A couple of week ago I woke up to the sound of little Sucrose sniffling in the dark. She was feeling sorry for herself as she lounged in bed. When I made an attempt to scoop her into my arms, she started wailing and crying more. Slowly through hiccups and more tears she managed to convey that her ‘toilet place’ was burning.
The poor darling. The crying didn’t stop for much after. Her doctor advised immediately starting her on ORS (oral rehydration solution) and to give a pain killer if she complained of more pain. The minutes couldn’t have passed more slowly as we waited for her to pass urine. The urge was there but none was coming at all. I was stupefied and bugged. I had heard of other children getting UTI, but foolishly thought Sucrose would be above it.
After the initial scare of her crying in pain, I started to look for reasons for this problem, and promptly fell into all wrong conclusions as I discussed with other parents and well wishers. At last the internet came to my help. Here is a bit of info I gathered about UTI to dispel some myths and assumptions about it.
What is UTI?
UTI or Urinary Tract Infection is an infection in our urinary system – the place where four of our pals are hard at work getting urine out of our body – the kidneys, urinary tract, bladder and the urethra. When bacteria enter this part from our digestive system, the seemingly harmless bacteria cause havoc which include a range of symptoms.
Types of UTI:
Cystitis – Most of UTI happens when the infection is in the bladder, where the urine is stored, or in the urethra. The urge to urinate is more and it might also hurt when the child urinates. There might be lower abdominal pain and the urine could be yellow and smelly. (I suspect Sucrose had this problem). Other symptoms I have listed down.
If early detection and subsequent treatment is not followed, any of these can lead to Pyelonephritis which is an infection in the kidneys. It causes fever, shivering, vomiting and pain, and would need immediate medical attention.
Symptoms of UTI:
- pain, burning, or a stinging sensation when urinating
- an increased urge or more frequent need to urinate (though only a very small amount of pee may be passed)
- waking up at night a lot to go to the bathroom
- wetting problems, even though the child is potty trained
- belly pain in the area of the bladder (generally below the belly button)
- foul-smelling urine that may look cloudy or contain blood (https://kidshealth.org/en/parents/urinary.html)
All of the above symptoms was accompanied by terrible crying and copious tears while urinating. After sometime Sucrose was scared to go to the restroom and had to be coaxed to even try. This can be quite nerve racking to the parent.
Risk factors of UTI:
Girls are more prone to getting UTI than boys. A girl’s urethra is shorter and closer to the anus and so unclean toilet habits can lead to infection spreading to the urethra.
Other than this, the reasons are to do most with genetics – malformed kidney or a block in the tract or an abnormal backward flow of urine from the bladder up (But this was ruled out for Sucrose).
Poor toilet hygiene is another reason for UTIs. For all us fussy mothers who worry ourselves sick thinking that unclean bathrooms or toilet seats might lead to UTI, there is no cause to worry. The bacteria causing UTI can’t simply enter the urinary tract from sitting on dirty toilet seats, except that it is kinda gross for us. But poor toilet hygiene – like not washing the pubic region after passing stools or urine or wearing underwear that is not clean can lead to bacteria breeding. And that in turn can lead to UTI. Also, Sucrose started holding up her urine when she started school as she didn’t find the toilets clean. This could also lead to bacteria breeding and may have resulted in the problem. I never did find out.
So what is personal toilet hygiene?
Washing the genital area with water after urinating or passing stools is very essential. While at home, we may ensure that our toddlers are cleaned properly after they use the bathroom, that might not be the case when they are in school. In Sucrose’s school she has difficulty getting a care taker to wash her if she had gone potty. It is difficult for toddlers to wash their bum at this young age. So yeah, that is a challenge. Girls especially have to be taught to wash from front to back to ensure no bacteria from the back enters the urethra. Children should be encouraged to use the health faucet after using the toilet.
How can we treat UTI?
Firstly our pediatrician asked me to start her off on ORS and fruit juices immediately. We did just that and kept track of the number of times she urinated and how much. It was tough and difficult to see her struggling through it. We had to take off from school for the few days it took for her to get slightly better. It is easily a month before we can see improvement.
She was also given a pain killer to dull the pain she felt while urinating. I gave it only on need basis. Urine samples were sent for urine culture test to decide further course of action, but luckily it came back negative. If the culture had shown the presence of bacteria then according to the type, antibiotics would have been started. Once antibiotics are started, it must be taken compulsorily until the infection is completely gone. A urine test is taken again to rule out bacterial growth. Even if the child begins to feel better, they must be made to complete the course.
The best therapy was of course ensuring the child drank a lot of fluids – tender coconut water, butter milk (lots of electrolytes in both), ORS (oral rehydration solution), water, milk, fruit juices and such. Drinking a lot of water helps dilute their urine and wash out the infection. The parent has to ensure that her ward passes urine even if it pains.
It was a huge relief when she got back to normal after a week. Now, I am ensuring that she drinks a lot of water and have given directions on how to wash herself. I hope the pain and trouble caused by the infection would be enough to remind Sucrose to ensure clean toilet habits.