Strong urine smell baby

How can you tell if your child is suffering from a urniary tract infection? How can your infant communicate the pain he or she is experiencing? Your baby’s foul-smelling urine may be able to tell you something. A new Canadian study found a link between smelly urine and urinary tract infections in children.

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University of Montreal researchers surveyed the parents of 331 children aged 1 to 36 months suspected of having a urinary tract infection. Out of 331 children, foul-smelling urine was reported by nearly 60% of the parents with UTI and 32% of children without UTI.

Pediatrician Elaine Schulte, MD, did not take part in the study but says foul-smelling urine is not typical. “Oftentimes, parents will come in saying there was an unusual odor coming from the diaper and that, of course, would prompt us to ask questions about other types of symptoms, whether it be fever or vomiting or just overall crankiness.”

Researchers say foul-smelling urine should make pediatricians and health-care providers more suspicious of this type of infection in a young child with an otherwise-unexplained fever.

“Good news, bad news. They found that it might increase the likelihood of having a urinary tract infection, but wasn’t definitive and it wasn’t particularly sensitive or specific.” explained Dr. Schulte.

The complete findings for this study are in the journal Pediatrics.

Strong Urine Smell in Infants

Raising an infant can be difficult. You are always second guessing if a symptom is something that will just pass or if you should take your child to the doctor. A strong urine smell from your infant is most likely a sign of a urinary tract infection, or UTI. According to Kids Health, about 8 percent of girls and 1 to 2 percent of boys have had a UTI by the time they are 5 years old. If your child has a strong urine smell you should see your doctor to determine the cause and treatment needed.

Cause

UTI is caused when bacteria infects the urinary tract, which is made up of the kidneys, bladder, ureters and urethra. These organs each play a role in removing liquid waste from the body. Bacteria can easily enter the urinary tract from the skin around the anus. Bacterial UTIs are not contagious.

Symptoms

In infants and young children, a UTI may be hard to detect because the symptoms are less specific. Sometimes, a fever is the only sign of a UTI in an infant. Infants may seem irritable, begin to feed poorly or vomit. Your infant’s urine may have a foul smell and may look cloudy or contain blood.

Risk Factors

UTIs are more often seen in girls because the urethra is shorter and closer to the anus. Uncircumcised boys younger than 1 year are also at a higher risk for developing a UTI. Other risk factors include an abnormality in the structure of the urinary tract, the use of bubble baths or a family history of UTIs. According to Kids Health, 30 to 50 percent of infants with a UTI are found to have vesicoureteral reflux. This condition is present at birth and is when the infant has an abnormal backward flow of urine from the bladder toward the kidneys.

Treatment

UTIs are treatable and it is important to catch them early. Treatment for a UTI includes an antibiotic for your infant. Untreated UTIs may lead to kidney damage, especially in children younger than 6.

Prevention

Frequent diaper changes can prevent the spread of bacteria in infants. It is important to wipe your girl from front to rear to prevent germs from spreading from the rectum to the urethra. Other prevention includes avoiding bubble baths and washing hands prior to changing your infant’s diaper to avoid the spread of bacteria.

Urinary tract infections (UTIs)

What is a urinary tract infection (UTI)?

Your baby’s urinary tract consists of her kidneys, bladder, ureters and urethra. The ureters are the tubes that connect her kidneys to her bladder. The urethra is the tube that runs from her bladder down to her genitals (NHS 2016).
A urinary tract infection (UTI) can happen when bacteria spread into the urethra from the skin around your baby’s bottom and genitals. The bacteria can cause inflammation at any point along the tract.
There are two types of UTI:

  • an upper UTI is a kidney infection, or an infection of the ureters
  • a lower UTI is a bladder infection (cystitis), or an infection of the urethra
  • (NHS 2016)

How will I know if my baby has a UTI?

