Why Does My Child Have Stinky Pee?

Most people know what “normal” pee smells like, but what happens if your child goes pee and it doesn’t smell normal to you? This is not as uncommon as you may think. Below are the most common reasons for abnormal urine odors.

Dehydration

Not drinking enough water is probably the most common reason for smelly urine. Urine is a combination of water and waste products. If your child is dehydrated, their urine is made up of more waste products than water which can make the urine have a stronger odor. You can check the color of your child’s urine to confirm whether they’re dehydrated (see picture below). Your child should be drinking enough water that their urine is light yellow to clear. 

Constipation

If your child is not having a soft daily bowel movement (poop) this could lead to urine that has a foul odor. It is not uncommon for parents to think their child may have a bladder infection when this occurs. This is a common misconception, and if the only symptom is the foul urine odor then chances are this is not a UTI. Constipation can keep the bladder from emptying completely on the first try and the leftover urine can become stinky from hanging out in the bladder for too long.

Urinary Tract Infection (UTI)

A UTI occurs when bacteria gets into the urinary system through the urethra and then begins to multiply in the bladder. As mentioned above, foul urine odor alone is not typically suggestive of a UTI. If your child has a UTI they will probably have more symptoms than just smelly urine. Your child may also having burning or pain with urination, increased urinary frequency and their urine may even turn cloudy or bloody. If your child has a fever with the above symptoms, prompt evaluation is warranted.

Nocturnal Enuresis (Bed Wetting)

Children who wet the bed at night tend to have a very strong odor to their urine. The exact cause is unknown but it is not uncommon for parents to report urine that smells like ammonia or even cat pee! If your child wets the bed on a regular basis and their urine smells normal during the day then this night time odor is nothing to be concerned about.

Vaginal Voiding

If your child is sitting on the toilet with their legs shut tight, urine can actually come out of the urethra and go back into the vagina. This urine can sit in the vagina and become stinky, grow bacteria and also leak out into the underwear later. It is not uncommon for parents to report damp underwear and a foul, sometimes fishy odor. This problem can usually be resolved by having your child sit with their legs spread wide apart on the toilet like they are riding a horse. Sitting on the toilet backwards is another option!

Foods/Vitamins/Medications

There are some common foods and medications that can change the odor of urine. Most everyone knows about asparagus pee, but there are some other foods and medications that can also change the odor of the urine. Some of the common ones are: Brussels sprouts, onions, garlic, curry, and salmon. If your child’s urine smells bad, think about whether they ate anything different that day and make a mental note of it so you can be on the lookout the next time that food is served.

Many children take medications on a regular basis. Some known medications that can change urine odor include multivitamins, antibiotics, and diabetes and rheumatoid arthritis medications.

This list is not all-inclusive. If you have any concerns, contact your child’s pediatrician.