You may have heard that the American Academy of Pediatrics (AAP) recently updated its guidelines for diagnosing and treating urinary tract infections (UTIs) in children.
The short version? UTI care is becoming more individualized—based on your child's age, symptoms, test results and risk factors. And when UTIs keep coming back, figuring out why can be just as important as treating the next infection.
Our pediatric urology team here at Connecticut Children's has experts in UTI treatment, management, and prevention. Here are some of the most common questions families ask.
Could it be a UTI?
Older children may tell you that it hurts or burns when they pee. Babies and toddlers can't.
In younger children, an unexplained fever, fussiness, poor feeding or vomiting may be the first clue.
Most UTIs in children are very treatable, but getting the right diagnosis matters.
UTIs can look different depending on a child's age.
In babies and toddlers, we look for unexplained fever, irritability, poor feeding or vomiting.
In older children, burning or pain when peeing, needing to pee more often or urgently, new accidents after toilet training, belly or back pain, and fever can all be signs.
Symptoms are the first clue—not the whole story! Urine testing helps put the pieces together and confirm if your child has a UTI.
Kelly Reilly, APRN, Urology,
Connecticut Children's
How do we diagnose a UTI?
To diagnose a UTI, we need a urine sample. Older children can usually provide one themselves. With babies and younger children, we may need to use a small catheter (like a straw) to get a clean sample and avoid treating a UTI that isn't actually there.
We typically use two tests:
A urinalysis is a quick test that comes back the same day and looks for signs of infection or inflammation.
A urine culture checks for bacteria and helps us determine which antibiotic is most likely to work but takes a few days for full results. These two tests together are used to determine if a child has a UTI.
One of the most important things for parents to understand is that we don't diagnose a UTI based on a symptom or a urine dip alone. The bladder only has so many ways to tell us it isn’t happy, but that doesn’t always mean that it is a UTI. We look at the whole picture.
Erin Floridia, PA-C, Urology,
Connecticut Children's
What do the new UTI guidelines from the AAP mean for parents?
You may notice that testing or treatment for UTI looks a little different from what was done years ago.
We may be able to treat a UTI with antibiotics for fewer days. Shorter courses can work well for many children with uncomplicated UTIs. How long your child needs antibiotics depends on their age, symptoms and how sick they are. At Connecticut Children’s, we made this shift years ago based on the most recent research. The new AAP UTI guideline confirms our standard of care.
Not every child needs extensive testing after a UTI. One UTI doesn't necessarily mean several tests or procedures. At Connecticut Children’s, we generally save additional testing for children with repeated infections, an abnormal ultrasound, or other reasons to suspect a urinary tract problem.
We're paying more attention to why UTIs keep happening. Constipation, holding urine and not completely emptying the bladder can contribute to repeated infections. Addressing those habits may help prevent future UTIs and we have many tricks from working with schools to targeted pediatric pelvic floor physical therapy.
I always tell families, preventing UTIs isn't one-size-fits-all.
Brenda Castillo Jiminian, APRN ,
Community Pediatrician
Why do kids get recurring UTIs?
One UTI doesn't necessarily mean something is wrong. But when infections keep coming back, we want to understand why.
Sometimes constipation, holding pee or not completely emptying the bladder is the reason. In other children, we may need to look for an underlying urinary tract condition.
Drink water! Encourage fluids at school and at home. This will help flush the urinary tract.
Manage constipation – stools can cause pressure in the bladder, making it harder to fully empty. Increase fiber foods and fluids.
Encourage regular trips to the bathroom and prevent rushing so your child can fully empty their bladder.
Promote good hygiene – wiping front to back for girls, changing underwear daily, and avoiding bubble baths.
And remember even with good prevention UTIs can still happen! It is very important to talk with your doctor for concerns and questions about your child.
Our urology team is dedicated to helping you and your child find out why their UTIs recur and will work tirelessly to develop a plan to help minimize their UTI risk moving forward.
