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UTIs in Children

What You Should Know

What You Can Do About It*

Don’t Let Your Child Be a Statistic

Aside from bedwetting, or sleep wetting, urinary tract infection (UTI) is one of the most-common infections in children, and its prevalence is higher in the first 2 years of life. According to a conservative estimate, by the age of eleven, 3 percent of girls and 1 percent of boys have had a detected UTI.

But your child doesn’t have to be a statistic! If you take good care of his or her urinary tract you can help to avoid infections that have been affecting so many kids.

Recognizing early the symptoms and properly treating childhood urinary tract infections is of the utmost importance. If left untreated, they can lead to serious, sometimes life-threatening kidney problems.

Natural Self-Defense Systems

The urinary tract is well protected against pathogenic, infection-causing bacteria. Our bodily self-defense systems include:

  • Urine – it functions as an antiseptic, helping to wash potentially harmful bacteria out of the body during normal urination.
  • Ureters and bladder – they are structurally designed to prevent urine from backing up toward the kidneys.
  • Bladder lining – when bacteria infect the cells that line the bladder they, literally, sacrifice themselves and self-destruct (a process called apoptosis, particularly important in the immune system). In so doing, the cells fall away from the lining, carrying the bacteria with them. This process eliminates about 90 percent of the E. coli.
  • Urethra – the boys’ urethra is longer than the girls’, not allowing bacteria quick access to the bladder; this probably accounts for why boys are less likely than girls to develop urinary tract infection. In addition, a male’s urethral opening is farther from sources of bacteria from the anus.

Common Risk Factors

Irritation of the urethra

Many substances, such as soap, bubble bath, synthetic clothing can cause soreness of the urethra, which makes it easier for bacteria to invade.

Improper wiping

This can increase stool and harmful bacteria around the urethra.

Holding the urine in

This allows more time for the bacteria, such as E. coli, to get to the bladder and multiply in there.


Large amounts of stool sitting in the colon can press up against the bladder and urethra, thus making it more difficult for the bladder to drain completely. This allows uropathogenic bacteria to grow.

Loose stools

Because it is less solid than a normal bowel movement, diarrhea can allow fecal bacteria to spread more easily across the perineum (the area between the anus and the scrotum or vulva) and into the urinary tract.

Anatomic abnormality

During development in the uterus, the tubes that connect the kidneys to the bladder, or the urethra, may not develop properly or may not hooked up right. This increases the risk of bladder infections.

Uncircumcised penis

(During the first year of life)

It is only true that an uncircumcised male has a higher chance of bladder infections during the first year of life. This risk goes away after age one. Therefore, it is no longer true that circumcising males leads to a significant decrease in the risk of bladder infections.

What About E. coli?

In most cases, urinary tract infection in children is caused by a variety of pathogens, infectious bacteria normally present in the intestines, especially in the rectum.

Nearly all infections of the lower urinary tract are caused by a few strains of uropathogenic Escherichia coli (UPEC), or E. coli for short.

Various strains of E. coli bacteria ordinarily reside in the lower gastrointestinal tract and do not belong in the urinary tract. However, they have multiple little hairs called cilia that function like little feet that allow them to climb from up the urinary tube (ureter), then into the bladder.

If E. coli bacteria get into the bladder, or the urethra, the body has ways of fighting them off. This includes the obvious methods of simply flushing them out with the urine.

Unfortunately, these bacteria have evolved ways of anchoring themselves to the cells of the urinary tract. The invading E. coli take advantage of receptors naturally found on the cells of the mucosal lining of the urinary tract.

These receptors are like molecular “docking bays” for substances which the cells need for their normal growth and development. E. coli use the “grappling hooks”, called type I pili, to first hook on to these receptors, and then to invade the cell. These hair-like appendages found on the surface of E. coli bacteria are composed of long, fibrous chains of a molecular “glue” called adhesin.

Once inside the cell, E. coli can live and reproduce in safety, shielded from many of the body’s defensive immune responses. These responses are so sophisticated that when the body detects that cells have been infected, it activates the cell suicide program. This process called apoptosis helps to destroy the bacteria.