It can be difficult to tell if a baby has a UTI. If your baby is unwell with any of the following, it could mean she has a UTI:

  • fever
  • vomiting
  • sleepy and lethargic
  • irritable
  • not feeding well
  • not gaining weight properly
  • jaundice
  • blood in her urine
  • unpleasant-smelling wee
  • (NICE 2007, 2017)

If your child is older and potty trained, she may need to wee a lot and it may be painful when she does (NICE 2007, 2017). She may not want to empty her bladder if it hurts to wee, and she may complain of a tummy ache.

Should I take my baby to the doctor?

It’s important to take your baby to your doctor if you think she has a UTI. If she has an upper UTI that’s left untreated, the infection could cause kidney problems.
If your baby has signs of a UTI, your doctor may need to collect a sterile urine sample to find out which bacteria are causing it (Harding 2016, NHS 2016a, NICE 2007).
It can be tricky to get a sterile urine sample from your baby (Kaufman et al 2017, NICE 2017a). Your doctor can explain the best way to do this. It may be a case of leaving your baby’s nappy off and then watching and waiting until she does a wee. You may then be able catch some of your baby’s wee in a clean pot (NICE 2017a).
Another method of collecting wee is putting an absorbent pad in your baby’s nappy, which can then be syringed to draw out a urine sample (Harding 2016, NICE 2007). However, this method doesn’t often give a sterile enough sample as it’s easy for the pad to be contaminated with other bacteria (NICE 2017a).
Your doctor may make a referral for other tests and treatment at the hospital if your baby:

  • is younger than three months and has any kind of UTI or
  • is older than three months and has a suspected upper UTI
  • (Harding 2016, NICE 2007, 2017)

Your GP will refer your baby urgently if she’s concerned that she could become seriously ill as a result of a UTI (NICE 2007, 2017). Rarely, an untreated UTI can develop into sepsis (NICE 2007, 2017).
Sepsis happens when a bacterial infection triggers the body to attack its own tissues and organs (UK Sepsis Trust nd). Sepsis is rare, but it’s important that your baby’s symptoms are checked by a doctor, just in case.
At hospital, your baby may have a scan called a renal ultrasound (NICE 2007). The scan will look at how her kidneys and bladder are working.

How will my baby’s UTI be treated?

Your doctor will prescribe your baby a course of antibiotics to take at home for three days (Harding 2016).
If the infection is in your baby’s kidney, she will need antibiotics for between seven days and 10 days (Harding 2016, NICE 2007, 2017).
Make sure you give your baby the antibiotics as instructed by your doctor or pharmacist (NHS 2016b).
Take your baby back to the doctor if she’s getting more poorly, or if she has any new symptoms (NICE 2007, 2017).
If your baby is under three months old or very poorly, she will need to go to hospital, where nurses will give her antibiotics through a drip (NHS 2016a, NICE 2007, 2017).
Your doctor may recommend a follow-up scan in the weeks or months after your baby’s infection, depending on her age, how many UTIs she’s had, or the seriousness of the infection. If your baby keeps getting UTIs, despite treatment, your doctor may recommend daily antibiotics to tackle the infection (NICE 2007).

Is there anything I can do to prevent my baby getting a UTI?

Some babies are more prone to UTIs, but there are a few things you can do to help protect your baby:

  • Wipe your baby’s bottom from front to back when you change her nappy.
  • Change her nappy as soon as she’s done a poo. She may get tiny bits of poo in her urethra if she has a dirty nappy, especially if she’s squirmy while being changed.
  • How to change a nappy A midwife explains the best way to change your baby’s dirty nappy.More baby videos

  • Exclusively breastfeed your baby for the first six months to boost her immune system and to help prevent her from becoming constipated. If your baby is constipated, it can cause her bowel to press on her bladder, making it harder for her to wee normally. Speak to your GP or health visitor if your baby is constipated.
  • Make sure your baby has plenty of fluids to help prevent constipation and to flush out bacteria. Her wee should be pale and clear during the day. Let her breastfeed whenever she wants. If your baby is formula-fed, offer her cooled, boiled water as well (NHS 2016, NICE 2007).
  • Don’t bath your baby in scented bath products.
  • (NHS 2016)

