In most cases, urinary tract infection (UTI) in children is caused by a variety of pathogens - infectious bacteria - normally present in the intestines, especially in the rectum (colon).
Nearly all infections of the lower urinary tract - of the bladder and the urethra - are caused by a few strains of uropathogenic Escherichia coli (UPEC), or E. coli for short.
Various harmless strains of E. coli bacteria are normally present in the body - but they do not belong in the urinary tract. These bacteria have multiple little hairs called cilia that function like little feet that allow them to climb from up the urinary tube, then into the bladder.
If E. coli bacteria get into the bladder or the urethra (tube that carries urine from the bladder), the body has ways of fighting them off - including the obvious methods of simply flushing them out with the urine.
These bacteria, however, 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. Like pirates in an old movie, E. coli use "grappling hooks", called type I pili, to first hook on to these receptors, and then to invade the cell.
These pathogenic grappling hooks 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.
In fact, these immune responses are so sophisticated that when the body detects that cells have been infected and activates the cell suicide program to destroy the bacteria, E. coli can actually flee the dying host
cell before it is flushed out - and look for new cells to invade!
UTI in Children: Top Risk Factors
- Irritation of the urethra - many substances, such as soap, bubble bath, stool, or clothing can cause soreness of the urethra, which makes it easier for bacteria to invade.
- Holding the urine in - this allows more time for the bacteria such as E. coli to get to the bladder and multiply in there.
- 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.
- Improper wiping - this can increase stool and harmful bacteria around the urethra.
- Anatomic abnormality - during development in the uterus, the tubes that connect the kidneys to the bladder, or the urethra, do not develop properly or are not hooked up right. This increases the risk of bladder infections. (More on this later).
- Uncircumcised penis; however, 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.
UTI in Children: Common Symptoms
These symptoms do not necessarily mean there is a bladder infection. They just mean there might be a bladder infection. The only way to diagnose it is checking a urine sample in the doctor's office or in lab.
- Pain or burning with urination.
- Frequent urination.
- Urgency (your child will have a very strong, painful urge to urinate).
- Fever (mild infections often w will not cause fever, but moderate to severe bladder infections that involve the kidneys do cause fever).
- Foul-smelling urine.
PLEASE NOTE: Occasionally the bacteria causing a bladder infection with ascend up into the kidneys and cause a kidney infection. This can be serious, since kidney infections can scar the kidneys.
In this case, the symptoms of bladder infection are accompanied by:
- Lower back pain or side pain - this is where the kidneys are located.
- High fever - this indicates a possible kidney infection. Unlike "viral infections" in which the fever fluctuates between normal and very high, with kidney infections the fever stays high (usually 102º F or higher) and your child looks and acts progressively sicker; bladder infections usually do not cause fever.
- Vomiting - this is also a common symptom when a kidney infection is present.
Fortunately, most bladder infections do not turn into kidney infections, and a small scar in one kidney infection is harmless. But kidney infections are to be taken very seriously and treated promptly.
UTI in Children: Medical Diagnosis
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, as there is usually no outward sign on the penis or vagina that indicates an infection.
Urinary Analysis (U/A)
This test is commonly performed in the doctor's office or in lab. It just 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 below). 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 below).
It 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.
Urine Culture
With no dobubt, urine culture 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.
PLEASE NOTE: 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 instead of going through the trouble of checking a urine sample. In these children, a urine may be checked perhaps every other infection.
UTI in Children: 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.
In addition to antibiotics, the following measures medical establishment considers useful:
- Drinking cranberry juice - considered by medical establishment useful, in addition to antibiotics, in helping the bladder to more easily flush out the bacteria (three cups a day od diluted pure cranberry juice during the course of antibiotics are recommended).
- Drinking lots of water - indreasing daily fuid intake to flush out the bacteria.
- Urinating frequently - not holidng in the urine; it keeps the bacteria from multiplying inside the bladder.
- Urinating in the warm bath - have your child sit in a warm bath and urinate if she or he is too afraid to urinate because of the burning.
- Avoiding irritants - soap, bubble bath, and shampoo suds can irritate the urethra and wash away it's protective mucus layer. Avoid bubble baths and don't allow your child to sit in soapy bath water.
- Avoiding tight underpants - this can irritate the urethra.
- Proper wiping - you need to teacj your child 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.
