A: Stephanie, thank you for your question about urinary tract infections. Urinary tract infections are not that common, but they affect at least 1% of infants and it’s important to get prompt diagnosis and careful treatment and follow-up.

Infections of the urinary tract—kidneys, bladder, and urethra—are caused by bacteria getting into the urinary system either from the urethral opening (where your baby pees from) or from the bloodstream leading into the kidneys. Urinary tract infections are particularly common in girls because their urethra is so short and close to their anus, so it’s easy for bacteria from the stool to get into the urethra. They are also more common in boys who are uncircumcised. Sometimes, urinary tract infections run in the family due to inherited abnormalities in the urinary system.

To help prevent urinary tract infections, always wipe girls— bottoms from front to back—and teach them to wipe themselves that way when they’re toilet learning. For girls and boys, it’s best to avoid using perfumed soaps or bubble bath which can irritate the urethra.

Signs of urinary tract infections in infants are foul-smelling or bloody urine, fever, and extreme fussiness. Older children might complain of tummy pain, pain with urination, and having to urinate more often; or they might have a urine “accident” after they’ve already been toilet-trained.
If your child has signs of a urinary tract infection, the doctor will take a urine sample and do a urinalysis and urine culture. If a urinary infection is diagnosed, antibiotics are prescoted to treat it. For infants and young children with urinary tract infections, doctors commonly recommend further testing to determine the cause of the infection—this could involve a blood test, ultrasound, x-rays, and special renal scans. If these tests identify urinary tract abnormalities, your child would be referred to a pediatric urologist for evaluation and treatment which might involve continuing antibiotics to prevent infections and possibly surgery.