Urinary Tract Infections in Children
Archived Q&A and Reviews
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Recurring Urinary Tract Infections in 5yr. old
Jan 2009
I have read all of the postings in BPN about UTI's. I still felt I needed to post my request for advice in our own particular situation: My daughter who is 5 years old has had recurring UTI's for a least one and a half years. What happens is not that she complains of pain when she urinates, but rather I notice her touching her vagina a lot. When I ask her what is going on, she says her vagina is ''itchy.'' Sure enough, it turns out to be another UTI.
We have been through all the standard tests, the ultrasound, the VCUG, and all have been normal, which is reassuring. However, she just cannot seem to kick these infections. We have tried everything that anyone ever recommends; no soap in baths, lots of cranberry juice, lots of water, lots of peeing, tips on proper wiping etiquette, etc. It has become a very big issue, unfortunately, although we tried not to make a big deal about it at first. She is at the age where she should know when to go to the bathroom when she feels the urge, but I am afraid she does not always do so, because she doesn't want to stop whatever activity she is doing. We have talked her through this time and time again, and I'm beginning to feel like a broken record. However, there is no real way to know whether this is at all due to her behavioral immaturity, or whether it is purely a physical limitation that she will grow out of.
Fortunately her pediatrician is very empathetic because her own daughter had the same problem years ago for about a year, and she just grew out of it. The problem is that I absolutely HATE to keep giving her antibiotics, but it seems to be the only thing that really works. Unfortunately, though we have to give her two additional medications just to treat side-effects from the antibiotics; antihistimine for skin itchiness, and creams for yeast in her vagina EVERY DAY. It is such a huge pain in the A-- for all of us, her included. We have also tried homeopathy to no avail. Mostly, I just feel sorry for her and want to make it go away.
We are in the process to get a 2nd opinion from a different urologist. The first one told me that it was probably due to constipation, but I do not think that is the problem, because my daughter's bowel movements are quite regular.
I'd love some advice, or support, or whatever.
Thanks, -Peeved
I feel for you. My daughter had this problem and I have two suggestions -- one reassuring, one decidedly not. On the reassuring side, the antibiotics are not ideal, but dealing with the infections is important because it can be painful and dangerous if you don't. My daughted ended up on an prophylactic dose of antibiotic for years and that kept the infections at bay, and although I worried about it, it really did turn out fine and worth it. On the not reassuring side -- I hate to bring this up -- in my daughter's case, after years of this 'mystery', it turned out to be caused by sexual abuse. In retrospect, I was shocked no doctors ever mentioned it. It turned out to be the only ''sign'' that was available to me when she was very young. I hope that is not the case for you, but given that doctors don't seem to mention it, I thought it important someone does. anonymous this time, definitely
I used to get a lot of UTIs as a child and adult, and as a result, did what I could to look up reasons for it. SO, here are a few things that come to mind. One, just make sure she is wiping in the right direction after she goes to the bathroom-- front to back. (I'm sure you're already trying to encourage that with her.) The second, is that she may be allergic to fragrances. That is what I found to be my problem--once I switched to a fragrance free, non-allergenic soap--Dove has a version of this--I have been free and clear. If she is taking baths with bubbly bath/fragrant soap, this could definitely be an issue. The other reason is that it could be food related. Spinach, for example, produces a protein that helps proflagate the bacteria already present for UTIs. Of course, if she's eating tons of spinach, I'd be impressed! But it could be other foods as well. Anyway, I wish you luck with finding an answer! Sarah
Urinary tract reflux surgery on my 3 yr old son
November 2006
My son, it appears, was born with a congenital abnormality in his kidneys and was diagnosed with urinary tract reflux after a few invasive tests. We are now at the point where surgery is the next step. Our urologist informed us about an endoscopic procedure to try to correct the reflux and also told us about the open surgery which can take care of the reflux with a higher success rate than endoscopic treatment. Does anyone have recent similar experiences? Pain afterwards or trauma urinating for the child? I just want to hear about people who've already dealt with it. My son's starting to be very afraid at the mention of seeing a doctor.
