What to Do When Your Toddler Says It Hurts to Pee

Parents of toddlers have enough bathroom issues to deal with between potty training and butt wiping. So when you hear “It hurts when I pee," it's totally understandable to feel overwhelmed. Worse is when your child is too young to say those dreaded words and you have to guess based on their signals.

So what does it mean when they say it hurts to pee? And what should you do? Three experts share advice.

Signs your toddler may be experiencing painful urination

While some toddlers can express themselves and tell you something is wrong, language skills can vary. If that's the case,  Dr. Jenna Wheeler suggests having your child point to where it hurts.

“If a child suddenly doesn't want to urinate, asking why can be helpful. They may not be able to express the issue but they may be able to convey clues to help diagnose.”

If your child is too young to communicate with words, trust your instincts to figure out what's wrong. “A lot of diagnosing toddlers is watching for the signs of illness and changes in typical behaviours. As a parent, listen to your gut instinct,” says Dr. Wheeler.

A fever without a cough or runny nose might be a urinary tract infection (UTI), but not always. “Your slightly older child might tell you that it hurts when she goes pee, but actually that history usually does not turn out to be a UTI. It is more commonly external irritation (vulvovaginitis) and not an infection,” notes Dr. Susong.

Watch for these signs:

• Crying, fussiness or complaining of pain or a burning sensation during urination

• Frequent trips to the bathroom with little output

• Cloudy, foul-smelling, or bloody urine

• Fever or irritability

• Abdominal pain or discomfort

When to Seek Medical Attention

If your child has bladder infection symptoms, see a doctor before the pain gets worse. Treating a UTI early helps prevent a more serious infection, says Dr. Wheeler.

So, if your child exhibits any of the following signs of infection, you should seek medical attention:

• Persistent pain or discomfort lasting more than a day

• High fever (over 101°F or 38.3°C)

• Visible blood in the urine

• Severe abdominal pain

• Inability to urinate or very little urine output

How is a toddler UTI treated?

To find out if your toddler—or older kid—has a UTI, your doctor will need a urine sample. Doctors use special collection bags to get urine samples from young kids.

The urine will be tested for bacteria. If the test is positive, your child will be treated with antibiotics.

Common causes of painful urination in toddlers

Painful urination in toddlers can have many causes, including UTIs, which are more common in girls. “UTI is caused by an infection in the bladder that can progress to become a kidney infection. The infection is typically a bacterial infection from bacteria from the poo contaminating and getting into the urethra and bladder,” says Dr. Susong.

Older girls are more prone to UTIs after puberty due to moisture and pH changes." That is why it is so rare in toddlers and young children. It is also more rare in boys because of their different anatomy. If a boy gets a UTI at any age, we always recommend taking a closer look at why by doing more evaluation," says Dr. Susong.

Painful urination can also be caused by irritants like bubble baths, soaps, tight-fitting clothing, or poor hygiene.

So how to prevent being in this predicament? Staying hydrated, wearing cotton underwear, using unscented detergents, and preventing constipation can help avoid UTIs, says Dr. Wheeler. "Constipation can prevent the bladder from fully emptying and lead to infection."

How to prevent future issues

Water

As most parents know, getting your child to eat and drink can be challenging, especially if they are feeling unwell. “Water is important because one of the best things to do to prevent UTIs is to stay hydrated," says Alyssa Smolen, MS RDN CDN. This is because water helps flush out bacteria, keeping the urinary tract functioning,

Vitamin C

“Vitamin C-rich foods like oranges or green leafy vegetables can play a role in urinary health," says Smolen. Vitamin C makes urine more acidic, which contributes to fighting bacteria from growing in the urinary tract.

Fibre

"Other considerations when preventing UTIs include being mindful of fibre. Regular bowel movements can help prevent UTIs, as irregular bowel movements can put pressure on the urinary tract.”

Probiotics

Dr. Susong suggests adding probiotics such as lactobacillus to your child’s diet to prevent bacterial adhesion (sticking to the lining of the urethra and bladder). “This may also change the gut and perineal bacterial flora which can help prevent "bad" bacteria such as e. coli from causing infection. In our house, we love kefir, active yogurts, and yogurt drinks.” (These good bacteria foods are also important to consume after taking antibiotics for a UTI.)

Cotton clothing

Then, switch to breathable clothing in natural fibres like cotton. And don’t forget to check that little ones who are potty-trained are wiping front to back or those changing their diapers are doing the same. Dr. Wheeler also emphasizes the importance of communicating with your child’s doctor.

What to avoid

And while there are no foods that can cause UTIs in kids, there are a few things that can exacerbate the symptoms, says Dr. Wheeler. These include acidic foods, caffeine, artificial sweeteners and high-sodium, spicy and processed foods.

Home remedies to alleviate discomfort

“Speak to your pediatrician and see if an over-the-counter medication like acetaminophen or ibuprofen is appropriate for your child. They can also recommend antispasmodic medication if needed. Lots of hydration to dilute the urine is one of the best treatments. Heating pads can help with abdominal pain as well.”

Lastly, a few lifestyle changes can address these concerns. These include proper bathroom hygiene, taking care of constipation issues promptly, taking regular bathroom breaks, and avoiding potential irritants.

FAQs

How can you tell if a child has a UTI?

Your child might have a UTI if they are crying or fussy during urination, they have to go to the bathroom frequently with little output, their urine is bloody, or they have a fever or are experiencing abdominal pain or discomfort.

What can be mistaken for a UTI in children?

Irritation from products such as bubble baths, soaps, lotions, and tight-fitting clothing can be mistaken for a UTI. If you suspect your child has a UTI, it’s best to avoid these types of products until they are diagnosed.

Can a child clear a UTI without antibiotics?

According to Dr. Wheeler, your child's doctor will need to prescribe antibiotics to treat a UTI. "Not treating it properly with antibiotics can lead to serious complications, including kidney failure and death."

What are the reasons for UTIs in kids?

UTIs are generally caused by bacteria from feces getting into the urethra and bladder. This can happen if a child doesn’t wipe properly or a caregiver does not wipe them properly.

Experts

• Dr. Jenna Wheeler, MD, is a pediatric critical care physician with Orlando Health Arnold Palmer Hospital for Children. She is board-certified in pediatrics and pediatric critical care.

• Dr. Becca Susong is a pediatrician passionate about supporting new moms during the fourth trimester and created a “podclass” to help with the postpartum transition.

• Alyssa Smolen, MS, RDN, CDN, is a New York/New Jersey-based registered dietitian.