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Suspecting A Urinary Tract Infection In Your Infant and Toddler
by Lynn Cates, M.D., F.A.A.P.
reviewed by Laura Jana, M.D., F.A.A.P.
It's easy to tell that a child has a urinary tract infection (UTI) if she feels the need to urinate a lot more frequently than usual, or if hurts for her to pass urine. However, children who get urinary tract infections may not develop these symptoms or may be too young to communicate about them.
General signs and symptoms
It is likely that your child will develop one or more general symptoms when she has a urinary tract infection, including:
- Fever. Fever can vary widely with urinary tract infections. Your child may not have any fever at all, or she may have a high fever and shaking chills. The height of the fever is not a very reliable way to tell what kind of urinary tract infection she has, but in general, the higher the fever (over 102.2 degrees Fahrenheit or 39 degrees Celsius), the more likely she has an upper-tract infection (e.g., infection of the kidneys, also known as pyelonephritis), and low-grade fevers (less than 100.4 degrees Fahrenheit or 38 degrees Celsius) are more commonly found with lower-tract infections (e.g., bladder infections, also known as cystitis).
Approximately 1 out of every 20 children age two months to two years with an unexplained fever will have a urinary tract infection. Since this is the group at highest risk for having undetected urinary tract abnormalities and for developing permanent kidney damage from urinary tract infections, it is very important that their urine be evaluated for infection anytime they have an unexplained fever.
- Looking sick. This may be your only clue that something is wrong-she just doesn't look right.
- Irritability. If your child is irritable, look for signs that she may be particularly fussy when she is peeing.
- Gastrointestinal symptoms. Stomachache, full-blown abdominal pain, vomiting, diarrhea, or a poor appetite.
- Weight loss. This can result from a loss of fluids caused by vomiting and diarrhea or a true loss in body mass from her poor appetite.
- Tired and less active. She may just seem unusually tired and droopy.
- Trouble sleeping.
Urinary tract signs and symptoms
Although signs and symptoms that point to the urinary tract are not always present or may be quite subtle, you might see one or more of the following when your infant or toddler gets a UTI:
- Changes in her pattern of urinating. You may notice she needs to be changed more often (frequency) or, just when you thought your toddler was finally toilet trained, she regressed and started having accidents or wetting the bed again.
- Crying when she urinates. If you notice that it seems to hurt when your child urinates, she may have dysuria (or pain, burning, or stinging when urinating).
- Vaginal redness or irritation. These may be signs of vulvitis or urethritis that can predispose her to an ascending urinary tract infection.
- Hesitation to urinate. Your toddler may be reluctant to pee because she knows it will hurt. This is known as hesitancy.
- A foul odor to the urine. You may notice a strange, new odor to her urine.
- A dark color or reddish tinge to the urine. This may indicate blood in the urine.
- Back or flank pain. These may signify a kidney infection and should be taken seriously and your child's healthcare provider notified-particularly in the presence of a fever or any specific signs of a urinary tract infection.
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Created February 28, 2001
Reviewed March 12, 2001
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