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Understanding UTI in Toddlers & Treatment Approach For A Pediatrician

UTI in toddlers

UTI in children: Causes, Symptoms, Treatment & When to Seek Help


While urinary tract infections in children are not common, they can still get them. It is also more likely for a UTI in toddlers to progress to kidney damage than for an adult, so it’s important to be aware of the signs to look out for and to be educated on ways to prevent further infection in your child. UTIs are easily treated but can lead to or be a sign of more serious problems, so make sure to see a doctor to prevent any lasting impact on your child’s health. 


UTIs can be caused by bacteria from the stool in their dirty diapers. This is why it’s important, especially in girls, to always wipe front to back and not back to front. Infants might also get UTIs if there is a problem with the anatomy of their kidneys or the ureters, which are the tubes that bring urine from the kidneys down to the bladder. In other cases, there can be a backflow of urine from the bladder back up to the kidneys during urination known as vesicoureteral reflux (VUR). 


UTI can happen during potty training when children are learning to hold urine. Holding their urine too long can give bacteria space and time to grow into an infection in the bladder. Sometimes UTI can present more commonly in children who have constipation because for these children dry stool particles can remain along the buttocks and then sometimes get wiped up to the front causing the bacteria to contaminate the urethra (the tube through which urine leaves the body). UTIs are more common in girls than boys because they have a shorter urethra that is closer to the anus. This is another reason girls should be trained to wipe front to back after urinating, even if they haven’t had a recent bowel movement. 


UTI in kids can also occur in hot summer months when children are not drinking enough water. If they’re not getting enough fluids to effectively flush their bladder, bacteria can accumulate, which can lead to an infection.



They do not always show clear-cut symptoms of urinary tract infections. They might have a high fever or chills and get fussy, but sometimes they may just have a high fever and not become fussy at all. Their symptoms might include crying with urination, vomiting, or diarrhea, along with fussiness and fever. Infants and younger toddlers won’t be able to tell you if they have a tummy ache or a backache as the infection begins to move up from the bladder through the ureters to the kidneys. Once infection reaches the kidneys, this becomes dangerous because it can lead to permanent kidney damage, so it’s important to get your child treated early. 


In addition to the symptoms described above in younger kids, older children might express burning with urination or hurting when they pee. Other signs are frequency (having to run to the potty every few minutes), or urgency (not making it to the potty on time), leading to urine accidents in their underpants. They may start wetting the bed at night after having been dry at night for months. You might also notice that when they urinate they can’t pee in a strong stream, but instead dribble out small amounts. This is called hesitancy. Other symptoms can be a strong odor, cloudy appearance, or even blood in your child’s urine. 


 If you prefer, the video above also talks about how I typically diagnose UTI symptoms in kids and what I do to treat it.

The first thing I do when it comes to diagnosing if your child has a UTI is talk to you, the parent, and take a good look at how your child is acting. What symptoms are you concerned about? How long have the symptoms been going on? What have you already tried at home? Is your child happy, playful, and bouncing off the walls? Are they looking sick or pale with fever and lying in your lap? Assessing the situation and the sequence of events helps me figure out what needs to happen next. 

If the facts seem to point towards a urinary tract infection (sometimes the facts indicate another cause of the symptoms), it is important to get a urine sample and check it for bacteria or certain cellular components that might indicate there is bacteria in the urine. For kids who are potty trained, a clean catch urine specimen is sufficient and nowadays over-the-counter dipsticks are even available in local pharmacies. 

Depending on how old your child is or if UTIs are recurring, I might decide to order certain studies that are important to make sure there are no anatomic abnormalities predisposing your child to UTIs or subsequent kidney damage. These might include a kidney ultrasound or a VCUG to make sure there is no urine back flowing from the bladder up towards the kidneys. These studies would take place after your child is feeling better from their current infection.

 In the tiniest of babies, my colleagues and I are trained to be extremely conservative. For example, when young children under the age of 3 months have a fever higher than 100.4° Fahrenheit, I recommend a comprehensive work up that takes place in your local emergency room which will include getting a clean urine sample through a catheter to make sure your baby doesn’t have a UTI. Even in older infants & toddlers who aren’t potty trained yet, a catheter urine sample may be required at times to make sure there is no infection of the urine. 

