A while ago, there was a mother on the Lilac Mom App who shared her daughter's experience of illness -
The baby had repeated fevers and went to the hospital several times for blood tests, but the cause was not found. During this period, the baby's mental state has been very good, and he can eat and sleep. Until the baby had a fever of 37.9 ° C and the bath cooled down, she found that the baby's vulva was red and had a small rash, so she "had a sudden idea" to go to the hospital to test the baby's urine.
As a result, it was found that the baby had a urinary tract infection and had hydronephrosis and needed to be hospitalized. What scared her was that if it was not found in time, repeated urinary tract infections could cause lifelong damage to the baby's kidney function.
Image source: Lilac Mom App "Planet"
In the conventional cognition, the mention of "urinary tract infection" seems to be a disease that only adults can get, but I did not expect that such a small baby would also have a urinary tract infection? It's so serious.
So what exactly is a urinary tract infection and how can it be prevented?
The incidence is high
It's easy to overlook
Image source: Stand Cool Helo
Urinary tract infection, as the name suggests, is a urethra infected by bacteria.
In fact, as many as 7% of baby girls and 2% of baby boys develop a urinary tract infection before the age of 6, and about 30% of children have a recurrence or even recurrent episode after the first illness.
Image source: MSD Manual
The urethra is the excretory mouth of urine. Although urine is a "waste product" of the body, it is sterile in itself, and when it is excreted through the urethra, it can also wash away some bacteria in the urethra.
Urinary tract infection occurs when bacteria travel up the urethra and invade the bladder or kidneys.
Image source: Figureworm Creative
Baby girls' anus is closer to the urethral orifice and the urethra is short, and when post-stool cleaning is not in place, this physiological structure is more likely to allow bacteria in the feces to enter the urinary system, causing urinary tract infections.
What is even more frightening is that even if the usual hygiene habits are good, the baby may also get sick; and sometimes it is already sick, and it may not be detected in time.
Because the typical urinary tract infection is a symptom of urinary tract irritation such as frequent urination, urgency, and painful urination, or fever with low back pain.
However, babies under 2 years of age usually lack typical symptoms, and infants and young children have poor specificity, sometimes only fever.
They can't give feedback on their feelings, unlike older children who can express abdominal pain, urinary pain, etc., and it is more difficult for parents to detect the condition in time.
Just like the baby at the beginning of the article, the mother usually pays attention to cleanliness, the baby can eat and sleep well, and no one can think that the fever is actually a signal of urinary tract infection.
Even if bacteria continue to invade the kidneys and have hydronephrosis, babies are still "like a nobody else," which is not uncommon in outpatient clinics.
Fever alone has no other symptoms, and blood routine checks may not necessarily reveal the obvious cause of infection. It will be mistaken for a general bacterial infection or cold, and there is no timely intervention. If a kidney infection is not treated in time, it will cause permanent damage to the kidneys.
Fever is accompanied by these symptoms
Be wary of urinary tract infections
Persistent low-grade fever with no apparent cause of infection, or sudden onset of high fever, regardless of age, should consider the possibility of urinary tract infection and require a urine test.
Especially these age groups and situations:
< girls aged 24 months;
< boys aged 24 months who have not undergone circumcision;
< 6 months of age and having undergone circumcision;
Children of any age, with a history of previous urinary tract infections and genitourinary abnormalities;
Children of any age with fever > 48 hours;
Children of any age with a temperature of > 39 °C.
Urinary tract infections are more important if the fever is accompanied by the following symptoms:
The number of urinations is large and the amount is small; the taste is heavy, the smell is peculiar, and the color is yellow;
Redness of the vulva, the appearance of diaper rash;
vomiting, not having good taste for milk or eating;
Crying incessantly, it is difficult to soothe.
Once the baby has a urinary tract infection, it should be sent to the hospital in time to avoid delaying the condition.
Usually, doctors recommend antibiotics (usually 10 to 14 days). What needs to be reminded here is that even if the symptoms disappear quickly after taking the drug, do not stop the antibiotic too early, otherwise the infection will be repeated and it is easy for the bacteria to become resistant.
If the baby is still infected repeatedly after formal treatment, it is necessary to consider that it may be congenital diseases such as kidney and urinary tract malformations, because these conditions will cause the urine flow to be blocked in the urinary tract, resulting in urinary tract infection, at this time it is necessary to check by imaging means such as imaging.
Avoid urinary tract infections in your baby
It's not enough to just clean it
80% of urinary tract infections are caused by Escherichia coli.
In addition, wearing open crotch pants and not changing the wet diaper in time will also expose the baby's genitals to bacteria, causing bacteria to invade the urethra and multiply.
Coupled with the imperfect development of the baby's own immune system and ureteral wall elastic fibers, it is easier to let bacteria take advantage of it.
Therefore, to avoid urinary tract infections in babies, the key is daily prevention.
In addition to inadequate cleaning, urinary holding is also one of the important factors that increase the risk of urinary tract infections. Therefore, pay more attention to the following points in daily life and develop good living habits:
1. Under the condition of a normal diet, let the baby drink water regularly and urinate regularly to "flush" the urethra. At the same time, pay attention to balanced nutrition and avoid constipation;
2. Educate the baby to "pee when you want to pee", do not hold urine, especially pay attention to the training of the self-toilet stage of the baby is easy to hold urine;
For babies who can use the toilet, their feet can be placed on the stool/floor when they go to the toilet in order to empty the bladder.
3. Pay attention to hygiene and cleanliness. Babies who use diapers are recommended to change every 2 to 3 hours; clean and put in place after each bowel movement;
Especially after the baby girl defecates, pay attention to wiping from front to back, and the dirty toilet paper should not touch the urethral opening; use warm running water to slowly rinse the private parts and farts;
Special attention should also be paid to the "sanitary dead end" of the baby boy's vulva.
Marlene. Pediatric Dermatology. People's Medical Publishing House. 2015.
[2] Consensus on the diagnosis and treatment of atopic dermatitis in children in China (2017 edition). Chinese Journal of Dermatology. 2017, 50(11): 784-789.
[3] Lisette A.，et al. Update of the EAU/ESPU guidelines on urinary tract infections in children. [J ]. Pediatr Urol 17 (2021) 200–207.
[4]https://www.sciencedirect.com/science/article/pii/S1477513121000681
Shen Qian. Norms for the diagnosis and treatment of urinary tract infections in children[J] . Chinese Clinical Journal of Practical Pediatrics, 2021, 36(5): 337-341.
[6] Brett White, MD, Diagnosis and Treatment of Urinary Tract Infections in Children. Am Fam Physician. 2011 Feb 15;83(4):409-415.
[7]https://www.aafp.org/afp/2011/0215/p409.html
Weinberg G A. Urinary tract infection (UTI) in children[R]. MSD Manual, 2018.
Audit expert Fan Yunzhu
Attending Physician of pediatrics at Lilac Clinic
Planner: Yang Jie
Producer: Yang Jie
Title image source: Stand Cool Helo
Part of the content of this article is published with permission from the Lilac Mom App "Planet" user @in the lower peach.