“How do you know if your child has a urinary tract infection?”

It is uncommon for young children to get urinary tract infections (UTIs), especially circumcised boys. Little girls who are toilet training get "one for free" due to hygiene issues, but otherwise, any child under the age of 4 years who has a culture positive UTI needs an evaluation for renal abnormalities. Most "pain while urinating" is NOT a UTI -- the most common symptoms are enuresis -- wetting accidents after a period of being dry. Abdominal pain, vomiting, and fever can be symptoms as well. The most common reason for little girls to complain of "pain while peeing" is external irritation; for boys, the most common reason is over-enthusiastic self-manipulation. UTIs can ONLY be diagnosed by a sterile urine culture.

Shelley C. Springer, MD, MBA, MSc, JD, FAAP

Symptoms of a urinary tract infection vary by age. In infants, the common signs are fever and irritability. In older children, the common signs are pain with urination, frequent urination, and urgency, meaning that when they have the urge to go, they cannot wait and sometimes have accidents. If the infection is confined to the bladder, they won't typically have fever. If the infection has spread to the kidneys, they may have fever, vomiting, or back pain. Urinary tract infections are much more common in girls. If male infants are uncircumcised, they have a slightly higher risk that circumcised males.