Children under one year are particularly vulnerable /File
Have you noticed symptoms like persistent fever, poor feeding, unusual irritability, crying during urination or foul-smelling urine in your baby?
Don’t waste time, rush your child to the hospital, for these could be signs of a urinary tract infection (UTI), a condition doctors say is more common in infants than many parents realise.
According to the latest 2024 and 2025 data from the Global Burden of Disease (GBD) Study, urinary tract infections remain a critical pediatric health concern with over 50 million incident cases annually.
Research indicates that by age seven, approximately 8.4 per cent of girls and 1.7 per cent of boys will have experienced a UTI.
Furthermore, the GBD study highlights that nearly 7 per cent of all infants presenting with an unexplained fever are diagnosed with a UTI, requiring immediate medical intervention to prevent long-term complications.
Paediatrician John Ngugi says children under one year are particularly vulnerable, but the causes and presentation differ between boys and girls.
“It is very possible for children under one year to get a urinary tract infection,” Ngugi explains.
“When you look at them, you group them into boys and girls because the causes are different and the presentations are different.”
In boys, especially those who are not circumcised, infections are often linked to obstruction. Parents may notice that the baby hesitates to pass urine or appears to withhold it.
“Instead of urine exiting in a straight path, you may see a bulge at the tip of the penis,” Ngugi says. “That could be an indicator that the boy could be having a urinary tract infection.”
For girls, hygiene plays a much bigger role.
“The girl child is more vulnerable because of hygiene issues and the proximity of the urethra and the anus,” Ngugi explains.
“If diapers are not changed on time, or if wiping is done from back to front, you are likely to contaminate the urethra.”
He stresses that cleaning should always be done from front to back, that is, from the urinary opening going downward toward the anus.
Cleaning upwards, from the anus toward the urethra, can transfer bacteria from stool into the urinary tract.
“The bacteria from the poop can actually ascend the urethra to cause infection in the bladder and sometimes even the kidneys,” he warns.
A moist diaper environment further encourages bacterial growth. If left unchecked, the infection can travel upwards, potentially leading to kidney infection, a serious complication that may cause long-term damage.
One of the biggest red flags in infants is fever without an obvious source.
“You examine the child and there is no throat infection, no ear infection, nothing else you can associate with the fever,” Ngugi says.
“Most of the time when infants have a urinary tract infection, they present with a fever whose cause may be very difficult to determine.”
Other signs include excessive fussiness, refusal to breastfeed, general poor feeding and discomfort during diaper changes.
In girls, parents may notice the baby becomes extremely uncomfortable when nappies are being changed.
Ngugi also cautions that diaper-related skin conditions can complicate the picture.
“You can have both an infection and bleeding,” he says. “Not directly from the vagina, but from the surrounding tissue because of skin irritation.”
Severe diaper rash, allergies to certain diaper brands or untreated dermatitis can cause inflammation and even bleeding around the genital area.
“I have seen children brought in where the diaper area is so irritated, it hurts and is actually bleeding because of the skin condition,” he adds.
Prevention, experts say, starts with simple but consistent hygiene practices: frequent diaper changes, proper wiping technique, allowing the diaper area to dry, and seeking medical care promptly when symptoms appear.
“As a parent, never ignore an unexplained fever in a child under one year,” Ngugi advises. “Early diagnosis and treatment can prevent complications.”
With millions of children affected each year globally, UTIs are not rare childhood illnesses.
But with vigilance, proper hygiene and timely medical attention, they are treatable and preventable.