Did you know that a condition called kidney reflux can cause repeated UTIs in babies? Find out more about kidney reflux. Last reviewed: April 2018 Harding, M. 2016. Urinary tract infection in children. Patient. patient.info
Kaufman J, Fitzpatrick P, Tosif S, et al. 2017. Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial. BMJ 357:j1341 www.bmj.com
NHS. 2016a. Urinary tract infections in children. NHS Choices, Health A-Z. www.nhs.uk
NHS. 2016b. Antibiotics. NHS Choices, Health A-Z. www.nhs.uk
NICE 2007. Urinary tract infection in under 16s: diagnosis and management. Updated 2017. National Institute for Health and Care Excellence, Clinical guideline, 54. www.nice.org.uk
NICE 2017a. Urinary tract infection in under 16s: Evidence reviews for UTI diagnosis in under 3 years. National Institute for Health and Care Excellence, Clinical guideline, 54 – Guideline Updates Team. www.nice.org.uk
NICE 2017b. Urinary tract infection – children. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. www.nice.org.uk
UK Sepsis Trust. nd. What is sepsis? Support, sepsistrust.org

Why does my urine smell sweet?

The most common reasons why urine may smell sweet include:

Diabetes

Share on PinterestTaking vitamin B6 supplements can change the smell of urine.

A person with uncontrolled diabetes may have blood glucose levels that are dangerously high. The body tries to get rid of the extra glucose in the urine, and this can cause a sweet smell.

People with sweet-smelling urine due to diabetes may notice other symptoms, including:

  • exhaustion
  • extreme thirst
  • appetite changes
  • unexplained weight loss

Diabetic ketoacidosis

This condition occurs when a person does not have enough insulin and usually, but not always, very high blood sugar levels.

Insulin helps the body break down glucose to use for fuel. When the body cannot produce enough insulin to use glucose, it begins breaking down fat. This causes acids called ketones to accumulate in the blood.

Diabetic ketoacidosis left untreated can be fatal and should be considered a medical emergency.

The condition is more common in people with type 1 diabetes, though people with type 2 diabetes can develop symptoms too.

Along with sweet-smelling urine, a person may have the following symptoms:

  • sweet-smelling breath
  • feelings of exhaustion
  • confusion
  • seizures

Maple syrup urine disease

Maple syrup urine disease is a genetic disorder where a person cannot process certain proteins. It is an inherited disorder, and a parent may notice their baby or child has sweet-smelling urine.

This disorder may be fatal if left untreated. It is possible for children to develop less severe forms of the disorder. Maple syrup urine disease is treatable. Parents should seek prompt medical care when a child has sweet-smelling urine.

Babies with this condition may also have the following symptoms:

  • tiredness
  • unusual movements
  • delayed development
  • poor eating
  • vomiting

A person may need to follow a strict diet, regularly undergo blood testing, or take medications to prevent liver failure if they have maple syrup urine disease. Some people with maple syrup urine disease eventually need a liver transplant.

Medications and supplements

Some supplements, particularly vitamin B6 supplements, can change the smell of urine. Certain medications may also change the way urine looks or smells.

People who have recently begun a new medication should talk to their doctor if their urine looks or smells strange.

Dehydration

When someone is dehydrated, it makes their urine more concentrated. The urine may appear very yellow, or even brown and more concentrated urine smells stronger.

While the most common smell is a pungent ammonia odor, some people report that their urine smells sweet or fruity.

When a person’s urine is very dark, they should drink more water. If symptoms do not get better in a few hours, an individual should go and see their doctor within a few days.

Yeast infection

Yeast is a fungus that commonly affects the vagina. Less frequently, it can also infect men.

Yeast infections do not cause the urine to smell but can cause vaginal discharge to smell sweet, similar to honey, bread, or beer.