Our son also has a urological problem which could be repaired by laparoscopy or open surgery. We have chosen the open repair because of the increased success rate, and the fact that the laparascope still requires 4-5 1cm incisions. The open surgery is one 3-4cm incision- so the difference is really negligible. As our child grows the scar will appear proportionally a lot smaller. In adults, laparascopic surgery recovery time is much less than open surgery. However, in children, it seems that the recovery is just about the same. Best of luck with your decision another mom
Hi - I have a suggestion for you if you are interested in trying a non-western route to solve your son's problem. Have you heard of Visceral Manipulation? It's a horrible sounding name, but basically it is a technique developed by a french osteopath, where practicioners have uncanny knowledge of the internal organs and can gently work with your body to bring about healing and restore your body to better health. There is an amazing practicioner who has been doing various body work techniques for 30 years and VM for over 15. His name is Michael Wagner and he is a wonderful man and a master at what he does. He has an office in Albany and in Marin. I'd give him a call and ask him what he could do for your son. 415-457-6392 Good luck! Sirena
Five-year-old son with urinary tract infection
June 2006
My 5 year old son was just diagnosed with a urinary tract infection. Despite not being thrilled to put him on antibiotics, I didn't worry too much about it. This morning, a friend advised that at age 6, her son had a UTI. Her doctor told her that they're quite uncommon in boys and ordered further testing which revealed that his ureter was backing up into his kidney causing damage. His kidney had to be removed. Obviously, I'm trying to follow up with my son's doctor to ask more questions, but wonder if anyone has had any experience with a UTI in a boy that either was/was not more than just that? Thanks!
Our son had a UTI at about 5months. He also had urinary reflux, but it was mild- moderate. We kept him on antibiotics to prevent anymore infections (every infection causes kidney damage). By 18 months, the reflux had resolved itself (it's common for kids to ''grow out of it'') and he hasn't had any trouble since. Good luck Ruth
I don't have experience with UTI in my son, but he was diagnosed in utero with a blocked ureter that caused his kidney to enlarge. We had the ureter surgically corrected when he was 7 months old. One of the symptoms of this can be a UTI, there is also a reflux syndrome that can cause backup into the kidney and infection, enlargement of the kidney etc. I recommend you question your doctor further and think seriously about follow-up since UTI's are extremely rare in boys/men, unless catheterized for some reason. I recommend our pediatric urologist Laurence Baskin, should you need to proceed with further diagnosis and treatment. He practices out of Highland and UCSF and is EXCELLENT. 510-547-1600 (OAK) 415-353-2200(SF) An ultrasound, though expensive, is simple, noninvasive and will tell you immediately if there is any enlargement of the kidney. Good luck Ilana
Daughter, 4, pees constantly - UTI?
January 2006
My daughter is four next week. In November she went through a phase of needing to go to the bathroom (pee) constantly- every five minutes- during the day. Nights were more or less normal. We had her urine tested twice for a UTI and both times it came back negative. No sugar or blood in the sample either. She went on a round of antibiotics after two weeks, and eventually (not immediately after starting) things went back to normal. Last week it started again- and again, two normal pee tests. I have her scheduled for a blood test to rule out diabetes, but, in the meantime, I'm at wit's end. My pediatrician's solution is to just put her on antibiotics, but I can't see doing that again after another two negative tests. I asked him about a disorder I read about but can't spell- basically stress peeing (I read it's more common than UTIs) and he said, very dismissively, that stress causes stomachaches, not peeing. Is that true? Is frequent urination a symptom of any other ailment? (As far as I can tell, there's no more urine, just more frequent visits. She's not abnormally thirsty either.)If it's nothing organic, what techniques can I use to lessen her anxiety? She's super bright, super high-strung and I'm trying to bee really careful not to make a big deal out of this but we literally spend all day in the bathroom. I don't know if this is relevant: she sleeps a lot (3 hr nap + 9-10 hrs at night)& she's off-the-charts tall (we're not)and grows really fast. Also, she's always been healthy as a horse. anon
my son had the same thing. we kept getting him tested(even took him to a pediatric urologist) and could find nothing. Then it just went away gradually over the course of about a year. I would say, if you have eliminated all medical possibilities, and it's not putting a significant hardship on your or her life, it's likely that she'll just grow out of it. good luck!
