Urinary tract infections (UTIs) in children are often tricky to spot, as the symptoms can be vague and age-specific — ranging from poor feeding in infants to painful urination in older children. Left untreated, UTIs can cause serious kidney damage, especially in the first two years of life.
A study from Ujjain, published in the Indian Journal of Microbiology Research, found the highest prevalence of UTIs in children aged 0–5 years, particularly among girls, with cases peaking during the rainy season. E. coli emerged as the most common culprit, and the findings underscored the importance of maternal awareness, frequent diaper changes, and hygiene in prevention.
To help parents understand how to spot, manage, and prevent UTIs in kids, ABP Live spoke to Dr Kanav Anand, Senior Consultant Paediatric Nephrologist at Sir Ganga Ram Hospital, New Delhi, who shared crucial insights on symptoms, treatment, and monsoon-specific risk factors..
ABP Live: Dr Anand, could you explain what a urinary tract infection (UTI) is in children, and how it differs from UTIs in adults?
Dr Kanav Anand: An infection anywhere in the urinary tract is called UTI. When it affects the lower urinary tract (urinary bladder) it is called lower UTI (cystitis) and when it affects the upper urinary tract (kidneys) it is called upper UTI or pyelonephritis. Pyelonephritis is the more severe form of UTI.
Children, as compared to adults, may come with very nonspecific symptoms like poor feeding, only fever, prolonged jaundice, persistent vomiting, prolonged jaundice or failure to thrive. UTIs can cause serious damage to the kidneys, especially if the child is very small (less than 2 years) or if there is some associated urinary tract anomaly like vesicoureteral reflux, where the urine flows backwards in reverse direction from the urinary bladder to the kidney via the ureter. Up to 30% of children with recurrent UTI may have vesicoureteral reflux (VUR), and approximately 20-30% children with UTI and VUR develop renal scarring (permanent damage to the kidneys), with around 10% developing hypertension and chronic kidney failure.
UTI, especially in small children, may lead to kidney damage, which may not be reversible. Recurrent UTI can cause damage to part or the whole of one or both kidneys. If the damage is severe, the child can end up with kidney failure requiring dialysis or a kidney transplant. In view of this serious complication, it is important to diagnose the problem at the earliest and start the treatment promptly. Occurrence of UTI below 2 years of age, delay in onset of treatment and presence of renal tract anomalies (mainly VUR) are the chief risk factors associated with kidney damage.
ABP Live: Why are children, especially during the monsoon, more vulnerable to UTIs compared to other seasons?
Dr Kanav Anand: Increased humidity during monsoons creates an ideal environment for bacteria to multiply in the genital area, especially in children who wear wet diapers for very long hours or wear damp undergarments contaminated with bacteria or fungi.
If children drink less water during this season, they can get dehydrated, leading to less frequent urination, giving more time for the bacteria to stay in the urinary tract and multiply, causing serious damage.
ABP Live: Are there certain groups of children who are at higher risk of developing UTI in monsoons?
Dr Kanav Anand: Prolonged diaper usage, damp contaminated undergarment usage, children with associated congenital anomalies of the urinary tract (like VUR), children with kidney stones, constipated kids, children using unhygienic public restrooms, ones who drink less water and children who hold urine for long hours.
ABP Live: Are there any common mistakes parents make that significantly increase risk of UTI in kids? What clothing or diapering practices can reduce the risk of infection during the rainy season?
Dr Kanav Anand: Not giving enough water to drink, replacing water with sugary drinks like juices to make up for daily fluid intake, not toilet training the kids for timed urine and stool passage, asking kids not to use toilets in schools resulting in prolonged urine holding, not adequately managing kids with congenital anomalies of the urinary tract, not changing the wet undergarments or diapers for long hours, not maintain genital hygiene.
Avoid diapers, but if you intend to use them, change them frequently. Wash undergarments with clean water and soap, and let it dry completely before using them. Use airy, loose clothes, and avoid tight-fitting pants.
ABP Live: What are the most common symptoms of a UTI in infants and toddlers, as well as in older children?
Dr Kanav Anand: The table below should explain all about the common symptoms for urinary tract infection in babies/infants and toddlers, as well as in older children.
ABP Live: Since fever is very common during the monsoon due to many infections, how can parents differentiate a fever due to UTI from one caused by other illnesses? When should parents consult a doctor if they suspect a UTI?
Dr Kanav Anand: Fever without any focus for more than 48 hours, pain while passing urine, increased or less frequency of urination, blood in urine, foul-smelling urine, cloudy urine, abdominal or loin pain. If the child has these symptoms, do a urine routine analysis and consult the doctor immediately.
ABP Live: How are UTIs typically treated in children? Do all cases require antibiotics?
Dr Kanav Anand: Yes, UTI requires antibiotics for treatment and any delay in start can lead to serious kidney damage. Antibiotics are given for 7-10 days, oral or intravenous (for very small children, very sick children and the ones who are unable to consume oral medicines due to vomiting).
ABP Live: Are recurrent UTIs a cause for concern? Could they signal an underlying kidney or urinary tract problem?
Dr Kanav Anand: Premature infants discharged from nursery unit, children with urinary tract formation defects (eg. VUR), stones in the urinary tract, urinary bladder function problems, constipation and children with family history of UTI or VUR are at a high risk of getting recurrent UTI.
ABP Live: What are the most important hygiene habits parents should teach children to prevent UTIs, especially during the monsoon?
Dr Kanav Anand: Here are some suggestions one can follow for the child’s health:
a) Avoid tight clothing, which can trap moisture and allow bacteria to grow.
b) Cotton underwear is preferable as it lets in air and keeps the area dry.
c) In case of a girl, the faeces should be cleaned from front to back to avoid germs going into the genital area.
d) The child should be encouraged to pass urine several times in a day (approximately at least 5-6 times).
e) Foreskin in an uncircumcised male child should be retracted and the area cleaned with water on a daily basis.
f) Avoid constipation as hard stools press on the urinary bladder, preventing complete drainage of urine.
g) Drink a lot of fluids.
h) Avoid bubble baths.
ABP Live: How important is proper hydration, and what fluids should children be encouraged to drink?
Dr Kanav Anand: Proper hydration ensures regular flushing of the urinary tract, as well as avoiding constipation and kidney stone formation. Ensure 70% of the daily fluid intake is plain water. Avoid sugary drinks.
(Kirti Pandey is a senior independent journalist)
[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]
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