Symptoms of a yeast infection include:

  • itching
  • burning
  • redness
  • irritation
  • a cottage cheese-like discharge
  • painful urination in some cases

Some over-the-counter remedies or prescription antifungals can treat yeast infections. If a person has symptoms for the first time, however, they should see a doctor, because several other conditions can be mistaken for a yeast infection.

BIRDS AND THE BEES
Why does asparagus make urine smell? Are there any other vegetables that have a similar effect?

Bob Adams, Birmingham UK

  • Asparagus contains a sulphurous compound called mercaptan (which is also found in rotten eggs, onions and garlic). When your digestive system breaks down mercaptan, by-products are released that cause the strange smell. The process is so quick that your urine can develop the distinctive smell within 15 to 30 minutes of eating asparagus. Not everyone suffers this effect; your genetic makeup may determine whether your urine has the odour — or whether you can actually smell it. Only some people appear to have the gene for the enzyme that breaks down mercaptan into its more pungent parts. Max Wurr, Stanmore, United Kingdom
  • Apropos – have you noticed that Sugar Puffs make one’s pee smell of, well …Sugar Puffs. Baffling! Elster, London
  • I am reliably imformed by a female friend that beetroot makes semen taste pleasant. Not quite the same, but a similar effect. The Cornish Deity, Lamorna, Cornwall
  • I have been the sole witness to the experience of my urine turning red when I had eaten beetroot. Fortunately I was forewarned, otherwise I probably would have freaked! Maureen , UK
  • I don’t know about vegetables. But sugar pops cereal make the urine smell pleasantly malty! Robert Case, Chicago, IL USA
  • I think it’s something to do with the body getting rid of waste or uneeded substances, which is one of the major reasons why we urinate (eg. disposal of urea from the blood to the bladder via the kidneys). Sugar is so highly concentrated in such cereals as described above that the body quickly turns it to solution and sends it onwards to the bladder. With beetrooot, it is the naturally present red colouring which is not required and so becomes a waste product and effectively ‘dying’ the urine. A common test for kidney damage is for doctor to inject a dye into the bloodstream which can show up on certain types of X-rays as it flows around the body. This dye is harmless and eventually leaves the body via urination and also can ‘dye’ the urine a different colour. Spyder Webb, Liverpool England
  • Puffed wheat affects me – but my wife claims that it has no effect on her. I wonder if this is more often noticed by men than women? Francis McLoughlin, Milton Keynes UK

  • Pretty much anything and everything you eat affects the smell of your urine and bowell movements… it’s just a matter of big differences and ones that we can’t notice. On that same note, what you eat also affects your secretions. It is said that people who eat a lot of naturally sweet foods, like berries, “taste” sweeter. Back to the pee, though, I’ve found that after eating tofurkey, my pee smells exactly like the tofurkey… (which smells like turkey). Melissa, Walled Lake, Michigan
  • Regarding beetroot making semen taste strange, so does asparugus. Fear not though I have been reliably informed by both gay and straight male friends pineapple has the opposite effect and it happens very quickly! Sharon, london UK
  • I feel from many test that this is not true! We have tried this a few times and it failed everytime. In reality, it make it taste worst. CAUTION DO NOT TRY THIS!!!!! Beatrice, Little Rock, USA
  • My Husband and i have just started to eat Asparagus as they say it is very good for you, and we have both had a giggle because when we went to the loo, we could’nt believe how strong the smell of our urine was, we both said it smelt like Barbecue food. But we still continue to eat Asparagus as it tastes lovely. Anna, Ashford Kent
  • I have also noticed that if you have a lot of coffee, this also makes urine smell exactly like Sugar Puffs. What’s the connection? Peter F, Sydney, Australia
  • I eat asparagus on the regular and love every last piece. It does make my pee smell really powerful and weird. I started to use the urinal and some guy walked up and started to do his thing next to me. He had to have been like “what the hell is that”, he probably thought it was him!! Funny, I almost laughed out loud. They say in almost everything I have read that only 40 percent of people`s pee will smell. I also smell it in my sweat. Clifton Maxson, Jacksonville, Florida, USA
  • I have also read that some people cannot smell the sulphurous fumes of asparagus-laced urine! So even if asparagus DID affect their urine, they wouldn’t know! This might be of some comfort to Clifton! Tilly Trelawney, Bodmin, Cornwall UK
  • I also find coffee makes my wee smell of sugar puffs. Helen, Nottingham, England
  • Hi, I am in the 4th grade, and I am doing my Science Fair project on, “Does Asparagus make your pee smell?” I am so excited, I am going to test all ages and compare them male vs female. Hunter Jordan, Bossier, USA
  • I had asparagus for dinner the other night and shortly after I had to go pee. When I started to pee I began to smell this very bad odor,I mean bad too, I was like this smell can’t be coming from me but sure enough it was my urine. I didn’t know why untill I shared it withan uncle of mine he then told me that aparagus does make your pee stinky. Alex Gomez, Fillmore, California, USA
  • I find that eating asparagus gives me painful ears and a sore throat. Has anyone else had this reaction? Howard Bailey, Preston
  • If you’re having side effects like a sore throat or your ears hurt it could mean you’re allergic to asparagus. Chardy Wolfe, Parma, Ohio, USA