Unfortunately, E. coli can flee the dying, self-destructing host cell before it is flushed out. And look for new cells to invade!

Here’s another problem: E. coli do return in as many as 30 percent of children apparently “cured” by antibiotics! Although within several days of medical treatments, the number of bacteria reproducing drop to zero, not all the bacteria are killed. They are able to survive by reverting to an inactive state.

Medical Diagnosis

When you bring your child into the doctor’s office for a possible bladder infection, checking a urine sample is the only way to diagnose it. Especially, when there are no outward signs on the penis or vagina that indicates an infection.

Urine Culture

This is the most accurate test to determine for sure whether or not an infection is present. The lab puts the urine sample in an incubator. If any bacteria are in the sample, they will multiply and show up. However, it takes 24 to 48 hours for the bacteria to grow enough to be detected.

Antibiotic Susceptibility Testing (AST)

If only one type of bacteria grows in the culture, the lab will expose the bacteria to a variety of antibiotics to see to which ones the bacteria are sensitive. This usually takes one day after the culture is positive. It helps to decide which antibiotic is best for the infection.

Urinary Analysis (U/A)

This test is commonly performed in the doctor’s office or in lab. It takes a few minutes. A dipstick is placed in the urine sample and up to ten different substances can be detected.

  • If the U/A is normal, and the child’s symptoms are mild, then you can probably just observe the child for the next few days. To be sure, a doctor can also send a urine culture to the lab (see above). Therefore, you should call the doctor’s office after one or two days to check the results. If positive, do not wait and call the next day again to check the sensitivity of the antibiotics (see above).
  • If the U/A is positive for infection, and the child’s symptoms are moderate to severe, probably a urine culture will be sent to the lab to confirm. However, a doctor will start an antibiotic treatment now to avoid allowing the infection to get worse.
  • If the U/A is positive, but the child’s symptoms are mild, a doctor may not start an antibiotic treatment while the urine culture is being done (since a positive U/A does not necessarily mean there is an infection).

Microscopic Urinalysis (U/A micro)

A doctor may also wait a few hours for the lab to run a microscopic urinalysis. A drop of urine is examined under a microscope to help in the decision whether or not to start an antibiotic treatment while the urine culture is running (see above).

Instead of going through the trouble of checking a urine sample, for older children with a known history of bladder infections (who have had several bladder infections with common symptoms) usually an antibiotic treatment is elected. In these children, a urine may be checked perhaps every other infection.

Standard Medical Treatment

Current standard medical care for a UTI includes taking oral antibiotics – a 5 to 7-day course (or longer for recurrent cases). If a kidney infection is suspected, a shot of a strong antibiotic can be given in the muscle to hit the infection harder, then continue with an oral antibiotic.

Periodic urine checks

After an antibiotic treatment, in about two weeks you should check another urine culture to make sure the urine has cleared up.

If your child has recurrent bladder infections, a urine culture should be checked every one or two months to monitor for infections.

If your child goes for six months without an infection, you can space out these urine checks per your doctor’s advice.

Prophylactic antibiotics

For children who have recurrent bladder infections, a daily prophylactic, low-dose of antibiotics is usually given to control any bacteria that may get into the bladder.

Prophylactic antibiotics are also given, if your child has known anatomic abnormality that makes him/her prone to infections.

Prophylactic antibiotics are given, if your child does not have abnormality, but continues to have infections despite the non-medical preventions.

Typically, these children will be taking an antibiotic for six to twelve months, then come off of it. The urine will be monitored with periodic urine culture checks (see above).

In addition to antibiotics

Medical establishment also the following measures considers useful:

  • Drinking lots of purified, lukewarm water – increasing daily fluid intake helps to flush out the bacteria.
  • Drinking cranberry juice – considered useful in addition to antibiotics, by helping the bladder to more easily flush out the bacteria (usually, three cups a day of diluted pure cranberry juice during the course of antibiotics are recommended).
  • Urinating frequently – not holding in the urine keeps the bacteria from multiplying inside the bladder.
  • Urinating in the warm bath – having your child sitting in a warm bath and urinate, especially if she or he is too afraid to urinate because of the burning.
  • Avoiding irritants – as soap, bubble bath, and shampoo suds can irritate the urethra and wash away its protective mucus layer.
  • Avoiding bubble baths – and not allowing your child to sit in soapy bath water.
  • Avoiding tight underpants – as they can irritate the urethra.
  • Proper wiping – teaching, girls in particular, how to wipe from front to back after having a bowel movement. For infants in diapers, be careful not to wipe around the vaginal area with a stool-contaminated wipe.
  • Avoiding constipation – large amounts of stool sitting in the colon can press up against the bladder and urethra, thus making it more difficult for the bladder to drain completely. This allows uropathogenic bacteria to grow.
  • Double voiding – have your child try to urinate twice each time to make sure the bladder is completely empty.

Limitations of Antibiotics

Although antibiotics are not ‘cure-alls’ for all, they have become a worldwide medical standard for urinary tract infections.

It is a well-known fact, however, that common antibiotic treatments do NOT successfully kill all the bacteria participating in the infection. Even after the antibiotic treatment, the number of bacteria reproducing drop to zero. This may, in fact, encourage many of the bacteria to persist in a resting, inactive state.

Even after a month of antibiotic exposure, about 10 million of the original 1 billion bacteria may remain.

Therefore, current standard drug treatments for bladder infections are not adequate and this phenomenon may account for many of the repeat urinary tract infections or non-responding to antibiotics.

Besides, children whose mothers are prescribed antibiotics during pregnancy have been found to have up to 20 percent increased risk of being hospitalized to serious infections.

Drawbacks of Antibiotics

Although routinely used, standard antibiotic treatments have many drawbacks as they:

  • Kill both the unwanted micro-organisms and wanted micro-organisms. (Research has shown that a single course of ciproflaxin can disrupt a third of the microbe species naturally present in the gut, and other work has suggested that in some people, the microbiome might never really recover.)
  • Lead to major disturbance in normal body microflora and intestinal microbiota.
  • Cause major disruptions in health, resulting in negative effects on immunity and metabolism.
  • Cause stomach upset, rash, and allergic reactions.
  • Lead to nasty yeast infections in girls; as the friendly bacteria are killed off along with the bad bacteria, the antibiotic insensitive yeast can grow out of control.

Therefore, due to the hazards, especially of prolonged antibiotic therapy, the need for antibiotics should be reduced. They often carry with them the risks of developing:

  • antibiotic-resistant bacteria,
  • gastrointestinal problems,
  • adverse effects on the liver and kidneys.

Bottom Line

Even low use of antibiotics in children can have a negative impact on their life.

Anatomic Abnormalities

Sometimes, aside from having ordinary bladder infection during their childhood, children can have anatomic abnormalities in the way the kidneys, bladder and urethra are hooked up. These abnormalities by themselves can cause recurrent bladder infections.

There are four possible abnormalities:

  • Tight or posterior urethral valves the valve or sphincter that normally keeps the bladder from emptying can sometimes be too tight or in the wrong position. This prevents the bladder from emptying completely; therefore, it can make the urine back up and cause backpressure on the kidneys. This abnormality can also cause the kidneys to dilate, which can lead to serious kidney damage, called hydronephrosis (back-pressure). Newborns born with this problem can either already have kidney damage from in utero backpressure, or can develop kidney damage rapidly during the first few months of life. Although this condition, occurring mostly in males, is rare, it does need to be diagnosed quickly. One clue to this problem is a weak urine stream. The urine will dribble out instead of shooting out to hit you in the face.
  • Vesicoureteral reflux (VUR) – when the flow of urine goes the wrong way. A one-way valve normally prevents the urine in the bladder from going back up into the ureters and kidneys. However, some children are born with immature ureter valves that allow the urine to go backwards and cause backpressure on the kidneys, or hydronephrosis. Although the backpressure on the kidneys is not as rapid and severe as the above problem, over time it can damage the kidneys. Most children often outgrow this problem as the valves mature over several years. Some, however, do not.
  • Abnormal kidneys or ureters – although very rarely, they can develop abnormally in a variety of ways. This condition prevents the urine from draining properly into the bladder and can lead to infections.
  • Hypospadias – a male birth defect, in which the urethra develops abnormally, usually on the underside of the penis. The opening can occur anywhere from just below the end of the penis to the scrotum. A form of hypospadias, in which the genitals are abnormally positioned, can also develop in females.