Have her tested for pinworms. I could have written your post several years ago when my daughter was four. My doctor gave me a kit to test her for pinworms and sure enough that was it. One prescription later and the symptoms were gone. Don't know if the same for your child but it's worth checking out. Good Luck, Diana
My 4 year old daughter is just getting off antibiotics for a UTI. When they tested her urine the test came back negative. The doctor then plated her urine and bacteria grew, which indicated that she did have a hard to detect infection. Our Kaiser doctor said she has seen this type of situation many times in children and has learned to take the testing a step further. I know my child has been very uncomfortable with this infection. Best wishes for a speedy solution. anon
2-year-old diagnosed with UTI
Feb 1999
My two year old daughter recently had a kidney infection caused (we think) by a UTI. The doctor at Childrens' has suggested a VCUG. I am reluctant to put her through another invasive procedure--she was already catherized once in the hospital. On the other hand, I don't want to take this too lightly. Has anyone had experience with this procedure and can advise me on it's effectiveness and whether it is warranted after just one UTI? Thanks in advance for any light anyone might shed! (By the way, I have already reseached some of this at a GREAT web site at www.icondata.com/health/pedbase. It is a database of pediatric diseases.)
From: Stephen (2/99)
Our 10 month old daughter was diagnosed with a UTI, which is extremely rare in such young children. Our pediatrician suggested an ultrasound and then a VCUG to determine if there were any physical abnormalities that may have caused the UTI. The ultrasound, done at 11 months, was negative, and then we had the VCUG done when our daughter was 12 months old. The procedure was quite quick and easy, and the radiologist assured me that the older children report only minor discomfort when the catheter is inserted, but not after it's in. Our daughter was quite young when she had the procedure done, and the worst thing for her was having to be held still for the x-rays (and not being allowed to reach down and grab the tube.) The procedure lasted about five to eight minutes, which is a little longer than it usually takes because it took a little while for our daughter to urinate the second time her bladder was filled with the contrast. Fortunately, the tests came out negative, but we were still glad we had it done just to be safe (especially since it was quite quick, safe, and painless.)
From: Alexandra (2/99)
I looked into this subject when we thought our son had a urinary tract infection. There is some debate in the medical profession about the whole question of diagnosing and treating uti's and kidney infections. An article that was very informative (which unfortunately I don't still have) was in Kidney International, July 1996, Volume 50 (1) p. 312-329, Asymptomatic Bacteriuria and Vesicoureteral Reflux in Children by Michael Linshaw, M.D., worth reading if you have access to a medical library (I think you can use Children's Hospital's library with a note from your doctor; you could call to see if they would have this journal). The article gave me a lot more information than I was able to get from our doctor, and showed me that different doctors dealt with this issue in very different ways.
As far as I understand, the purpose of the VCUG is to look for reflux, as reflux has been associated with an increased risk of kidney infection. Then there is the question of what one does if there is reflux. If it is severe enough, many doctors recommend surgery to correct it, in order to reduce the risk of damage to the kidneys from any future infections. Some studies, though, show that the surgery doesn't actually reduce the risk of damage to the kidneys due to infection. Of course, there are various risks with the surgery. Also, some studies show that in many children with reflux, even severe reflux, the situation naturally corrects itself as the child grows up. There are risks with the VCUG too: a small percentage of children die, and another small percentage become very sick, from reactions to the dye they use; the catheter carries a small risk of damage to the urethra and of introducing infection into the bladder; real risks from the x-ray radiation aren't completely known; and of course there's all the emotional stress too. So, before doing the VCUG, it seems important to weigh the possible benefits - which would be finding an abnormality that, when treated by surgery or in any other way, really does reduce the risk of damage to the kidneys - versus therisks. There is also some disagreement about the typical use of antibiotics with uti's or apparent uti's. Some studies have shown that, if there is bacteria in the urine but no other syptoms of infection, it may be better not to give antibiotics, as killing off the existing bacteria may leave the child open to a more virulent infection. Also, many doctors put children on prophylactic antibiotics for long periods when the child has had repeated infections, but there is some question in the medical field about the wisdom of doing this also, both in terms of the actual efficacy in protecting the kidneys, and in the effect on the child's health overall.