  • I’ve noticed the asparagus smell before but tonight I had it for dinner, went to the loo literally ten mins after I’d eaten and it stank! Never realised it could react that fast! Weird!! Lindsay Abbas, Lincoln, Lincolnshire, UK
  • I eat a children’s “breakfast cereal” crudely named Weetos on a daily basis as it makes my ordure reek of sweet Swiss chocolate. Parson Major, Tunbridge Wells, UK
  • I’m with the tofurkey. Within about half an hour of eating it, my pee smells like tofurkey. Kevin, Edmonton Canada
  • Glad I looked on the web before I went to the doctor.I ate asparagus and that evening I thought I had a urine infection. The smell was of strong sulphur I also react to onions & if I eat garlic I can smell it in my sweat. I guess I have the gene. Does anyone know which gene this is? Freda, Blackburn, UK
  • I do have the strange and sweet urine smell after I eat asparagus. For a long time I identified this smell as diabetic urine. I was truly happy when I found out it was simply the asparagus that causes the sugary smell (but after 3 days, the smell is more like pure sugar). I wonder if eating asparagus is bad for the pancreas? Christiane Guignard, RN, Havana, Florida, USA
  • It’s asparagus season – so I was curious about the distinct smell when pee-ing having eaten asparagus. There’s a lot to read – and interesting that not all asparagus eaters have smelly pee, and only a proportion can actually smell it. Btw, my pee also reminds me whenever I’ve had Sugar Puffs/Puffed Wheat for breakfast! John Gimson, Bude, Cornwall England
  • Within ten minutes of eating asparagus the worst odour is produced when I urine. I thought something was wrong with me. I didn’t realize it was from the vegetable. I was frightened because my urine smelled very strong for 3 days. I might have to give up the green stalks because the smell isn’t worth it. Fiona, San Diego, US
  • I’m female and fish (especially haddock), green veggies and puffed wheat cereals are worse for me. The urine is very strong and sometimes embarrassing. I love these foods and I know they are good for me so don’t want to avoid them! Trish Campbell, Coventry UK
  • It’s not to do with genes… About half the population experience strange smelling (and sometimes green!) urine after eating asparagus – this is due to sulphur-containing amino acids in the veg that break down during digestion. Different people form different amounts of these compounds after eating asparagus, and many people cannot smell the odour even when they produce the compounds. Ruby, Ipswich UK
  • Why do you lot think it is necessary to discuss you toilet habits?!! Phil, Canterbury Uk
  • If I drink cider it makes my wee smell quite peculiar. I also thought I had a urine infection the first time this happened. Howard Brown, Bridgnorth Shropshire
  • To see it worked into a sentence with the word semen certainly explains how “beetroot” got its name. I. P. Daily, Hobbit on the Cistern Wales
  • I’ve noticed after eating asparagus that my pee is bright yellowish green. B12 vitamin supplements seem to have the same effect and I wonder if it’s the same cause. Jennifer Macdonald, London, Ontario Canada
  • I love fish and I eat enormous amounts of it. After eating some fish eg herring seabass or catfish pee stinks to high heaven but after eating others – trout salmon and hallibutt for example it doesn’t! Why is this (no one seems to know this) lieecy, bolton uk
