Why does my child complain of pain when she urinates, if she doesn't have a bladder infection?

Otherwise healthy young children can occasionally complain about pain with urination. Bladder infections (UTIs) can certainly cause this symptom, as well as fever, belly or back pain, and the frequent, urgent need to urinate. That's why we'll usually check urine samples and urine cultures in young children with urinary symptoms. We will also check for blood, stones, and sugar in the urine at this time (all of which can cause pain.)

Most of the time, fortunately, children don't have UTIs as an explanation for their pain. However, there are a number of other common reasons that children, especially girls, can have painful urination.

Urethral irritation. The tip of the urethra is very sensitive and can become easily irritated, from chemicals, chafing, etc. To reduce irritation, we recommend the following:

  • Don't use bubble bath in the tub.
  • Don't let the cake of soap sit in the tub with your child.
  • Little girls should wipe gently from front to back after using the toilet.
  • Wear clean underpants every day. Underpants should be changed during the day if they get damp from urine or sweat.
  • Avoid tight pants and shorts.
  • If your child is toilet trained at night, have him or her go without underwear at night. This will let air circulate around the skin.
  • Don't use any ointments or creams on your child's urethra. These products should not be used on this already sensitive area, as they can make irritation worse.
  • Discourage your child from rubbing or scratching the itchy area. Just like repeatedly scratching an itchy bug bite can infect it, scratching at the urethra can introduce bacteria.
  • Use sitz baths two or three times a day to soothe and cleanse the area. Fill the bathtub with a few inches of warm water (don't put anything else in the water) and let your child sit in it for about 10 minutes.

Concentrated urine.  Chemicals eliminated in the urine can also inflame the urethra as they pass through. The stronger and more concentrated the urine, the more irritating it can be. To keep the urine dilute, you'll want to do the following:

  • Let your child drink plenty of water to keep herself well hydrated. This is particularly important when the weather is hot and/or drinks aren't readily available, such as when traveling.
  • Avoid caffeinated beverages such as coffee, tea, and soda. Caffeine irritates the bladder.