‘Urinary tract infections is not caught by using outside loos’

Our paediatric expert professor R Kishore Kumar answers questions related to child healthcare.

> My daughter, four years old, has just been diagnosed with mild UTI. How can this be prevented? We often have to take her to the bathroom when we are outside, such as at shopping malls, cinema halls etc. She also goes to a playschool where I’m assuming she uses the bathroom quite often. Does contracting an UTI depend on using outside bathrooms? If yes, what are the proper precautions we can take when outside to ensure she doesn’t contract an infection?
Radhika, Jalahalli
UTI (Urinary Tract Infections) are the second most common infections in children next to URTI (Upper Respiratory Tract Infections) — the so-called snotty nose and cough and cold. But UTI may often go undiagnosed as this depends on testing the urine when one suspects UTI. It is not caught by using outside toilets. But they can to a certain extent be prevented in girls by cleaning their bottom from front to back and never from bottom to front — a girl could have a germ in her stool and if this comes in contact with her urethra while cleaning, she can get ascending UTI. Hence we always recommend cleaning the bottom from front to back. In boys generally the UTI is thought to be not related to bottom cleaning.

> My son is seven years old and very boisterous. He keeps falling and scraping his knees/elbows. Sometimes the cut is quite deep and bleeds a bit. I wanted to know what is a good antiseptic cream that I can use on his cuts and bruises. Also I keep worrying about giving him an anti-tetanus shot each time. How often must he get anti-tetanus shots? Please advise.
Kirthika, RMV Extension
This is one of the most common questions which parents ask! Anti-tetanus shots should be given at 6 weeks, 10 weeks, 14 weeks, 18 months (when they get triple antigen), 5 years and then every 5 years thereafter. There is no need to repeat anti-tetanus injections in between, provided the triple antigen was given at the correct time and was potent at the time of injection. What I mean is many pharmacies/ doctors don’t have power back up and in cases of sudden power failure, your vaccine, which is supposed to be stored at a certain temperature at all times, doesn’t remain potent. Too many anti-tetanus shots can cause hyper-immune serum in some individuals. The best antiseptic is to clean the wound with something like alcohol wipes or Dettol and leave it open to dry or put a band-aid depending on how deep the wound or bruise is.
 
> I have a two-year-old daughter. She has been on the bottle from the time she was six months old as I had to get back to work. She shows signs of being very dependent on the bottle. We have tried to wean her off it for quite some time now but have to go back to it because of her acute distress on not being allowed. She refuses to have her milk from glass, sippers etc. Also, she still gets up every night — between 3 and 4 am — and asks for a bottle. She also has a regular night-time feed. How do we get her out of this habit and wean her from the bottle completely?
Jagriti Prasad, Whitefield
It absolutely amazes me as to how common this question is! This is what I call ‘battle of will power’ — when a child cries, the parents (including myself) yield to their whims and fancies. The child learns by default — next time that’s what I have to do! They cry more till they get it! That’s why they are called terrible toddlers — they are terrible by adult imagination, but not really terrible. I would suggest you read a book called Toddler Taming by Dr Christopher Green to learn the tactics since there is too little a space for me to advise you!

First you have to decide what you really want. Getting a child to follow your desires/habits is easy if you are consistent.

Professor R Kishore Kumar is Consultant Neonatologist and Paediatrician, The Cradle, Jayanagar