Spinal Cord Injury (SCI)

Neurological conditions like a spinal cord injury or impairment (SCI), usually result in neurogenic bladder – an unstable or atomic bladder, with no muscle tone.

Children with this condition have lost, partial or complete, control over their bladder and sphincter due to the compromised nerve receptors. These receptors are responsible for:

  • contracting and relaxing the muscles of the bladder and the sphincter,
  • registering feelings of pressure or release.

As a result, most paraplegics are exposed to the regular use of catheters and drugs. Unfortunately, catheters often increase the risk of urinary tract injuries and repeated bladder infections. It is a common problem in children with spinal cord impairment.

Exposed to repeated or long-term courses of antibiotics, in time, they also develop resistance to drugs what makes maintaining healthy urinary tract for them even more difficult.

Contrary to a popular belief and common medical practice, children with spinal cord injuries or spinal cord impairment do not have to suffer from chronic bladder infections and be exposed to vicious antibiotics.

Spina Bifida

Spina bifida is a birth defect of the backbone and spinal cord. It is the most common cause of neurogenic bladder in children. In this condition, the bones of the spine do not close all the way during fetal development. With this opening, the spinal cord, nerves, tissue and spinal fluid are exposed and may protrude through the opening as a small sac.

The lower the spina bifida happens on the spine, the less severe child’s symptoms will be from the defect.

In children with spina bifida the bladder dysfunction can lead to high-pressure bladders and urinary tract infections (UTIs). The last ones are a common source of morbidity among children with this condition that can damage the kidneys over time and may lead to kidney failure.

Children with spina bifida often lack feeling and control of their bladder and bowel in the same way as they may lack feeling and control of their feet and legs. This is because the nerves in the spine connecting the brain to the bladder (or bowel, or legs) have been interrupted, or disconnected.

In children with this condition UTIs are mainly due to the bladder not emptying properly. Only about 5% of them are able to empty their bladders without help.

The result is that they cannot usually feel when their bladder is full. And, after they have tried to empty it, it may still contain the residual urine.

The stagnant pool left in the bladder gets smelly and easily becomes infected. And over a period of time the stones (urinary calculi) may develop as well.

Bladder infections may affect the kidneys causing pyelonephritis and kidney damage, making the child ill. It may also happen with ureteric reflux when the infected urine travels up towards the kidneys. 

Because of the lack of feeling, many children with spina bifida do not know when they have an infection. They do not suffer from the scalding pain, which other children feel when they get cystitis.

Clean Intermittent Catheterization

The best way to prevent UTIs is to be sure that the bladder empties regularly and completely. One way of doing so is by clean intermittent catheterization (CIC) along with being vigilant with a hygiene program and following strict hygiene guidelines.

There are different length catheters available suitable for either boys or girls. The urine flows out of the bladder through the catheter into the lavatory, or into a container, and then the catheter is removed after complete emptying. This should be done 4 – 5 times a day, but for those who have a smaller bladder this may need to be increased to 6 times. With practice catheterization becomes quite easy and may take less than five minutes.

Unfortunately, children with spina bifida are often constipated and pressure from an overfull bowel may add to the difficulty of emptying the bladder. They may also have poor control over their bowel movement.

Since most urinary infections are caused by bacteria which normally live in the bowel, mainly E. coli, it is important to wash this part of the body carefully. Girls should be taught always to wipe from front to back.

Medical Antibiotic Treatment

When necessary, antibiotics and other drugs are given in small doses for months or years to prevent urinary infections. They are mainly used for children who have reflux. In spite of this, urinary infections may still break through and need a course of a different treatment.

Doctors also recommend such preventive measures as:

  • Maintaining adequate fluid intake by encourage your child to drink at least 4 cups a day of purified, lukewarm water and carry a drink bottle with them at all times. (The aim is to increase the intake to 2 liters). 
  • Ensuring regular complete bladder emptying (good drainage).
  • Relieving constipation.
  • Ensuring the use of appropriate catheter size and type.
  • Maintaining a strict hygiene routine.

