Urinary Problems and Injuries, Age 11 and Younger

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Urinary Problems and Injuries, Age 11 and Younger

Topic Overview

Urinary problems and injuries are a concern in children. A young child may not be able to tell you about his or her symptoms, which can make it hard to decide what your child needs. An older child may be embarrassed about his or her symptoms. When your child has a urinary problem or injury, look at all of his or her symptoms to determine what steps to take next.

The urethra, bladder, ureters, and kidneys are the structures that make up the urinary tract.

Pain during urination (dysuria) and a frequent need to urinate are common symptoms in young children. When your child has only one of these symptoms, or when the symptoms are mild, home treatment may be all that is needed to prevent the problem from getting worse and help relieve symptoms. Mild symptoms include:

  • A frequent need to urinate. A child's bladder is small and does not hold as much urine as an adult's bladder. For this reason, frequent urination is common and is not necessarily a sign of a urinary problem. Your child may urinate more because he or she is drinking extra fluid, feeling nervous, or simply from habit.
  • Urine that is more concentrated and appears darker, if your child is slightly dehydrated. Give your child more fluids to prevent serious problems from dehydration. As your child drinks more fluids, the color of his or her urine will return to normal.
  • Burning pain when urine touches irritated skin around the vagina or urethra. Pain during urination because of skin irritation occurs more often in girls (genital skin irritation) than it does in boys.

Pain during urination and a frequent need to urinate can also mean your child has a urinary tract infection. Urinary tract infections (UTIs) are the second most common bacterial infection in children. When your child has an infection, bacteria grow in the bladder and irritate the bladder wall. This causes pain as soon as a very small amount of urine reaches the bladder. You may find your child trying to urinate more often than usual in an effort to soothe the pain. But your child will pass very little urine because the bladder has only collected a small amount since the last time he or she urinated. Symptoms of a UTI vary depending on a child's age.

Newborns and children younger than 2

Babies and very young children who have UTIs often have symptoms that do not seem specific to the urinary tract. Symptoms may include:

  • Fever, especially without other signs of infections, such as a cough or runny nose. In babies, fever may be the only symptom of a urinary tract infection.
  • Frequent or infrequent urination.
  • Strong or bad-smelling urine.
  • Dark or blood-streaked urine. Note: It is common for newborns to pass some pink urine in the first 3 days of life. This may be from crystals in the urine. Parents will notice a pink color to the urine in the diaper.
  • Lack of interest in eating or refusing food.
  • Diarrhea.
  • Vomiting.
  • Squirming and irritability.
  • Diaper rash that doesn't go away.

Children age 2 years and older

Young children who have a UTI usually have symptoms that are more clearly related to the urinary tract. Symptoms may include:

  • Burning with urination (dysuria). This is the most common symptom of a urinary tract infection.
  • Fever.
  • Frequent need to urinate (frequency) without being able to pass much urine.
  • A strong desire to urinate (urgency).
  • Strong or bad-smelling urine.
  • Blood in the urine (hematuria). Note: Urine may look pink, red, or brown.
  • Belly pain.
  • Pain in the flank, which is felt just below the rib cage and above the waist on one or both sides of the back.
  • Vomiting.
  • Discharge from the vagina.
  • Sudden, new daytime wetting after a child has been toilet trained.

UTIs are caused when bacteria, such as Escherichia coli (E. coli), which are normally present in the digestive tract, enter the urinary tract. Two common types of UTIs are:

  • Bladder infections, which occur when bacteria get into the bladder by traveling up the urethra.
  • Kidney infections, which usually occur when bacteria get into a kidney by traveling from the bladder up the ureters. Kidney infection also may occur if bacteria from an infection in another part of the body travel to the kidneys through the bloodstream.

Except during the first 3 months of life, girls are more likely than boys to have urinary problems. Girls are also more likely than boys to have more than one UTI.

Babies and young children who have problems with the structure or function of the urinary tract may be more likely to have UTIs. A problem such as vesicoureteral reflux or an obstruction in the urinary tract may make it hard to empty the bladder completely. This will allow bacteria to grow and spread more easily through the urinary tract. These problems may be present at birth (congenital) or can be the result of surgery, injury, or past infection.

During the first year of life, boys are more likely than girls to have a structural (anatomic) reason for urinary problems. If your child has a known structural or functional problem with the urinary tract, follow your doctor's instructions about when to seek care for urinary symptoms.

In rare cases, a urinary symptom may indicate a more serious illness, such as diabetes.

An injury, such as getting hit in the back or genital area, may cause urinary problems. A visit to a doctor is usually needed if your child has trouble urinating, cannot urinate, or has blood in his or her urine.

