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.
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.
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.
Urine color and odor
Many things can affect urine color, including fluid balance, diet, medicines, and diseases. How dark or light the color is tells you how much water is in it. Vitamin B supplements can turn urine bright yellow. Some medicines, blackberries, beets, rhubarb, or blood in the urine can turn urine red-brown.
Some foods (such as asparagus), vitamins, and antibiotics (such as penicillin) can cause urine to have a different odor. A sweet, fruity odor may be caused by uncontrolled diabetes. A urinary tract infection (UTI) can cause a bad odor.
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
Strong or bad-smelling urine.
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.
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.
cases, a urinary symptom may indicate a more serious illness, such as
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
Is the plan helping get your child's blood sugar under control?
Diabetes illness plan working
Diabetes illness plan not working
How fast is it getting out of control?
Quickly (over several hours)
Blood sugar quickly worsening
Slowly (over days)
Blood sugar slowly worsening
Do you think your baby has a fever?
Did you take a rectal temperature?
Taking a rectal temperature is the only way to be sure that a baby this age does not have a fever. If you don't know the rectal temperature, it's safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious.
It is easy for your diabetes to become out of control when
you are sick. Because of an illness:
Your blood sugar may be too high or too
You may not be able take your diabetes medicine (if you are
vomiting or having trouble keeping food or fluids down).
not know how to adjust the timing or dose of your diabetes
You may not be eating enough or drinking enough
Many prescription and nonprescription medicines can cause
urinary symptoms. A few examples include:
A baby that is extremely sick:
May be limp and floppy like a rag
May not respond at all to being held, touched, or talked
May be hard to wake up.
A baby that is sick (but not extremely
May be sleepier than usual.
May not eat
or drink as much as usual.
An illness plan for people with diabetes usually covers things like:
How often to test blood sugar and what the target
Whether and how to adjust the dose and timing of insulin
or other diabetes medicines.
What to do if you have trouble keeping
food or fluids down.
When to call your doctor.
The plan is designed to help keep your diabetes in control even
though you are sick. When you have diabetes, even a minor illness can cause
Symptoms of diabetes may
Increased thirst and more frequent urination,
especially at night.
An increase in how hungry you
Losing or gaining weight for no clear
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in children are:
Diseases such as diabetes, cystic fibrosis, sickle
cell disease, and congenital heart disease.
which are used to treat a variety of conditions.
after organ transplant.
Chemotherapy and radiation therapy for
Not having a spleen.
If you're not sure if a child's fever is high, moderate, or
mild, think about these issues:
With a high fever:
The child feels very hot.
It is likely
one of the highest fevers the child has ever had.
With a moderate fever:
The child feels warm or hot.
sure the child has a fever.
With a mild fever:
The child may feel a little warm.
think the child might have a fever, but you're not sure.
Pain in children 3 years and older
Severe pain (8 to 10): The pain
is so bad that the child can't stand it for more than a few hours, can't sleep,
and can't do anything else except focus on the pain. No one can tolerate severe
pain for more than a few hours.
Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and
sleep, but the child can tolerate it for hours or days.
Mild pain (1 to 4): The child notices and may complain of the pain,
but it is not bad enough to disrupt his or her sleep or activities.
Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:
Your age. Babies and older
adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.
Try home treatment to relieve the
Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
It can be hard to tell how much pain a baby or toddler is in.
Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.
Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.
A severe urgency problem means
You are uncomfortable most of the
You get the urge to go again right after you have just
The problem interferes with your daily
The urge keeps you from sleeping at night.
A moderate or mild urgency problem means
The urge to urinate comes more often than you are
used to, but it is not constant.
It does not interfere much with
your daily activities.
It usually does not keep you from
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.
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
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
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.
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.
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.
How this information was developed to help you make better health decisions.