How can my 4-year-old prevent another UTI?

DEAR DOCTOR K:

I think my 4-year-old daughter may have a urinary tract infection. How will it be treated? And what can I do to make sure she doesn’t get another one?

DEAR READER:

A urinary tract infection (UTI) occurs when bacteria infect urine in the kidneys, bladder or urethra, a small tube that connects the bladder to the outside.

In girls (and women), the urethra is located in front of the vagina. The opening of the urethra is also near the rectum. The large intestine (the colon and rectum) are filled with bacteria. During bowel movements, those bacteria start living on the skin around the rectum and near the urethra. If those bacteria get into the urethra, they can move up into the bladder. From there, they can move into the kidneys. This is what causes a UTI.

Some girls and women have a tendency to get repeated UTIs. One reason is that some women inherit a tendency to have bacteria stick more easily to the cells of their urinary tract.

UTIs can cause fever, pain with urination, back pain and stomach pain. Repeated UTIs over months and years can cause kidney damage, particularly if they are not treated promptly.

To check for a UTI, your daughter’s doctor will take her temperature because UTIs often cause fever. The doctor will also examine her. A UTI can cause tenderness in the lower part of the belly (where the bladder is) or in the lower back (where the kidneys are). He or she will also test your child’s urine for infection.

If your daughter does have a UTI, the doctor will prescribe an antibiotic. Make sure your daughter takes her antibiotic exactly as directed. She should finish the entire course of antibiotics, even if she starts to feel much better after the first several pills. If the antibiotic is stopped too soon, the UTI can return.

Over-the-counter medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may help relieve pain and fever. (Never give a child aspirin or any products containing aspirin.)

Drinking lots of liquids will help clear the infection and prevent dehydration — when children develop high fevers, the sweating can cause serious dehydration. Applying a heating pad or warm compress to your daughter’s belly or lower back may help relieve discomfort.

UTIs are painful and uncomfortable. To prevent another one:

  • Make sure your daughter drinks enough fluids and urinates regularly.
  • Avoid bubble baths and strong soaps that could irritate the genital area. This is especially true before puberty.
  • Teach your daughter to wipe herself only from front to back, especially after bowel movements. Wiping from back to front moves bacteria to the skin around the opening of the urethra.
  • Have your daughter wear cotton underwear, not nylon or other fabrics. Cotton allows air to circulate more freely, which helps prevent bacteria from growing.

There is no perfect protection against getting urinary tract infections, but these measures will help reduce the risk.