BY RUTH DSOUZA PRABHU
As mothers, time makes us an expert on every kind of crying there is— the hungry cry, the sleepy one, the I-am-irritated cry, the loud tantrum, the give-me-attention cry and much more. But every once in a while comes a cry that leaves us stumped! This is perhaps the time that panic sets in, the emergency calls to friends are made and finally the doctor is woken up in the middle of the night. While at most times the reason for this crying may be a small one, there are a few occasions when you need to be alert and pick up on the signals at the right time. One such instance is the possible sign of a Urinary Tract Infection (UTI).
A UTI is something most adults, especially women, are familiar with. We may have had them at some point in our lives, at least once, if not more. But did you know that little children are quite susceptible to them as well?
“UTIs are different in children as it can cause serious complications if left untreated,” says Dr Vikas Satwik, head – neonatology and pediatrics, Motherhood Hospitals. “In children, a UTI can present with symptoms completely unrelated to the urinary system. For example, a UTI can present symptoms like vomiting, feeling unwell, reduced feeds, etc. Most children may not complain of burning micturition (constant spurts of urine passing with a burning sensation) as seen in adults. However, children born premature, those with some block in fl ow of urine or reflux of urine from the bladder back to the kidneys, are more susceptible to recurrent urinary infections,” Dr Vikas, adds.
Keep an eye out for: It is an established fact that UTIs in small children are very different from what an adult undergoes. While UTIs tend to occur more during the monsoons, when it comes to young children, UTIs are usually due to congenital anomalies and can occur through the year.
“Parents should always keep an eye out for children crying while passing urine as this may be due to severe burning experienced by them,” advices Dr Santosh Palkar, urologist, Zen Hospital, Mumbai. “The kind of fl ow of the urine should also be noted. Keep an eye out to see if blood is present in the urine,” he says.
Dr Vikas also adds that while some children suffering from a UTI may display symptoms, it is not necessary that symptoms will present for all kids. “Sometimes, children may just be irritable and start crying. Some may show signs of a stomach ache, fever, lack of appetite etc. In infants, urine may produce foul smell.”
If left unattended: Dr Santosh emphasises that any kind of infection can cause a fever, including a UTI. “Do not always consider a fever as a viral infection as there could be other reasons for it, too. If the infection is still overlooked, it can lead to renal damage.” If the urinary infection increases and it reaches the kidney, it can cause permanent kidney damage and scarring. Repeated scarring can lead to high blood pressure and reduced kidney function, including kidney failure. Dr Vikas warns that in a if a UTI is left unchecked, especially among children as young as two to three years, they can suffer from high blood pressure as will most likely be a lifelong problem for him. If renal failure sets in, he may need frequent dialysis and even a renal transplant.”
The treatment: Once a UTI is suspected, it is usually diagnosed with a clean catch urine sample which is then tested for the presence of pus and bacteria. An appropriate antibiotic is started which may be either oral or intravenous, depending on the severity and age of the child. An ultrasound of kidneys and bladder is undertaken, depending on the intensity of the UTI and bacteria causing the infection. If the UTI is severe or recurrent, further investigations to look at renal damage or the cause of UTI is undertaken at a later stage.
How to be careful: Small changes or precautions will help prevent UTI s among children. Here’s what you can do.
● Make sure to change the diapers regularly.
● Evidence suggests that breastfeeding prevents UTIs in children in first six months.
● Clean the baby from front to back after urine and bowel movements.
● In older children, instead of cleaning them with the wet tissues, it is better to wash them with the water.
● After three to four years of age, ensure they drink plenty of water.
● Avoid constipation by proving a diet rich in fibre.
Irrespective of the age group, it is essential for everyone to ensure they are drink plenty of water. Parents should keep a check and ensure children pass urine at regular intervals.
If you suspect that your child may be suffering from a UTI, it is important that you seek medical help as soon as possible. It can prevent a great deal of pain and illness for your child and safeguard your child’s well-being in the long run.|MB