*Based on various available sources and studies, our research and practical experience. Last modified on December 21, 2020.

Alternative Natural Measures

Supplemental D-Mannose

Within 1 to 2 days, supplemental D-mannose, a close cousin of glucose, can cure up to 90 percent of all E. coli bladder infections. Even more remarkably, it accomplishes this feat without killing a single bacterium!

And because it gets rid of the bladder infection-causing bacteria without committing “bactericide,” children who use it suffer none of the unwanted side effects of antibiotics:

  • No gastrointestinal problems!
  • No yeast infections!
  • No resistant bacteria!

Tastes Good!

It is ideally suited for children. Because it tastes so good, children actually enjoy taking it.

No Known Drawbacks

When faced with a potentially pathogenic germ like E. coli, conventional, pharmaceutically based medicine typically confronts the problem by throwing the most potent poisons it can find at the bugs – antibiotics.

Unlike virtually any conventional pharmaceutical medication, supplemental D-Mannose has no known drawbacks.

Just As Effective As Antibiotics

Happily, “bacteria-cide” is not the only possible avenue of attack. Years of clinical experience have shown that supplemental D-Mannose is just about as effective at curing bladder infections caused by E. coli as antibiotic drugs.

The First Line of E. coli Treatment

Many research reports have demonstrated its mode of action and effectiveness against E. coli. There is no argument at all about this among researchers who have studied it.

Natural medicine-oriented physicians have been recommending D-mannose to people with bladder infection since the mid-1980s with great success.

Supplemental Probiotics

One of the best-documented applications of probiotic supplements is in the prevention and treatment of urinary tract infections.

Health benefits of the quality supplemental probiotics can be summarized as follows:

  • They are safe for daily use.
  • They support urogenital and vaginal health, production of the lactase enzymes and protect the gut lining from unwanted materials.
  • They promote the proper “gut flora”.
  • They support and stimulate the immune system.
  • They inhibit some types of detrimental/pathogenic bacteria.
  • They help to restore and re-establish the body beneficial microflora damaged and killed by pharmaceutical antibiotics.
  • They help to normalize digestion (by adhering to the cells of the intestinal wall without damaging it).
  • They promote and support regularity and alleviate constipation.

Probiotics are found in fermented foods such as yogurt, sauerkraut, and kefir. Many of these foods rich in probiotics are still of great importance to the diets of most of the people in the world.

Scientists, however, have found a way to freeze-dry these beneficial bacteria and put them in capsules. The specific microorganisms found in these capsules are usually lactobacilli and bifidobacteria, which are the major probiotics found in the human intestinal tract.

Antibiotics and the Gut Bacteria

The repetitive use of antibiotics leads to multiple adverse health effects, as these drugs:

  • Kill both the unwanted (pathogenic) micro-organisms and wanted (beneficial) micro-organisms.
  • Deprive the gut of normal, protective microflora, resulting in major disruption in health.
  • Cause stomach upset, rash, and allergic reactions (e. g. Bactrim).
  • Lead to nasty yeast infections due to overgrowth of Candida albicans (as the friendly probiotic bacteria are killed off along with the bad bacteria, the antibiotic insensitive yeast can then grow out of control).

Therefore, due to the hazards, especially of prolonged antibiotic therapy, the need for antibiotics should be significantly reduced.

As for almost all good (friendly) bacteria it takes six months to recover after exposure to antibiotics, probiotic supplements are a simple and effective way to get them re-established in the gut microbiota, or “gut bacteria”.

The efficacy of probiotic supplements is based solely on the number of live organisms present. Therefore, desired therapeutic results can be achieved by taking the minimum of 50 billion viable bacteria per day.

Grateful Mother Writes to Us

(Real Life Story)

She is antibiotic-free!

Dear Andrew,

My daughter, now 9, was born with multiple complications, which had led to many surgeries and a lifetime of having to catheterize to urinate.

Because of the catheterizing, she was plagued for about 3 years with UTIs which involved being on a daily antibiotic and huge doses of very strong antibiotics about every 2-3 months…

It was a downward spiral, which just kept getting worse.

