Urinary tract infections (UTIs) are a common cause of acute illness in infants and children.

Types of urinary tract infection

UTIs can be categorised as

• Uncomplicated- the most common type of UTI resulting from a transient infection that quickly resolves without damage
• Complicated- where the cause is due to a dysfunction or disease of the urinary tract such as vesicoureteral reflux and bowel and bladder dysfunction

For a young child, a fever with no apparent cause is consideration for a possible UTI.

Symptoms of a urinary tract infection

Symptoms of a UTI in an infant can include

• Fever
• Irritability and fussiness
• Vomiting
• Poor feeding 
• Lack of energy 

Symptoms of a UTI in an older child may provide more clues including

• Fever or vomiting 
• Burning pain when urinating 
• Increased urge and frequency to urinate including overnight
• Urine that is dark coloured or cloudy, and has a strong smell 
• Lower abdominal (under bellybutton) or back pain 
• Blood in the urine

A word on fevers

A fever is a natural response mounted by our immune system to kill off the cause of the infection. Once the fever has done its job of clearing the infection, your child’s temperature will return to normal. Read more about the importance of fevers here.

Infants under 3 months of age, however, are at high risk of complications from fevers so it is recommended to seek medical attention immediately.

Prompt contact with your healthcare provider is also recommended for a child between 3 and 6 months of age when their

• fever is up to 38.9 degrees and they are unwell
• fever is over 38.9 degrees

How common are urinary tract infections?

In newborns, the rate of UTI infection can vary greatly from 0.7% for full-term infants, 2.9% for premature infants and 4-25% for very low birth weight infants. UTIs are more common in males for the first three months of life, after which females have higher rates. The age range of 1 to 5 years is when children are most likely to experience their first symptomatic infection with occurrence 10 to 20 times more common in preschool aged girls than boys. It is estimated that about 7.8% of girls and 1.7% of boys will have a UTI by the age of 7 and 11.3% and 3.6%, respectively, by the age of 16.

Why are girls more prone to urinary tract infections?

Girls have much shorter urethras making it easier for opportunistic pathogens to enter the urinary tract and up into the bladder.

And girls’ urethra is much closer to their anus where there is a large population of bacteria making it easier for unfavourable translocation of faecal bacteria into the urinary tract. 

What is the most common cause of urinary tract infections?

80 to 90% of UTIs are caused by Escherichia coli (E. coli). E. coli are a normal resident of the large bowel, the lower part of our gut, but some strains called uropathogenic E. coli (UPEC) can find their way into the urinary tract, adapt to the harsh environment there. Latch on to the wall of the urinary tract such as the bladder and cause an infection.

The remaining culprits mainly include other types of bacteria, in some cases viruses and yeasts and in very rare cases even worms.

What increases my child’s risk of a urinary tract infection?

Risk factors for acute UTIs include: 

• inability to completely empty bladder: either due to structural or functional abnormalities
  • the uninterrupted and complete passage of urine out assists in clearing any unfavourable bacteria lurking around   
• transfer of gut bugs found in stools to the opening of the urinary tract
  • for girls- wiping their bottom after a poo from back to front (bottom to vagina)  
  • sitting in soiled nappies 
• gut dysbiosis due to
  • heavy antibiotic use can disrupt the gut bug environment and promote an overgrowth of E.coli leading to gut barrier dysfunction and gut inflammation  
  • chronic constipation 
  • overconsumption of white flour products (bread, pasta, cakes, and sugars coupled with inadequate intake of plant fibres
• A history of maternal UTI during pregnancy can mean a 6 times greater chance of a UTI in their child

Why is my child prone to recurrent urinary tract infection?

Recurrent UTIs are defined as 3 or more urinary tract infections in a 12-month period.

Recurrent UTIs are common in children with vesicoureteral reflux and bowel and bladder dysfunction. It is important that these kids are provided with preventative treatment plans to support their immune systems and gut-urogenital microbial environments.

For those without structural or functional abnormalities, recurrent UTI risk factors include ongoing issues with hygiene, disrupted gut and urogenital microbial environments, and immune resilience.

One very important factor is the ability of bacteria such as E. coli to skilfully embed themselves into the wall of, say, the bladder, and create little community homes with a protective barrier to evade clearance by our immune system. This is a chronic infection and symptoms of a UTI will resurge alongside bouts of sluggish digestion and immunity or stress.

What does a targeted plan with your naturopathic practitioner involve?

We understand that a UTI means your child’s natural antibacterial defences have been overwhelmed and require support to get back up on their feet.

Our priorities include

• getting on top of the current infection and reducing pain and inflammation
• supporting and enhancing the immune response to zap the pathogens
• increasing fluid intake to increase flushing through the bladder and urethra
• ensuring appropriate hygiene is maintained (that means wiping front to back and changing soiled nappies as soon as possible) 
• restoring and supporting a balanced gut and urogenital/ vaginal microbiome
• supporting gut and urinary tract wall integrity and repair
• reducing the risk of reoccurrence

Does this sound perfect for your child?

Get in touch with us today so we can support your child on a path to better health and immunity