Understanding UTIs in Children

Clare Louise Young
Aug 20
4 min read

Urinary tract infections (UTIs) aren’t just something adults get — they’re one of the most common bacterial infections in children. Recognising them early, and knowing how to support your child’s bladder health, can make a big difference to comfort and long-term wellbeing.

What Happens in a UTI?

The urinary tract includes the kidneys, bladder, ureters (tubes connecting kidneys to bladder), and urethra (the tube that carries urine out). A UTI happens when bacteria enter this system and start to multiply.

Most infections in children are caused by E. coli, a bacteria that normally lives in the gut. Because the urethra is short, especially in girls, bacteria can move from the bowel to the bladder more easily. Wiping back-to-front, constipation, and even toilet training struggles can all increase the risk.

Why UTIs Matter in Children

While many infections are mild, recurrent or untreated UTIs in children can sometimes lead to kidney damage or scarring. That’s why healthcare professionals take them seriously, especially in babies and younger children.

It’s also worth noting that younger children often can’t describe the classic UTI symptoms adults get (like burning on urination). Instead, they may just seem generally unwell with vague symptoms.

Signs and Symptoms

UTIs can look different depending on age:

Babies and toddlers may show:

Fever without an obvious cause
Irritability, crying more than usual
Vomiting or poor feeding
Unexplained tiredness

Older children may complain of:

Pain or burning when passing urine
Needing to go more often or urgently
Passing only small amounts at a time
Pain in the lower tummy, side, or back
Cloudy or foul-smelling urine
New-onset bedwetting (if previously dry at night)

Because these symptoms can overlap with other childhood illnesses, urine testing is important for diagnosis.

How UTIs Are Diagnosed

For babies and young children, a urine culture from a clean-catch, catheter, or (rarely) suprapubic sample is usually needed to confirm a UTI. Dipsticks are more useful in older, toilet-trained children, but cultures still guide the right antibiotic.

Most children don’t need scans. Ultrasound or other imaging is considered only for atypical or recurrent infections, or after a first febrile UTI in certain age groups.

Common Triggers in Children

Constipation: A full bowel presses on the bladder, preventing it from emptying fully and creating a breeding ground for bacteria.
Toilet habits: Not going when they need to, rushing on the toilet, or not fully emptying the bladder.
Wiping front-to-back: Especially important for girls to prevent bacteria moving from the bowel.
Bubble baths and perfumed soaps: These can irritate the urethra.
Underlying conditions: Occasionally, structural issues in the urinary tract or vesicoureteral reflux (urine flowing back up towards the kidney) can contribute.

The Role of the Immune System and Microbiome

The bladder has its own protective layer (the GAG layer) to stop bacteria sticking. But if a child’s immune system is run down, or if there’s gut dysbiosis (an imbalance of gut bacteria), infections are more likely to take hold.

Antibiotics are sometimes essential, but repeated use can disrupt the gut and urinary microbiota. Emerging research suggests this may increase the chance of recurrence in some children — another reason why antibiotics are used judiciously and targeted to the right bacteria. Preventive daily antibiotics aren’t routinely recommended after a first UTI, but may be considered for a small group of children with repeated infections.

Practical Ways to Support Children’s Bladder Health

1. Encourage Good Hydration

Make water the main drink, and offer it regularly throughout the day. Diluted urine makes it harder for bacteria to thrive.

2. Healthy Toilet Habits

Encourage children to wee when they need to — not to “hold on”.
Make sure they take their time and fully empty the bladder.
For girls: remind them to wipe front-to-back.

3. Address Constipation Early

A fibre-rich diet, adequate fluids, and regular toilet routines are key. Chronic constipation is one of the most overlooked contributors to UTIs in children.

4. Avoid Irritants

Skip bubble baths, perfumed soaps, and harsh wipes that can irritate the urethra.

5. Support Gut Health

Include fibre-rich fruits, vegetables, and wholegrains to feed beneficial bacteria. Fermented foods (such as yoghurt or kefir) can also support microbial balance.

6. Post-Toilet Hygiene

Gentle handwashing and wiping front-to-back can reduce bacteria transfer.

7. Medical Support When Needed

If your child has repeated UTIs, always seek medical guidance. In some cases, imaging of the urinary tract may be advised to rule out structural issues.

When to See a Doctor Urgently

Any baby under 3 months with a fever should be checked immediately.
A child with a high fever, vomiting, or pain in the side/back could have an infection that has spread to the kidneys — this needs prompt medical attention.
Blood in the urine, or recurrent UTIs, always warrant further investigation.

The Bigger Picture

While UTIs are common — affecting many children at some point — they shouldn’t be ignored. With good hydration, healthy toilet and bowel habits, and prompt treatment when needed, most children recover quickly and avoid long-term complications.