Shaken Baby Syndrome

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Amniotic fluid problems

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Antenatal Classes

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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Urinary Tract Infections

Urinary tract infections (UTI) are infections that occur in the urinary tract. The urinary tract consists of the bladder, kidneys and urethra. The kidneys are 2 bean-shaped organs situated against the spine in the lower back. They are responsible for filtering waste and water from the blood to produce urine. The urine travels from the kidneys down two narrow tubes called the ureters, into the bladder. The bladder is a balloon-shaped organ that stores the urine. When the bladder is sufficiently full, the bladder muscles contract, pushing the urine out of the body through a tube at the bottom of the bladder known as the urethra (Paediatric Society of New Zealand, 2005-2010; American Academy of Family Physicians, 2000-2010).


UTI are relatively common in children and may cause them to have high fevers and become generally unwell. Girls usually suffer from more frequent infections of the urinary tract than boys, but newborn male babies are more susceptible to infections than females. UTI may affect the urethra (causing urethritis), the bladder in the form of cystitis, and/or the kidneys, causing pyelonephritis. Immediate treatment of UTI is necessary to prevent scarring of the kidneys, which is most likely to affect children under the age of 5. Scarring of the kidneys due to recurrent infections may lead to high blood pressure or kidney failure in adulthood (Collins, 2003).



·         Burning or pain when urinating

·         Frequent urination with only small amounts of urine

·         Fever

·         Diarrhoea and vomiting

·         Irritability

·         Less active than usual

·         Abdominal pain

·                Back pain

·                Wets his clothing even though he is potty-trained, or bed wetting after being dry at night

·                Urine that smells bad

·                Red, pink or smoky coloured urine, due to the presence of blood (American Academy of Family Physicians, 2000-2010)


In infants and young children the symptoms of a UTI may not be as obvious or specific. Signs of a possible infection include:

·         Recurrent unexplained fevers

·         Unexplained abdominal pain

·         Vomiting and diarrhoea

·         Failure to thrive or grow normally

·         Poor feeding

·         Shivering

·         Drowsiness

·         Unexplained fatigue (Leary, 1990; Paediatric Society of New Zealand, 2005-2010)



·                The most common cause of UTI is a result of bacteria entering the urethra and bladder from the rectum.

·                Bacteria may also spread to the urinary tract from the bloodstream.

·                Girls are more prone to UTI because their urethras are shorter and there are often many bacteria in the vagina which is close to the opening of the urethra.

·                The urinary tract is designed to keep urine moving. Any condition that causes the stagnation of urine may predispose your child to UTIs:

o   Blockage or malformation of the urinary tract. These problems usually occur in either the valves or the bladder neck. If the valves are incompetent or do not close properly when the bladder contracts, urine flows back into the urethra instead of out of the body. Residual urine that is allowed to stagnate may result in an infection. Similarly, an infection may occur if there is an obstruction of the bladder neck, where the bladder meets the urethra. This prevents the bladder from emptying completely.

o   Urinary reflux. Urinary reflux is a congenital condition that makes children particularly susceptible to infection. When the bladder empties, some urine passes backwards into the kidneys. Reflux tendencies usually disappear without treatment by 9 years of age.

·                Children who suffer from chronic constipation are also at a higher risk of developing UTIs.

·                Children who have repeated UTIs and have resultant kidney scarring are also more susceptible to infection.

·                Meatal stenosis is a condition in males caused by the narrowing of the urethra where the urine comes out the penis. This may result in a mild obstruction of the urine flow, possibly leading to UTIs. Meatal stenosis cannot always be diagnosed by looking at the meatus or opening of the penis. Signs of this condition include discomfort on urination, a short urinary stream that ‘sprays’ a lot, or excessive dribbling after urination (Collins, 2003; Leary, 1990; Paediatric Society of New Zealand, 2005-2010; American Academy of Family Physicians, 2000-2010).



UTIs are diagnosed by means of a urine sample. In certain circumstances, further investigation may be required to check for possible kidney scarring or the existence of structural abnormalities in the urinary tract, such as a renal ultrasound scan and DMSA renal scan. If urinary reflux is suspected, a MCU (micturating cysto-urethrogram) may be performed (Collins, 2003; Paediatric Society of New Zealand, 2005-2010).



The aim of managing UTI is early detection, before the infection ascends into the kidneys, and to detect any structural abnormalities in early infancy, before either of these results in irreversible kidney damage. Your child should see a doctor within 24 hours of developing symptoms (Leary, 1990).


Antibiotics are the primary treatment for UTI. Treatment generally lasts for 5-7 days. Seriously ill children and babies may need to be hospitalised for intravenous antibiotic treatment. A day or two after treatment has ceased, your child’s urine will be retested for any signs of residual infection. If the infection is still present, another course of antibiotics may be prescribed (Collins, 2003; Paediatric Society of New Zealand, 2005-2010).


Encourage your child to drink plenty of fluids. This helps to dilute the urine, eases the pain and discomfort experienced on urination, and assists the body in getting rid of bacteria (Collins, 2003).


How to help prevent UTIs

·         Avoid the use of bubble bath and scented soaps.

·         Dress your child in loose-fitting clothing and undergarments.

·                Teach female children to wipe their bottoms from the front towards the back, so that bacteria from the rectum do not enter the vagina.

·                Teach uncircumcised male children how to wash the foreskin of their penises correctly.

·                Teach your child not to hold in his urine, to respond to the urge to urinate immediately and to wait for his bladder to empty completely on urination.

·                Encourage your child to pass urine regularly, at least every 4 hours and before bed.

·                Constipation should always be treated.

·                Ensure your child drinks plenty of fluids, especially water (Collins, 2003; Leary, 1990; Paediatric Society of New Zealand, 2005-2010; American Academy of Family Physicians, 2000-2010).




Bilharzia, also known as schistosomiasis, is a parasitic infection caused by blood flukes or schistosomes. It is caused by exposure to these organisms in fresh water, i.e. streams, rivers, lakes and dams in endemic areas. In South Africa, schistosomes are found in areas such as Knysna and the Limpopo (


Blood flukes penetrate the pores of the skin whilst you are immersed in fresh water inhabited by the particular species of snail that acts as a host for this parasite. After exposure, there is a 4 to 6-week incubation period, during which time the schistosomal eggs migrate to the liver and mature into male and female adults. These adults mate and migrate to different areas of the body, depending on what type of blood flukes they are, often settling in the walls of the bladder and rectum. Extrusion of eggs results in bleeding and the primary characteristic of bilharzia is blood-stained urine. Chronic infection may lead to scarring of the bladder, which obstructs the flow of urine and predisposes the sufferer to bladder cancer later in life (Leary, 1990;



The symptoms of bilharzia vary, depending on the type of blood fluke responsible for the infection. Less serious symptoms sometimes seen during the early phases of the illness include a short-lived, itchy rash (‘swimmers itch’), cystitis and diarrhoea. Others symptoms that may present themselves are fever, headache, urticaria and lymphadenopathy (



Bilharzia is tested for by means of blood tests, as well as stool and urine samples (



Do not allow your child to swim in rivers or dams in areas where bilharzia is prevalent. Conventional swimming baths are a safe alternative because they do not harbour the snails that are essential for the life cycle of schistosomes (Leary, 1990).


If your child presents with bilharzia symptoms, especially blood in the stool or urine, after swimming in affected areas, seek medical assistance immediately. There are effective drugs available for the treatment of bilharzia (Leary, 1990).