Discharge Instructions for Pyelonephritis (Child)

Urination and hygiene

• Do what you can to get your child to urinate at least 3 to 4 times during the day. Make sure they don't delay. Holding urine and overstretching the bladder can make your child’s condition worse.

• Encourage your child to urinate in a steady stream rather than starting and stopping during urination. This helps to empty the bladder all the way.

• If your child is a girl, make sure she wipes from front to back.

• Wash the child’s genital area with no or very gentle soap (not bar soap) and rinse well with water. Dry thoroughly.

• Constipation can make a urinary tract infection more likely. Talk with your child’s healthcare provider if your child has trouble with bowel movements.

Other home care

• Be sure your child finishes all the medicine that was prescribed, even if they feel better. If your child doesn’t finish the medicine, the infection may return. Not finishing the medicine may also make any future infections harder to treat.

• Keep your child’s bathwater free of bubble bath, shampoo, or other soaps. Continue this practice when your child is well.

• Have your child wear loose cotton underpants during the day.

• Encourage your child to drink enough water each day to keep the urine light-colored. Ask your child's healthcare provider how much water your child should try to drink daily.

Follow-up care

Follow up with your child’s healthcare provider, or as advised. Babies and young children often have an underlying reason for the infection. Close follow-up and further testing are very important to prevent future infections.

When to call the healthcare provider

Call your child's healthcare provider right away if your child has any of the following:

• Trouble urinating or decreased urine output

• Severe pain in the lower back or flank

• Fever (see "Fever and children" below)

• Shaking chills

• Vomiting

• Bloody, dark-colored, or bad-smelling urine

• Inability to take prescribed medicine because of nausea or any other reason

• Pain or burning during urination

• Need to urinate more often

• Urgent need to urinate, or wetting of underwear or bedding by a child who knows how to use the toilet

• Belly pain

• Unexplained and lasting irritability in an infant

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider