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Dealing with urinary tract infections in children

Wednesday, June 3rd, 2020 00:00 | By
Shadrack Kimwele, a paediatrician. Photo/PD/COURTESY

Jasmine Atieno @sparkle Mine

When Linnet Kalama’s eight months old was first diagnosed with a Urinary Tract Infection (UTI), she was alarmed.

She was also guilty that the child may have suffered from it for long without her knowledge. 

“In fact, I was not aware that a baby could even contract such an infection. I thought it was for adults.

Also, I had tried to consult other mothers on social media, using a pseudo, on what my child could be suffering from and most of them said jaundice.

But others advised me to seek medical advice from a paediatrician,” says Linnet whose daughter is now two years old. 

The baby had constant high fever. Also, she would cry a lot. After a visit to a doctor, he suggested a urinalysis, which came back positive.

“The doctor said the baby would cry a lot because of discomfort while peeing.

After taking medication and heeding to the doctor’s advice such as frequent diaper change and increasing fluid intake, she recovered,” she says. 

UTIs in infants and toddlers happens when bacteria from their skin or poop gets into the urinary tract and multiply.

It is in fact common, but since they are poor in communication at this age, it is not easily detected.

Infants and toddlers cannot vocalise UTI symptoms, cannot submit spontaneous urine samples, and have other distinct characteristics when compared to children over two years. 

Shadrack Kimwele, a paediatrician, says children two years and older who present with urinary symptoms including dysuria (pain, discomfort, or burning sensation when urinating) and urinary hesitancy have an overall eight per cent risk of UTI. 

“After two years of age, children are more able to report and give specific symptoms, such as dysuria.

The prevalence of UTI in boys two years of age and older is low, especially in circumcised boys.

Girls are more likely to get UTIs because their urethra is shorter. Bacteria from the anus can more easily get into the vagina and urethra.

Important factors that affect prevalence in this age group include bladder or bowel-withholding behaviours, congenital anomalies of the urinary tract, and previous history of UTI.

It is important for all parents to be observant of their infants’ general behaviour,” says Kimwele. 

According to the health officer, there are preventive measures, which should help in protecting the young ones from infection.

In infants and toddlers, frequent diaper changes can help prevent the spread of bacteria that cause UTIs.

For children who are potty trained, it’s important to teach them good hygiene. Girls should know to wipe from front to rear, not rear to front in order to prevent germs from spreading from the rectum to the urethra.

Diagnosis, preventive measures

For school-going girls, it is important to keep them away from bubble baths and strong soaps that might cause irritation, and they should wear cotton underwear instead of nylon because it’s less likely to encourage bacterial growth.

“Antibiotics are normally used in treatment of UTIs in children. Give prescribed antibiotics on schedule for as many days as your doctor directs.

Keep track of your child’s trips to the bathroom, and ask your child about symptoms such as pain or burning during peeing.

In case of severe pains, the doctor may have to prescribe medication that numbs the lining of the urinary tract.

After several days of antibiotics, the doctor has to repeat the urine tests to confirm that the infection is gone. It’s important to make sure of this because an incompletely treated UTI can come back or spread, which might cause bigger problems like kidney infections.

Kids with a more severe infection may need to be admitted so they can get antibiotics by injection or intravenously, which is normally delivered through a vein right into the bloodstream,” he says.

To diagnose a UTI, health care providers do a physical exam and take a sample of pee for testing.

How a sample is taken depends on a child’s age. Older children might simply need to pee into a sterile cup. For younger children in diapers, a catheter is usually preferred.

A thin tube is inserted into the urethra up to the bladder to get a “clean” urine sample.

The sample may be used for a urinalysis a test that microscopically checks the urine for germs or pus, which attempts to grow, and identify bacteria in a laboratory. 

Knowing what bacteria are causing the infection can help your doctor choose the best treatment.

As a parent too, it is important to provide a clean environment for your child, advises the paediatrician. Encourage your child to drink plenty of fluids, but avoid beverages containing caffeine, such as soda and iced tea.

Linnet says her child being diagnosed with UTI was an eye opener and she has become more observant of her child’s bathroom behaviour as she grows. “I am sure if it happens, again I will catch it in time.

My first experience caught me by surprise,” says the mother of one, and a grocery store operator. 

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