A urinary tract infection has to be treated with antibiotics. It will not go away on its own. At home, parents might try to flush the bladder with cranberry juice or increased fluid intake, but the bacterial infection has to be cleared out before it gets big enough to start moving back to the kidneys and create the damage we talked about above. Symptoms often begin to resolve within 24 to 48 hours of being on antibiotics, but it’s always important to finish the full course of antibiotics so that small amounts of bacteria don’t remain behind and create harm, or come back as an infection again.


In girls, there can be a confusion of whether symptoms are related to a UTI or if they are just experiencing external vaginal irritation. 

Girls can get easily irritated in the vaginal region from a number of things, such as: 

  • Bubble baths and bath bombs 
  • Tight-fitting clothing like leotards, leggings, and tight jeans that create heat and moisture in the vaginal region 
  • Use of scented, fragranced soaps or detergents that can be irritating 
  • Staying long periods of time in wet bathing suits 
  • Poor wiping and stool contamination as discussed above

When there is vaginitis or external irritation, there are things that can be done to help soothe that external irritation, including sitting in a baking soda sitz bath. To do this, simply put 3-4 tablespoons of baking soda in a bathtub of lukewarm water and have your child sit in it for 10 to 15 minutes. It also helps to wear loose-fitting cotton underwear or shorts to help air out the region. If this still doesn’t resolve the symptoms of burning, frequency, hesitancy, or urgency, or if these symptoms are accompanied by a fever of more than 100.4° Fahrenheit at any point, it is important to be seen by a doctor to check for a possible UTI in kids. 


Thes following symptoms indicate things might be getting worse:

  • Your child already had minimal discomfort in the genitourinary region and now has developed a fever greater than 100.4° Fahrenheit. 
  • Symptoms progress to vomiting, diarrhea, or loss of appetite. 
  • Your child is tired, looks pale, or doesn’t want to play. 
  • Your child is complaining of lower abdominal pain or exquisite pain in the middle of the back.
  • You notice blood in the urine.


  • The only absolute way to diagnose a urinary tract infection is to collect urine and test it for the presence of leukocytes, nitrites, and bacteria. 
  • During the pandemic, telemedicine helped a number of young children with urinary tract infections through the help of over the counter urine dipsticks. In recent years, these dipsticks have become available to check for leukocytes & nitrites, the two abnormal cellular findings that indicate a urinary tract infection more than 99 percent of the time. 
  • Sometimes, we are able to talk about the symptoms in a telemedicine visit, take a look at the child to see if they are ill appearing, and examine the belly with the help of a parent. Subsequently, an experienced medical professional might prescribe antibiotics if they feel it is necessary based on the child’s history and the clinical exam.


Below are some tips to help your child before you get to your appointment with the pediatrician. This applies to toddlers and older children only. A parent should seek more immediate medical attention if an infant under the age of one has concerning symptoms like high fever and fussiness.

  • If it’s the middle of the night, you might give your child a dose of Tylenol to help their pain. 
  • You might increase fluid intake; it does not have to be cranberry juice. Even increased water intake will help flush the bladder to minimize the accumulation of bacteria. Caffeinated drinks and sodas will not help in this situation. They can actually make things worse by irritating the bladder. 
  • You might try a warm baking soda sitz bath, as we discussed above, to help ease any irritation of the urethra and relax pelvic muscles. If your child has been hesitant to pee on the potty because it is burning or hurting them, sitting in a warm bath like this might actually help the child’s muscles relax and make them urinate in the bathtub itself.


UTIs quickly resolve if treated appropriately, but can lead to serious problems in young children if not identified in a timely and effective manner. When in doubt, ask your doctor. It can be hard to know what is causing your child discomfort, especially when they’re too little to talk. Always trust your instincts and consult your pediatrician when you suspect something is wrong. Our Best Pediatrician in Irvine is available to help ease any concerns you may have and guide you on what steps to take next. 

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