Periodic Urine Checks
After an antibiotic treatment, you should check another urine culture in about two weeks 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 appropriate - if a child:
- has known anatomic abnormality that makes him prone to infections or
- does not have abnormality but continues to have infections despite
the non-medical preventions.
Typically children will take an antibiotic for six to twelve months, then come off of it and monitor the urine with periodic urine culture checks.
UTI in Children: Limitations of the Antibiotic Treatments
It is a well-known fact 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, and
- 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.
UTI in Children: Drawbacks of the Antibiotic Treatments
Although routinely used, standard antibiotic treatments have many drawbacks, such as:
- antibiotics successfully kill both the unwanted micro-organisms and wanted micro-organisms;
- long-term or often repeated antibiotic use leads to major disturbance in normal body microflora, and sometimes to major disruption in health;
- antibiotics, such as Bactrim, may cause stomach upset, rash, and allergic reactions;
- many girls end up with nasty yeast infections; as the friendly 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 used to clear up the infection, should be reduced, as all antibiotic therapies carry with them the risks of developing:
- antibiotic-resistant bacteria,
- gastrointestinal problems, and
- adverse effects, especially on the liver and kidneys.
Urinary Tract: Natural Self-Defense Systems Against Bacteria
The natural safeguards - bodily defense systems that protect the urinary tract against pathogenic, infection-causing bacteria include:
- The flow of urine which functions as an antiseptic, helping to wash potentially harmful bacteria out of the body during normal urination. (Urine is normally sterile, that is, free of bacteria, viruses, and fungi!).
- The ureters (tubes that carry urine from the kidneys to the bladder) and bladder which are structurally designed to prevent urine from backing up toward the kidneys.
- The bladder lining - when bacteria infect the cells that line the bladder they, literally, sacrifice themselves and self-destruct (a process called apoptosis). In so doing, they fall away from the lining, carrying the bacteria with them. This process, sugested by some interesting research, eliminates about 90% of the E. coli.
- The male urethra is longer than the female's, not allowing bacteria quick access to the bladder and this
probably accounts for why males are less likely than women to develop urinary tract infection. In addition, a male's urethral opening is farther from sources of bacteria from the anus.
Repeated UTIs in Children: Possible Factors
Children who have had three or more (3+) infections a year are likely to continue having them. In other words, they can get another infection within 18 months of the last one, or even more requently.
Possible multiple factors behind recurrent urinary tract infections include:
- The ability of E. coli bacteria to attach to cells lining the urinary tract.
- Chemical irritation due to commercial toiletries, such as bath additives and washing powder.
- The separate infections, stemming from a strain or type of bacteria different from the infection before (even when several urinary tract infections in a row are due to E. coli, slight differences in the bacteria indicate distinct infections).
- The inadequacy of the current standard drug (antibiotic) treatments for urinary bladder infections.
Some children, however, have recurrent symptoms suggestive of urinary tract infection - but without infection being present. Although this condition is not serious, it can be troublesome.
Because of the chance of kidney infection (pyelonephritis), repeated or chronic urinary tract infections should be always treated thoroughly to ensure that the urinary tract is free of bacteria.
UTI in Children with 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 that 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, and can make the urine back up and cause backpressure on
the kidneys. This can 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. This condition that occurs mostly in
males is rare, but 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.
- Vessico-ureteral reflux (VUR) - the problem here occurs
where the urine tubes from the kidneys empty into the bladder. These
tubes are called the ureters. A one-way valve normally prevents the
urine in the bladder from going back up into the ureters and kidneys.
Some children are born with immature ureter valves that allow the urine
to go backwards and cause backpressure on the kidneys, or
hydronephrosis. The backpressure on the kidneys isn't as rapid and
severe as the above problem, but over time it can damage the kidneys.
Children will often outgrow this problem as the valves mature over
several years. Some, however, do not.
- Abnormal kidneys or ureters - very rarely the kidneys, or
the tubes that drain them into the bladder, can develop abnormally in a
variety of ways. This 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.
UTI in Children with Spinal Cord Injury (SCI)
Neurological conditions like paraplegia, a spinal cord injury, also
called spinal cord impairment (SCI), usually result in neurogenic
bladder - an unstable or atomic bladder, with no muscle tone.
