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Ask Dr. Marla – Does my toddler have a urinary tract infection?


I’m toilet-training my toddler, and I heard that “holding it” can lead to a urinary tract infection. What are they and how do I know if my child has one?


Urinary tract infections (UTIs) are caused when bacteria at the bottom of the bladder move upwards. As the distance is shorter in girls, it’s easy to understand why we see infections more commonly in girls than boys. 

Urinary tract infections can present with painful and frequent urination, complaints of burning with urination, blood in the urine and fever.

You are correct that there is a link between holding in urine –as well as stool – to UTIs.

Holding stool can be associated with these infections because stool is rich in bacteria. The issue is often one of constipation. With diets low in fibre, constipation is more common and contributes to the problem. Many children with wetting problems are actually constipated.

Some medical literature cites that children who are trained too early, before they are mature enough to understand the importance of eliminating when they feel an urge, are more likely to hold as they are not keen to interrupt play time. 

Many children are pushed into early training because of pre-school requirements.

When teaching girls to urinate, it is important to wipe from front to back to avoid bringing bacteria from the rectum to the urethra and then the bladder.

Is Your Child Ready? Toilet training can take time and patience. While most parents expect their children to be trained by two, every child sets their own pace with some children being trained by age four. Toronto’s SickKids Hospital points out that your child has to be at a certain level of maturity – both physically and mentally.

Signs a child is interested include:

  • knowing he or she needs to go
  • ability to use words or gestures to communicate that need
  • walks to the potty chair and sits down
  • able to follow one- or two-step directions.

Readiness is key!

Dr. Marla Shapiro is a medical doctor, author, broadcaster, lecturer and parent.

Originally published in ParentsCanada magazine, April 2014.

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