Check your child's symptoms to decide if and when your child should see a doctor.

Check Your Symptoms

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Home Treatment

Starting home treatment at the first minor signs of an urinary tract infection may prevent the problem from getting worse and help clear up your child's infection.

  • Encourage your child to drink extra fluids as soon as you notice the symptoms and for the next 24 hours. This will help dilute the urine, flush bacteria out of the bladder, and decrease irritation. Cranberry or blueberry juice may be a good choice.
  • Do not give your child caffeinated or carbonated beverages, which can irritate the bladder.
  • Encourage your child to urinate often and to empty his or her bladder each time.
  • A warm bath may help soothe your child's genital pain and itching. Avoid using bubble bath or perfumed soaps, which may cause genital skin irritation. It is okay if your child urinates in the bath water. This may help relieve some of his or her pain.
  • Skin irritation may increase your child's discomfort.
    • Look at your child's genital area with each diaper change. Increased redness may mean skin irritation. Avoid further irritation by changing your child's diapers often. For more information, see the topic Diaper Rash.
    • Air-dry the skin on your child's bottom when possible.
    • An allergy to soap or laundry detergent may be causing your child's skin irritation. If you think this may be the problem, try a different product that is unscented, such as CheerFree or Ecover, rather than a detergent. Rinse twice to remove all traces of the cleaning product. Avoid strong detergents.
    • Use gentle soaps, such as Basis, Cetaphil, Dove, or Oil of Olay, and use as little soap as possible. Do not use deodorant soaps on your child.

Constipation may be present if your child is not drinking enough fluids. For more information, see the topic Constipation, Age 11 and Younger.

If your child has been diagnosed with a urinary tract infection

  • Follow all home care instructions your child's doctor gave you.
  • Give your child his or her medicine exactly as prescribed. If you are having difficulty giving the medicine, call your child's doctor for advice.
  • Follow up with your child's doctor as instructed after your child has finished the course of antibiotics. Many children will require further testing. For more information, see the topic Urinary Tract Infections in Children.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Your child is unable to urinate (retention) or has a dry diaper for longer than 12 hours.
  • New urinary symptoms develop, such as localized back pain (flank pain) or blood in urine (hematuria).
  • Other symptoms such as fever or vomiting develop.
  • Symptoms become more frequent, do not improve, get worse, or interfere with daily activities.

Prevention

The following may help prevent urinary problems in children.

  • Encourage your child to drink more fluids. Water is best. This will help dilute the urine, flush bacteria out of the bladder, and decrease irritation.
  • Do not give your child carbonated or caffeinated beverages, which can irritate the bladder wall.
  • Wash the genital area once a day with plain water or mild soap. Rinse well and dry thoroughly.
    • Use gentle soaps, such as Basis, Cetaphil, Dove, or Oil of Olay, and use as little soap as possible.
    • Do not use deodorant soaps on your child.
    • Avoid bubble baths, powders or perfumed soaps, which can irritate and dry the skin.
  • Wash your child's clothes with a mild soap, such as CheerFree or Ecover, rather than a detergent. Rinse twice to remove all traces of the cleaning product. Avoid strong detergents.
  • Change your child's diapers when wet and immediately after a bowel movement. Wash your hands before and after each diaper change.
  • Wipe your child from front to back when changing a diaper or helping with the toilet, and teach children to wipe in this direction. This may reduce the spread of bacteria from the anus to the urethra.
  • Dress your child in cotton underwear and loose clothing.
  • Encourage older children to urinate whenever they feel the need.
  • Avoid constipation. For more information, see the topic Constipation, Age 11 and Younger.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your child's doctor diagnose and treat your child's condition by being prepared to answer the following questions:

  • What are your child's symptoms?
  • When did the symptoms start?
  • What do you think may have caused the symptoms?
  • Has your child had a fever?
  • Has your child ever had a problem like this in the past? If so, when? What was done to treat it?
  • Does your family have a history of urinary problems?
  • Has your child had a recent injury to the belly, pelvis, or back?
  • What home treatments have you tried, and how effective were they?
  • Does your child have any health risks?

A urine specimen may be collected during your child's office visit. Do not encourage your child to go to the bathroom immediately before the office visit. Special urine collection bags or a catheter may be used to collect urine from a baby or toddler who is not toilet trained.

Credits

ByHealthwise Staff
Primary Medical ReviewerKathleen Romito, MD - Family Medicine
Specialist Medical ReviewerH. Michael O'Connor, MD - Emergency Medicine
Last RevisedApril 12, 2011



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