Children with spinal cord injuries have lost, partial or complete,
control over their bladder and sphincter due to the compromised nerve
receptors that are responsible for:
- contracting and relaxing the muscles of the bladder and the sphincter, and
- registering feelings of pressure or release.
Due to this condition, most paraplegics are exposed to the regular use
of catheters and drugs. (The more traditional cap and bag, with
continual drainage, is falling from favor even though it is a safer system).
However, catheters often increase the risk of urinary tract injuries
and repeated bladder infections - 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.
However, 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.
D-Mannose: Natural Alternative to Antibiotics
D-mannose, a close cousin of glucose, can cure up to 90 percent of all E. coli bladder infections within 1 to 2 days. Even more remarkably, D-mannose accomplishes this feat without killing a single bacterium!
And because it gets rid of these bladder infection-causing bacteria without committing "bactericide," children who use it suffer none of the unwanted side effects of antibiotics:
- no gastrointestinal (GI) problems,
- no yeast infections, and
- no resistant bacteria.
In fact, D-mannose has no adverse side effects of any kind.
It Tastes Good!
As a bonus, D-mannose actually tastes good. Where a "spoonful of sugar" helped the medicine go down in Mary Poppin's day, with D-mannose, a spoonful of sugar is the medicine.
It Is Effective and Safe!
Because it is so effective and so benign, women (even pregnant women) who are susceptible to recurrent bladder infections, can safely take D-mannose as a preventive measure to head off future E. coli attacks.
It Is Suitable for Children
D-mannose is also ideally suited for children with bladder infections. Because it tastes so good (it is a sugar, after all!), children actually enjoy taking it.
It Is Just As Effective As Antibiotics
Although D-mannose is still virtually unknown to many practitioners of conventional medicine, many research reports have demonstrated its mode of action and effectiveness against E. coli, the microorganism that
causes most bladder infections.
Moreover, several years of clinical experience have shown that it is just about as effective at curing bladder infections caused by E. coli as antibiotic drugs.
It Has No Known Drawbacks
At first glance, D-mannose may sound too good to be true: a "medicine" that's highly effective, perfectly safe, pleasant to use and available without a doctor's prescription. Yet, it is true!
Unlike virtually any conventional medication, and many natural or alternative treatments as well, D-mannose has no known drawbacks.
D-Mannose Vs. Antibiotics
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.
While there is nothing essentially wrong with killing disease-causing bacteria, this approach does have some very serious drawbacks. Happily, "bacteria-cide" is not the only possible avenue of attack.
Another, more natural way to eliminate E. coli infections from the urinary tract is to beat them at their own game. If they are going to cause trouble, bacteria usually have to find a way to adhere (stick) to the body tissue they are infecting.
In bladder infection, E. coli attach to cells lining the bladder and urinary tract using filmy, hair-like
projections called fimbria on their cell walls.
At the tip of each fimbrium is a glycoprotein (a combination carbohydrate and protein) called a lectin that is programmed to bind to the first molecule of the sugar mannose that it encounters.
It turns out that molecules of mannose (produced inside urinary tract lining cells) naturally dot the surfaces of these cells. Here they act as "receptors," inviting the fimbria of E. coli to attach, and allowing
them to bind to the tissue in a tight, Velcro-like grip.
If not for this attachment to the cell's mannose, any E. coli that had successfully ventured up the urethral river would be unable to stick to the slippery surface and would be washed right back out on the next tide of urination.
How Does D-Mannose Work?
Now imagine what would happen to E. coli in the urinary tract if those sweet little mannose molecules they crave were present not just on the surface of the epithelial cells but surrounding them in the urine as well.
The E. coli could not turn around without bumping into D-mannose "just floating around" in the urine. Unable to resist the tasty bait they suddenly find themselves swimming in, they would latch onto the nearest mannose molecules, and happily sail off into the porcelain sunset.
Those few E. coli left clinging to mannose molecules on cells then become easy prey for white blood cells and other agents of the immune system.
In addition to its natural occurrence in the cells lining the epithelial tract, the sugar D-mannose is also found in relatively large quantities in fruit such as peaches, apples, oranges, and certain berries, like cranberries and blueberries.
Extracted in the form of D-mannose, a white crystal sugar similar to glucose, it can be easily dissolved in a liquid and swallowed. (Mannose can also be synthesized from other simple sugars.)
When someone with bladder infection consumes a dose of D-mannose, the sugar is absorbed in the upper GI tract, but at a much slower rate than most other sugars. (For example, glucose is absorbed more than eight times faster.)
