Burning with Urination

Dear Lisa,

Today my 8 year old daughter was at the pool all day in her bathing suit swimming and playing in the hot sun. Now it’s 8:30 at night and she tells me that when she went to the bathroom to urinate that it burned and only a little urine came out. Otherwise she is acting normal and doesn’t have a temperature. The doctor’s office is closed and I won’t be able to bring her in for a visit until the morning. Is there anything I can do in the mean time to help the burning go away? How can I tell if her symptoms are from a urinary tract infection?

“Worried about a urinary tract infection”

Dear “Worried about a urinary tract infection”,

A young girl can develop discomfort with urinating after being outdoors in the sun and in the pool all day for a couple of reasons. Wearing a wet bathing suit for a long period of time may cause a vaginal irritation or a vaginal yeast infection. (1) Also exercising in the heat for extended periods may cause a child to become overheated and dehydrated. This is a concern if your daughter did not drink extra fluid today while outside in the heat.

Ours bodies compensate for overheating and dehydration by concentrating and withholding urine. When the urine becomes concentrated it can burn when it comes out. Therefore the pain your daughter felt with urination may have been due to external irritation from concentrated urine. Also, she may have noticed only a small amount of urine output because of mild dehydration.

The first thing you can do is give your daughter extra fluids to drink. She should have two large cups of liquids, such as sugar sweetened iced tea, lemonade, cranberry juice or Gatorade. If she urinates a couple of times and no longer complains of burning it means that she drank enough.

If your daughter still complains of burning with urination or continues to have only a small amount of urine come out at a time, you can give her a baking soda bath. This will soothe the exterior vagina in case it is irritated. You can sprinkle a couple of Tablespoons of baking soda in a warm bath and let her sit in it for 20 minutes. This will soothe the area and take away any irritation.

When your daughter gets out of the bathtub, gently pat her dry instead of rubbing the area. You can externally wipe (do not insert into the vaginal opening) an over-the-counter anti-fungal crème such as Monistat or Lotrimin to her outer vagina. (2) These anti-fungal cremes treat vaginal yeast infections. When she goes to bed, she should wear a light cotton nightgown with no underwear so that the area stays dry.

If your daughter still has symptoms despite these interventions, she should be evaluated by a healthcare professional in order to rule out a urinary tract infection. Signs of a Urinary Tract Infection include pain with urinating, change in urinary pattern or flow, urinary incontinence, change in urinary stream, urinary frequency, urinating in the middle of the night, visible blood in the urine, diarrhea, foul smelling urine, abdominal pain, back pain, irritability or fever. (1)

To test for a Urinary Tract Infection, your doctor will need a clean catch urine sample collected in a sterile container in order to do a urine culture. (1) Therefore it is a good idea to have your daughter drink fluids before going to the doctor’s office so that a sample can be obtained.

If your daughter is exhibiting signs of a Urinary Tract Infection, having a lot of discomfort with urination, experiencing abdominal pain, develops a fever or if she has a history of Urinary Tract Infections, it would be important to contact her doctor this evening for further guidance. Some after hour clinics are open late into the evening, which may be an option for you if your daughter’s symptoms persist, interrupt her sleep or cannot be tolerated until the doctor’s office opens in the morning.

I hope she is feeling better soon.

References:
(1) Betz C, Hunsberger M, Wright S. Family-Centered Nursing Care of Children. 2nd ed. Philadelphia, PA:W.B.Saunders Company. 1994:1524-1526.
(2)Chow M, Durand B, Feldman M, Mills M. Handbook of Pediatric Primary Care. Albany, New York:Delmar Publishers Inc. 1984: 492.


Lisa-ann Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

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