Urinary tract infections in babies
Urinary tract infections (UTIs) are the most common cause of bacterial infection in babies. Studies in the UK show that 2.1% of girls and 2.2% of boys will have had a urinary tract infection by the age of 2. They occur when bacteria enter the urethra into the bladder and kidneys. Sometimes abnormalities in the urinary tract (the organs in the body that filter blood to produce and release urine) can cause urinary tract infections.
What are the symptoms of a urinary tract infection in babies?
It is quite difficult to diagnose a urinary tract infection in a baby. Symptoms are often nonspecific and can include fever, vomiting, irritability and crying, poor diet, drowsiness, poor weight gain or weight loss, and a bloody or smelly diaper.
Should I see a doctor about this?
Yes, any baby with a fever should be seen by a doctor as soon as possible. Consult your GP or go to A&E outside of opening hours. The medical team will perform tests, which include testing your toddler’s urine.
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My baby has been diagnosed with a urinary tract infection – what happens next?
Urinary tract infections in babies can be serious and should be treated with antibiotics. If your baby is less than 3 months old, he will most likely be admitted to the hospital and receive antibiotics, which are often given intravenously. This means that the antibiotics will be injected into your little one’s veins directly into the bloodstream. Babies cannot metabolize antibiotics, which are swallowed, as adults can, so they often need to be given intravenously. Babies over 3 months old can sometimes be treated with oral antibiotics.
Once the infection has subsided, the medical team caring for your little one may suggest further tests. This is for two reasons: First, they will want to make sure that your baby’s kidneys are recovering properly from the infection. Second, urinary tract abnormalities can often be the cause of infections. It is important to look for these abnormalities because there is an increased risk of recurrent infections, if they are not treated.
Your specialists will recommend one or all of the following exams:
Kidney and bladder ultrasound
This is an easy, painless exam where your doctor will examine the size of the kidneys and look for any abnormalities, such as urinary blockages, scarring, or asymmetric kidney growth.
Voiding cystourethrogram (MCUG)
This is a special type of x-ray and looks for vesicoureteric reflux, which is if urine passes from the bladder to the kidneys while your baby pees. The contrast dye is inserted into your little one’s bladder with a very thin catheter. The x-ray then shows what happens to the dye when your baby urinates. In some babies, the dye does not only leak from the bladder outside the body, but also out of the kidneys, putting these children at a higher risk for urinary tract infections. Most babies will come out of this condition, but will need to be covered with a small dose of antibiotics for a longer period.
A DMSA (dimercaptosuccinic acid) scan
This is a test that uses a chemical (DMSA) to look for parts of your baby’s kidneys that are not working or not working at all. This can happen when the kidneys are scarred by previous infections or when a kidney has not worked from birth due to an innate problem. DMSA emits gamma rays, a source of radiation, which is picked up by a special camera. The image will then show the colored parts of your toddler’s kidney that are functioning well and the scarred or defective parts without color pickup.
You can find more information about these tests at https://www.infokid.org.uk.
Can I prevent urinary tract infections in my baby?
Unfortunately, these infections cannot be avoided unless a diagnosis of urinary tract abnormality has been made before the first infection. Before your little one is born, his kidneys will be checked during your ultrasound exams. Urinary tract abnormalities can sometimes be detected during these exams. This is not always the case, so a normal ultrasound before birth does not necessarily rule out infection later.
It is important that you see your doctor if your baby is unwell or has a fever. It’s the best way to help your little one. Having to go to the hospital can be stressful and frightening. Knowing that this is a fairly common condition can help, and the medical staff will be sure to help you and your little one through these difficult times.
Article by Sophie Niedermaier Patramani, pediatrician and doctor of Little Tummy
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