Moreover, unlike other sugars, D-mannose is not readily converted to glycogen (and stored) in the liver, but instead passes directly into the bloodstream largely unchanged what makes it suitable for diabetics.
As the D-mannose-laden blood passes through the kidneys, a considerable proportion of the sugar is extracted and added to the urine.
The D-mannose-sweetened urine flows from the kidneys through the ureters to the bladder and on to the urethra, literally sugar-coating any free-floating E. coli it might encounter, so they cannot stick to cells any more.
It also unsticks most of the E. coli already "velcro-ed" to the inner surface of the bladder and urinary tract, ultimately flushing them all down the drain.
D-Mannose: First Line of E. Coli Treatment
First, the "molecular mechanism" of the action of D-mannose on E. coli is scientifically proven. There is no argument at all about this among researchers who have studied it.
Second, literally tens of thousands of women working with natural medicine doctors have successfully applied this science to their own bladder infections.
Considerable circumstantial evidence, combined with common sense and several of clinical experience, makes a compelling case for the therapeutic value of D-mannose.
Epidemiological Evidence
Perhaps the best available evidence, though, comes from the experience of people who have used it. Natural medicine-oriented physicians have been recommending D-mannose to people with bladder infection since the mid-1980s with great success.
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In one case, a 5-year-old girl had almost continuous bladder infections for her entire life that had failed to respond to every antibiotic therapy her physicians tried (72 doctors in all!).
At the end of their rope, her doctors were now considering a kidney transplant, since her kidneys were starting to fail due to years of chronic infection.
Since urine culture showed her bladder infection was due to E. coli, she was started on D-mannose (1 tsp in a glass of water every 2-3 hours). Within 48 hours, her infection had vanished, and her kidneys were saved!
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Laboratory Studies
In one laboratory study, for example, rats' urinary tracts were inoculated with E. coli. Within one day, those rats also given D-mannose were found to have significantly lower levels of bacteria in their urine.
In another study, administering a mannose-like substance (niethyl a-D-mannopyranoside) to E. coli-infected mice led to a 90 percent reduction in bacterial attachment to the urinary tract.
Research in humans shows that ingesting D-mannose significantly elevates blood mannose levels, a prerequisite if urinary levels are to rise.
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D-Mannose PLUS: Supplement Facts:
Serving Size: 1 Level Teaspoon (4.7 grams)
Servings Per Container: 30
Amount Per Serving:
- D-Mannose: 1,500 mg
- Cranberry Extract (Vaccinium macrocarpon) (Fruit): 800 mg
- Vitamin C (as ascorbic acid): 60 mg.
Other Ingredients: Natural mixed berry flavor, xylitol, citric acid, silicon dioxide and stevia extract.
Contains no added starch, salt, wheat, gluten, corn, coloring, dairy products, or preservatives.
Keep container tightly closed in a cool, dry and dark place. Keep out of reach of children.
Recommended Intake
Directions: Mix 1 level teastoon (4.7 grams) in 4 to 6-ounces of purified, cold water.
For relief from a urinary tract infection, repeat four to six (4-6) times per day.
For prevention of a urinary tract infection, drink once or twice a day.
Description: D-Mannose is a naturally occuring simple
sugar, closely related to glucose. Clinical studies have demonstrated
its ability to prevent E. Coli bacteria from adhering to the
inner walls of the bladder, potentially reducing the incidence and
severity of urinary tract infections. D-Mannose Powder PLUS
combines d-Mannose with Cranberry extract to enhance its
effectiveness.
These statements have not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease.
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© 2003-2012 Remedy-Bladder-Infection.com: Urinary Bladder Infection. Natural UTI Cure Treatment Prevention. Holistic, alternative, herbal and nutritional treatment for cystitis (infection of the bladder), urethritis (infection of the urethra) and urethral symdrome. Prevent and remedy urinary tract infection (UTI) in children without antibiotics and drugs. The information provided herein on bladder infection in children is a general overview on this topic and may not apply to everyone, therefore, it should not be used for diagnosis or treatment of any medical condition. While reasonable effort has been made to ensure the accuracy of the information on bladder infection in kids and teenagers, Full of Health Inc. assumes no responsibility for errors or omissions, or for damages resulting from use of the UTI herein.
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