I have always looked for alternatives from Western medications to heal the body and bring it back to homeostasis. In my long and desperate search I found Uribiotic Formula.

I knew this would help my daughter, so I told her urologist about what I was putting her on. They were very happy to help out.

Since her infections were so huge and she had been on daily antibiotics for so long it has taken about 9 months of working very diligently with Andrew at Full of Health.

Now, my daughter’s urologist says that she is antibiotic-free!

She has been off daily antibiotics for 2 months now and without a full-blown infection requiring high dose antibiotics for 4 months.

This is so amazing and such a benefit for her future! This is one more huge piece of the puzzle for bringing my daughter into optimal health throughout her life.

Thank you, Andrew, from the bottom of my heart for creating Uribiotic Formula!

Jenny B.

La Mesa, California, USA

Doing amazingly well!

Hello Andrew,

I’m so excited to email you once again about the progress of my daughter, now 10. She has been on your Uribiotic Formula for almost a year and a half and has been doing amazingly well!

A few weeks ago, she had her yearly urological checkup and ultrasound to keep tabs on everything. What the doctors found amazed them!

In the past ultrasounds she already had signs of nephrosis (kidney damage) and thickening of the bladder wall (also not good). Each year the tests showed more and more damage.

BUT, the test a few weeks ago showed that the damage to her kidneys was almost undetectable and her bladder wall showed no signs of thickening. Both hard to reverse the damage! Of course, we are going to “continue what we are doing.”

When I found on the Internet the Uribiotic Formula for my daughter I was just hoping to put a stop to the damaging antibiotic cycle happening to her body. I never expected it would reverse the damage already done!

Once again, from an overjoyed parent, thank you, Andrew!

Jenny B.

La Mesa, California, USA

No antibiotics for over a year!

My daughter continues to do great with Uribiotic Formula, d-Mannose MAX, and UT ProbioticsUltra. No antibiotics for bladder infections for over a year!

Thanks, Andrew!

Jenny B.

La Mesa, California, USA

The miracle your products have accomplished

Hello Andrew,

It has been 2 years since my last review and my daughter is doing wonderfully! She was 9 when I first found your URIBIOTIC… She is now 12.

She has not had a full-blown infection needing antibiotics for a bladder infection for years now.

Her urologist and nurse refer others to me at times for information and I am happy to tell them the miracle your products have accomplished with my daughter. I hope that we can help others find these healthy ways to heal the body.

Once again, from the bottom of my heart, THANK YOU!

Jenny B.

La Mesa, California, USA

How Do I Know if My Child Has a UTI?

(Symptom Checker)

Your child might have a urinary tract infection?

Interested in getting a second opinion?

The UTI symptoms can develop quite rapidly – over a matter of hours, or more slowly – nagging for several weeks. Although not everyone with a urinary tract infection has symptoms, most children get at least some, especially:

  • a frequent and sudden urge to urinate, sometimes incontinence may occur; having to go a lot during the day and/or night (one of the hallmark symptoms of a UTI;
  • a sharp pain or painful, burning sensation with itching in the area of the bladder or urethra during urination (dysuria).

It should be noted, however, that some mild cases of acute urinary tract infection may disappear spontaneously without any treatment.

All UTIs, though, should be thought of as the warning signs of something going on inside the urinary tract. They may seem unimportant at first, but they should never be ignored.

Please fill in our five-part questionnaire below, answering all questions thoughtfully, to the best of your knowledge. By doing so, you will be much better prepared for an eventual doctor’s appointment. It might also help your doctor determine if your child needs a urine test, which is not always a routine practice.

As for the symptoms, they are sensations or perceptions of changes in health experienced by your child and/or most likely observed by you as a parent.

Within 12 to 24 hours, you will email* you back the results along with our brief recommendations (if necessary) that may help you get your child’s urinary health back on track. The information given, however, is not intended to diagnose, prescribe or replace the advice of a physician or other healthcare professional.

*Confidentiality Assurance

As privacy is one of the most important issues for all of us on the Internet, please rest assured that all your answers in this questionnaire are strictly confidential. We do not share any part of the completed questionnaire with anyone. Also, your email address is safe with us. We will never rent, sell, or exchange your contact information with anyone.

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