UTI Symptoms in Children by Age: When to Contact a Doctor
In children younger than 2, a urinary tract infection (UTI) may cause unexplained fever, fussiness, or poor feeding without obvious urinary symptoms. Children age 2 and older may report burning when they pee, a sudden need to go, or lower belly pain. Contact your child’s clinician today for possible UTI symptoms or fever without a clear cause. A baby younger than 3 months with a temperature of 100.4°F (38°C) or higher needs immediate medical evaluation. A urine test is needed to confirm a UTI.
Babies and children younger than 2
Young children may not be able to show you where it hurts. Watch for:
Fever without an obvious explanation.
Unusual fussiness.
Poor feeding or reduced appetite.
Poor weight gain.
Vomiting or diarrhea.
These symptoms can have many causes. The absence of crying during urination does not rule out a UTI, and fever may be the only noticeable sign. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) explains these age-related symptoms.
Do not wait for a young child to develop burning or other obvious urinary symptoms before contacting their clinician about unexplained fever.
Children age 2 and older
As children become better able to describe symptoms, a bladder infection may be easier to recognize. Possible signs include:
Pain or burning with urination.
Needing to pee often or urgently, sometimes passing only a small amount.
New daytime accidents or bedwetting after toilet training.
Pain or discomfort in the lower belly.
Cloudy urine or visible blood in the urine.
Ask simple questions such as, “Does it hurt when you pee?” and “Where does your tummy hurt?” A child who cannot yet explain symptoms may still show the less specific signs seen in younger children.
Urine appearance or smell alone cannot confirm a UTI. Burning can also have other causes, including irritation around the genital area. A clinician needs to assess the symptoms and arrange urine testing.
When symptoms may mean a kidney infection
Fever or chills, nausea or vomiting, and pain in the back, side, or groin can signal a kidney infection. Seek prompt medical care today, particularly when these occur with urinary symptoms. A child does not need to have every sign to need care.
NIDDK describes these possible kidney-infection warning signs. Do not rely on home care alone while waiting for them to pass.
Where and when to seek care
Immediate evaluation: A baby younger than 3 months has a temperature of 100.4°F (38°C) or higher. Call their clinician immediately; if prompt evaluation is unavailable, go to an emergency department.
Care today: Your child has possible UTI symptoms, unexplained fever, blood in the urine, or possible kidney-infection signs. Contact their pediatrician. If the office cannot see them promptly, ask where to go for pediatric urgent care or emergency evaluation.
Emergency department now: Your child cannot keep fluids down, is peeing much less than usual, cannot urinate, has severe belly or back pain, or appears very ill.
Call 911: Your child is unresponsive, very difficult to wake, or having serious trouble breathing.
What to do while arranging the visit
Write down when symptoms started, the highest measured temperature, feeding or drinking changes, vomiting, and changes in wet diapers or bathroom trips. Mention any previous UTIs.
Offer breast milk or formula to infants and usual age-appropriate fluids to older children, in small amounts if needed. Do not force large amounts or delay care to see whether fluids help. Encourage toilet-trained children to use the bathroom when they need to go.
Ask the clinic how it wants a urine sample collected. Collection methods depend on age and toilet training; urine squeezed from a diaper is not a reliable sample. The clinician may order a urine culture to identify bacteria and guide treatment.
A confirmed bacterial UTI generally needs prescribed antibiotics. Do not give leftover or someone else’s antibiotics. If antibiotics are prescribed, give them exactly as directed and seek reassessment if symptoms worsen or are not improving as expected.
This article provides general education and does not replace medical evaluation, diagnosis, or treatment for your child.
By Sang Hyun Ahn, MD
