Urinary Tract Infections

little boy hand upURINARY TRACT INFECTIONS IN KIDS
“UTIs are very common in children. Kids can get them at any age as they grow,” says Dr. Khoury, medical director of pediatric urology at CHOC. “What’s important for parents to remember is that UTI is a generic term. The urinary tract starts with the kidney and goes all the way to the urethra opening where we urinate from. When we think about a UTI, there is a big difference between a child with a kidney infection versus a child with an infection of the bladder.” Dr. Khoury says the most common UTI in girls is a bladder infection, caused by bacteria in the bladder. The most serious is when the bacteria ascends to the kidney and causes kidney infections. These are associated with high fevers, and the children may become very sick and need intravenous antibiotics in the hospital.

DOES MY CHILD HAVE A UTI? COMMON SYMPTOMS
It’s harder to diagnose a UTI in a baby who can’t talk versus an older child who can tell you what’s wrong. Noticing symptoms are important so you’ll know when to take your child to the doctor. Dr. Khoury says the most common symptoms of a UTI in a baby or child include: a fever of unknown origin; frequent urination; urgency of urination (or the child says he can’t hold it); a hot or burning feeling during urination; and occasionally, blood in the urine.

DRINK UP! THE IMPORTANCE OF WATER
For children and adults, water is one of the most important parts of any diet. When we don’t drink enough water, our bodies can’t function at their best. When we get dehydrated, we feel tired and less able to think clearly, and our bodies can’t cool off as well either. Water is also an essential part of the diet to help prevent urinary tract infections. As a guideline, Dr. Khoury says children ages 1-8 should drink the same number of 8-ounce cups of water as their age. So, a three-year-old should drink three cups of water daily; a six-year-old should consume six cups. Kids 9 and older should drink 8 cups of water daily. (These guidelines are for water only and do not include other beverages a child may drink in a day.)

FAST FACTS

  • Risk of developing a UTI during childhood: Girls: 8% and Boys: 2%
  • Number of children who will visit a doctor’s office annually for a UTI: 1.3 million +
  • Percentage of children in the U.S. affected by UTIs annually: 3%

View the full feature on Kids and Urinary Tract Infections

Dr. Bixby
Dr. “Tony” Khoury
CHOC Pediatric Urologist

PHYSICIAN FOCUS: DR. ANTOINE “TONY” KHOURY

Dr. Khoury is the medical director of pediatric urology at CHOC and a world-renowned specialist in pediatric urology. Dr. Khoury completed his residency in urology at the University of Toronto in Canada. He completed a clinical fellowship and a research fellowship in pediatric urology at the Hospital for Sick Children in Toronto, followed by a research fellowship at the University of Calgary in Alberta, Canada, in the area of biomaterial-related infections.

Dr. Khoury’s philosophy of care: “I take a very analytical approach to the patient’s
medical issues and listen to the family. With that in mind, I tailor my diagnostic
studies and surgical intervention to the patient’s needs without putting them at risk for under-investigation or overtreatement.”

EDUCATION:
Ain Shams University Medical School in Cairo, Egypt

BOARD CERTIFICATIONS:
Urology

More about Dr. Antoine “Tony” Khoury

This article was featured in the Orange County Register on July 15, 2014, and was written by Amy Bentley.

Four Ways to Prevent Urinary Tract Infections in Children

Urinary tract infections are a common and painful ailment for children, but a few simple strategies can go a long way toward keeping the problUTI_Prevention_Tips_CHOCem at bay, says Dr. Antoine Khoury, medical director of urology at CHOC Children’s.

Dr. Khoury offers four measures parents and children can take to promote good urinary tract health in kids.

Drink lots of water

Parents should encourage children to stay hydrated.

“Water is really important,” explains Dr. Khoury. “Drinking water increases the volume of urine. This helps the child flush bacteria from their bladder out.”

A dehydrated body conserves water, which can prompt constipation and reduce the frequency of urination, and the flushing of bacteria, Dr. Khoury says.

“Constipation also stops the bladder from emptying completely,” he says. “This results in retention of some bacteria in there that will start multiplying as soon as the child stops peeing.”

Dr. Khoury also says that children should examine their urine to ensure proper hydration.

“If it’s yellow, it’s concentrated so they haven’t had enough water to drink,” he says. “It should be the same color as the water in the toilet bowl, which is clear.”

Urinate frequently

Ensure children urinate every two to three hours or at least seven times a day, which reduces the length of time that urine sits in the bladder and bacteria can grow, Dr. Khoury says

“Kids should go to the bathroom when they wake up; before going to school or at morning recess; at lunchtime; at afternoon recess or when they get home from school; before dinner; between dinner and bedtime; and before they go to bed,” he says.

Children also should be encouraged to use the toilet at school and not “hold it” until they get home, as some kids might do because they don’t want to give up playtime at recess.

To help encourage children to urinate regularly, parents can buy their kids a watch with multiple alarms or set a schedule, Dr. Khoury recommends.

“I tell kids, ‘I want you to be your bladder’s boss. You tell your bladder it’s time to go,’” he says.

Eat a healthy diet

Preventing and correcting constipation is an important factor in ensuring proper urinary tract health, children should eat plenty of fruits, veggies and foods rich in fiber, Dr. Khoury says.

Fiber-rich foods include cereals, whole wheat bread and Fiber One bars.

“I prefer water, but if parents have to give the kids juice, use cranberry juice or prune juice,” Dr. Khoury says.

Practice good hygiene

Cleanliness, good toilet habits and proper hygiene in the genital area helps prevent the introduction of bacteria into the urinary tract, Dr. Khoury says.

When using the toilet, girls should be taught to wipe from front to back to prevent the spread of bacteria, he recommends.

Uncircumcised boys should be taught to regularly clean their penis and foreskin in the bath or shower, Dr. Khoury advises.

More articles about urinary tract infections in kids:

  • Circumcision and Urinary Tract Infections
    Some evidence shows that circumcised boys have a lower chance of developing urinary tract infections (UTIs) in their first years of life, but the added protection  may be miniscule, say ...
  • Urinary Tract Infections
    “UTIs are very common in children. Kids can get them at any age as they grow,” says Dr. Khoury, medical director of pediatric urology at CHOC. “What’s important for parents ...
  • Urinary Tract Infections: Fact or Fiction?
    Urinary tract infections (UTIs) are common ailments for children and adults alike, but many myths about the condition persist. Today, a nurse practitioner at CHOC Children’s Urology Center helps discern between ...