Urinary tract infections (UTIs) are common in children, affecting around eight percent of girls and one to two percent of boys by age five

When Infection Hits

Dr. Jennie Berkovich

Show me a squirming toddler with fever and no other symptoms and I’m likely to send you to the restroom with a urine sample cup. Urinary tract infections (UTIs) are common in children, affecting around eight percent of girls and one to two percent of boys by age five. UTIs can range from mild bladder infections (cystitis) to more severe kidney infections (pyelonephritis). Unlike viral infections that resolve without antibiotics, timely UTI diagnosis and treatment with antibiotics is necessary to avoid bladder and kidney scarring.

UTIs are more prevalent in girls. Common risk factors are constipation, long baths (especially with bubbles), remaining in wet clothes or bathing suits, inadequate fluid intake, and holding in of urine. Less common causes are anatomic abnormalities like vesicoureteral reflux (VUR) — backflow of urine from the bladder to the kidneys — and urinary tract abnormalities like obstructions or neurogenic bladder. These are often diagnosed after a child experiences recurrent UTIs.

Symptoms can be nonspecific, especially in younger children. Fever, irritability, vomiting, poor feeding, and abdominal pain may be the only signs. Older children may report urinary frequency, urgency, or burning with urination. Any unexplained fever in an infant warrants evaluation for a UTI.

Diagnosis requires symptoms as well as a positive urine culture from a properly collected sample. I commonly see “contaminated” urine samples, which means bacteria is growing that is most likely a result of a poorly obtained sample. A “midstream catch” is the best way to get a sample from an older child. Babies and toddlers who are in diapers should ideally have a catheterized sample. However, that is not always practical or available.

Depending on the age of the child at the first UTI, an ultrasound and/or voiding cystourethrogram (VCUG) may be needed to look for anatomic abnormalities or reflux. Reflux comes in various degrees and may be treated with preventative antibiotics, surgery, or may just need observation.

Oral antibiotics are a first-line treatment for uncomplicated UTIs. IV antibiotics in the hospital are needed for infants, kids who are very sick, or those who can’t tolerate oral medication.

Not all UTIs can be prevented, but encouraging adequate fluid intake and voiding habits, treating constipation, and teaching kids good hygiene can go a long way to avoid them being that squirmy toddler in my waiting room!

Dr. Jennie Berkovich is a board-certified pediatrician in Chicago and serves as the Director of Education for the Jewish Orthodox Women's Medical Association (JOWMA).

Mindfulness

Shira Savit

WE

hear a lot about mindful eating and its benefits, yet many struggle to achieve it, especially when they have an urge to eat emotionally or compulsively. Clients often share with me that they feel guilty because they “know they should be mindful, pay more attention, slow down, and be aware of amounts,” but can’t in the moment, which then leads to even more self-criticism.

Instead of feeling guilty, try shifting perspective: Don’t try to be mindful when it’s “time” to be mindful. Huh? Yes, work on mindfulness when food isn’t involved — when you’re not baking a cake, at a Shabbos seudah, or taking your kids out for pizza.

Here are a few simple ways to incorporate mindfulness throughout your day:

Engage in mindfulness during routine activities. For example, while washing dishes, focus on the sensation of the water and the dishes. Notice the temperature, the pressure of the sponge in your hand, or the sound of the water running. When walking, pay attention to the feeling of your feet touching the ground, the rhythm of your breath, and the sights and sounds around you.

When your children come home from day camp, give each one a few minutes of undivided attention. Give them a hug and notice the temperature of their body, the feel of their hair, or the sound of their voice. This practice not only strengthens your relationship, but also enhances your mindfulness.

When lying in bed at night, focus on the feel of the sheets, the comfortableness of the bed, the fluffiness of the pillow supporting your head.

By introducing mindfulness in small moments throughout the day, we build our “mindful muscles.” Over time, these muscles strengthen, and mindfulness becomes more natural, requiring less effort during encounters with eating.

Shira Savit, MA, MHC, INHC is a mental health counselor and integrative nutritionist who specializes in emotional eating, binge eating, and somatic nutrition. Shira works both virtually and in person in Jerusalem.

That’s the Thing about Ice Cream

Zipora Schuck

Years ago, we sat at a family simchah with a young relative who was served ice cream for the very first time. After tasting a spoonful, she shrieked loudly, “My mouth is freezing!” Her wise mother gently responded to her, “Chana, that’s the thing about ice cream — it’s cold.”

Sometimes the best way to acclimate to a challenging situation is to remove the drama and emotion surrounding it, and just deal with the facts that can’t be changed. Once you reach that acceptance, it’s easier to handle the difficult aspects of it. After all, you can’t argue with or adjust the very nature of something.

That’s the thing about this job — it includes a lot of paperwork.

That’s the thing about summer — the outdoors is filled with mosquitoes.

That’s the thing about this teacher’s tests — they require a lot of studying.

Recognizing what can or can’t be changed, or what is or isn’t negotiable, will help shape our reactions and choices after.

Zipora Schuck MA. MS. is a NYS school psychologist and educational consultant for many schools in the NY/NJ area. She works with students, teachers, principals, and parents to help children be successful.

(Originally featured in Family First, Issue 900)