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To diagnose urinary infections or kidney diseases in children, obtaining a urine sample is crucial. Since infections are common in children, ensuring a clean and accurate sample collection is essential. While older children can use the 'clean-catch' method, infants require the 'bag specimen' method. Collecting uncontaminated samples from young girls demands extra care due to anatomical challenges. Contamination leads to false-positive results, potentially leading to unnecessary treatments or invasive tests.
Steps
Using the Clean-Catch Method
Gather necessary supplies. For older girls who can urinate independently, use the clean-catch method. You'll need a sterile specimen cup, antibacterial wipes, paper towels, and medical gloves. Your doctor might provide these items along with special wipes for cleaning.
Prepare Your Daughter: Explain the process to your daughter and encourage her to inform you when she needs to urinate. Remove her clothing from the waist down, ensuring unobstructed access to the toilet. Position her with legs spread apart.
- If feasible, bathe her earlier in the day and clean her genitalia with soap and water.
- Encourage her to urinate at the first sensation, not when urgency sets in.
Thorough Hand Washing: After undressing your daughter and placing her on the toilet, wash your hands meticulously with warm, soapy water to prevent bacterial transfer. Use paper towels as a barrier while handling wet wipes.
- Lather thoroughly, including between fingers and underneath fingernails, for at least 20 seconds.
- Consider using alcohol-based sanitizer for added cleanliness.
- Avoid touching your mouth or face after sanitizing your hands and before cleaning your daughter.
Clean Genitalia: With your daughter positioned on the toilet, gently clean her genital area using antibacterial wipes. Ensure a single stroke from top to bottom for each wipe, disposing of them afterward.
- Use separate wipes for different areas to prevent cross-contamination.
- Avoid wiping from bottom to top to prevent bacterial transfer from the anus.
Wear Gloves and Prepare the Cup:
After cleaning, wear medical gloves and prepare the collection cup. Prevent contamination by handling the cup carefully.
- Avoid touching the cup's interior when opening it.
- Place the cup upside down on a clean surface until ready for use.
- If a sterilized cup is unavailable, boil a small glass jar and lid for about 10 minutes, then air dry before use.
Collect Urine Sample: Position the cup near your daughter's urethra and instruct her to urinate. Collect midstream urine in the cup, refrigerating it promptly after collection.
- If necessary, stimulate urination by running water.
- Collect midstream urine for optimal sample quality.
Secure the Cup and Label It: After collecting the urine sample, securely seal the cup with its lid on a paper towel. Avoid touching the inside of the lid. Wash your hands again and dry them. Label the cup with the date, time, and your daughter's name using a felt marker.
- If at the doctor's office, hand the sample to the nurse or assistant.
- If at home, refrigerate the sample and deliver it within 24 hours to prevent bacterial growth.
Bag Specimen Method
Gather Your Materials: For an infant unable to urinate on a toilet, use the bag specimen method. You'll need a special bag provided by your doctor, a sanitized specimen cup, antibacterial wipes, and hand sanitizer.
- The bag fits under the diaper and collects urine.
- Though prone to contamination, bag samples offer insight into your child's urinary health.
Prepare Your Infant: Remove your infant's clothing and diaper. Place her on a changing table. Clean her genital area and position the collection bag. Avoid using baby powder and overfeeding before collection to prevent contamination.
- Bathe her and clean her genitalia before attempting to collect urine.
- Offer liquids to stimulate urination after bathing.
Sanitize Your Hands: On the changing table, sanitize your hands thoroughly. Ensure they air dry before handling your infant. Apply sanitizer underneath fingernails and up to your wrists.
- Do not apply sanitizer to your infant's genitalia; use antibacterial wipes instead.
- Apply a second round of sanitizer for added safety.
Clean Your Infant's Genitalia: After sanitizing your hands, thoroughly clean your daughter's labia and the area around her urethral opening (meatus). Gently separate her labia and wipe over the meatus from top to bottom. Then, clean within the labial folds near the urethra.
- You may wear gloves, but it's optional.
- Wipe only in one direction, avoiding circular motions.
- Avoid wiping from the anus to the vagina to prevent bacterial transfer.
Apply the Collection Bag: Open the plastic bag and position it over your infant's labial folds. Ensure the adhesive strip sticks to her skin, then secure her diaper over it.
- Always cover the bag with a clean diaper to prevent leaks.
- Check your infant regularly to monitor urine output.
- Be prepared for the bag to shift due to your infant's movement.
Transfer Urine to the Cup: After your infant urinates, wash your hands and remove the collection bag. With care, pour the urine into the sterile cup, filling it about halfway. Seal the cup, wash it, and air dry. Label the cup with the date, time, and your daughter's name before storing it in the fridge.
- Prior to removing the bag, prepare the cup by placing its lid upside down on a paper towel.
- Avoid touching the inside of the cup or lid during transfer.
Tips
- If using the bag method, there's minimal risk to your infant, though adhesive irritation is possible. Consider alternative methods if needed.
- Consult your doctor about using a toilet hat for urine collection if necessary for accuracy.
- Store urine samples in the fridge if not immediately sent to the lab, ensuring use within 24 hours to prevent contamination.
Essential Supplies
- Sanitized collection cup
- Antibacterial wet wipes
- Bottle of hand sanitizer
- Paper towels
- Vinyl or latex medical gloves
- Urine collection bag