It's a complicated issue. In the worst cases, kidney infections with few symptoms can cause serious permanent damage in children, which is the reason that the doctors act so aggressively with the situation, and a good reason for parents to take the matter seriously. However, as you noted, some of the tests are very invasive, and some studies are in fact calling into question some of the medical protocol. Our pediatrician is Robin Winokur in Berkeley. She seems pretty knowledgeable about all this, and relatively uninvasive in her approach in general. It might be helpful to get a second opinion since you're unsure about the VCUG.
Also, I have heard that some people have good success with treating and preventing uti's and kidney infections with homeopathy. Hahnemann Clinic in Berkeley takes care of lots of children, and they also have m.d.'s on staff. Christine Ciavarella there is quite good. Homeopathy could be a good alternative to doing nothing or doing invasive tests. For myself, I don't have a medical background and am just a concerned parent who's done some reading and talked to a couple of people and considered all this for our own child; if you have any questions about what I've said, though, you are welcome to call me, Alexandra. Good luck.
Frequent UTIs in 8-year-old girl
June 2001
My 8 yr. old daughter has had four urinary track infections in the last 8 months. We just had a test taken at Children's Hospital and they couldn't find anything wrong structurally, so we're still searching beyond the obvious (improper wiping, bubble baths, etc.) Has anyone had experience with this in themselves or their children. I'd appreciate any feedback. Thanks.
I had very frequent UTIs until I saw a urologist, who said I probably had not been treated long enough for any of my infections. When this happens, the bacteria simply burrow deeper into the lining of the bladder, which makes them even less likely to be reached by the next course of antibiotics that is taken. While taking antibiotics the symptoms would abate because the amount of bacteria was reduced, but then the population would just regrow in what should normally be a sterile environment. Also some people, like me, have bladders where the neck is bent over more than usual, which is conducive to infection as well. His solution was to put me on Keflex for a really long time -- I think it was 6 weeks -- and this did the trick. Didn't have another one for many years.
I also get frequent UTIs and what I do is drink lots of water (1-2 large cups at a time). When I was younger, my mother always warned me not to sit on warm or hot places or I will have pain urinating. I always make sure that I have something cool to put on top of my car seat when the weather is hot. Maybe reminding her to avoid sitting on hot surfaces and drink lots of water (not juice or soda). mey
When I was in my 20's, I went through a several year period of frequent (perpetual?) UTI. After finally getting kidney infections (later turned into septicemia), I figured out how to avoid the UTI - I push fluids all day long. I think what happened (not confirmed by any doctors) is that I had heat stroke once during a strenuous athletic event and since then, had problems with UTI unless I kept myself WELL-hydrated. So, I drink a 10-cup coffee pot of water every morning and every afternoon at work, then I drink another 1-2 thermosful at home in the evening (depending if I have a glass of wine which is a diuretic.) I can feel bladder and urethral irritation when I haven't had enough water. One of my daughters tends to not drink enough and she occasionally gets some irritation when not well-hydrated. So, without knowing anything about your daughter's situation, you may want to see if she is not drinking enough and therefore, not emptying her bladder enough causing enough buildup to produce UTI. Best of luck to you, and I hope it gets cleared up REAL soon. Write if you feel the need to talk.
The British Medical Journal 2001:322:1571 just reported the results of the following study:
In a randomized study of 150 women with a history of UTI, the investigators asked one group to drink 50 mL of cranberry-lingonberry juice daily, another to drink 100 mL of a lactobaccillus drink 5 days/week, and a third to drink neither beverage. In the cranberry group, the number of episodes of UTI was reduced by about half at 6 months, while the lactobaccillus drink was ineffective.
Overall, 16% women in the cranberry group, 39% in the lactobacillus group and 36% in a control group had at least one UTI during the year-long study, Dr. Tero Kontiokari of the University of Oulu and colleagues report. The finding suggests that this popular remedy could be a good way to prevent recurrence of the painful infections and reduce the need for antibiotics, Dr. Tero Kontiokari, of the University of Oulu in Finland, and colleagues report
Since cranberry juice is a natural food product and readily available, it seems a useful means for self administered prevention of urinary tract infections, the authors conclude. Lynn