protected]. Our smoke free policy Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free NHS Premises' to find out more. Leaflet number PAED54 Publication date January 2016 Review date January 2018 Department Paediatrics Location Stepping Hill Hospital