  • On a similar note, I find that when I eat spicy food my urine feels very hot. I like chili and make it very hot, but within half an hour my wee feels like molten lava! If I don’t urinate then I feel the heat building up in my bladder. Curiously this phenomenon has replaced the more customary ‘ring of fire’ most people experience after spicy food. I used to get a hot bottom but around five years ago (in my early 30s) this was replaced by lava-wee. Simon Brown, Southsea, United Kingdom
  • I discovered a great way to get my nephews to eat their veggies. At a recent family dinner, asparagus was served. Of course, the boys didn’t want to eat it. When I told them that eating asparagus would make their pee smell like a skunk, they were all like, “No way!” I said, “Yes! Way!” Their father, who was a medical student, chimed in and confirmed. The two boys said, “Cool!” and their plates were clean in mere minutes. Now they can’t get enough “skunk weed.” (Methyl mercaptan is one of the chemical constituents of the skunk’s musk.) Randy S., Erie, PA USA
  • With me it is BBQ chips lol within 10 to 15 min. I can smell the spices very strong. Very strange, doesn’t happen with anything else I know of. Andrea, Toronto, Canada
  • I once ate Asparagus and pissed myself, and everyone noticed, and said ‘err, you smell like Asparagus piss’. I must have the gene, fascinating!! Marcus DiMaro, Lincoln UK
  • I’ve thought for a long time that ‘Asparagus P’ would make a great name for a rapper. Ed, Perth Australia
  • Asparagus makes my urine smell very rapidly, and I think it is like brasso (metal polish)- bit odd really…. Jonathan, Billesdon Uk
  • I tried asparagus for the first time recently and Im 51 years old. Yes, it has a peculiar, yet unpleasant odor, kinda like when my maltese terrier peed on the floor. I saute mine in butter and season it to taste. I just started changing my diet because I’m trying to lose weight & this was recommended but I’ve broken out in this horrid BODY RASH like heat bumps and I dont know if its the asparagus, the hot sun, my uniform is polyester, or its simply my high stress level. Which brings me to comment on this: I have 28 food allergies, all healthy foods and I have 15 or so allergens to environmental, dust, perfumes, sprays, cigarettes(smoke), animals, chicken/eggs, dairy, I’m lactose, I have vitaligo since 2009 spreading, the ultraviolet rays burn my skin, I am miserable but you will always see me laugh/smile. Nothing has worked but today Im going to try this epsom salt bath, I cant sit in water cause it dries me terribly and my skin cracks if I dont hurry to moisturize it. Sad huh? yep Lina, las vegas usa`
  • I ate a large bunch of asparagus last night with my dinner and my urine smelt very strong until about 1pm today, so it took about 18 hours to go through fully. It was also a dark colour. I haven’t noticed it before when having eaten asparagus but yesterday, I had a particularly large bunch. Greedy me! When I’ve been drinking ground coffee, I smell that in my urine too. Portia, Manchester United Kingdom

  • the gene only determines if you can smell it, but it makes everyone’s pee smell but only about 40% of people can smell it. cj, d town us
  • Not everyone has the gene that breaks down the mercalstan in asparegus that gives that skunk smell in our urine. It lasts two days with me. mimi taylor, cambridge,ma. usa
  • Re the bit about your body getting rid of excess sugar in breakfast cereals through urination, this would only happen if you suffered from diabetes. In the non-diabetic person, all of the sugar, no matter how much you take in, is retained by the body (it’s still in caveman mode and doesn’t know when it’s going to get fed again!). This is why taking excess sugar makes you put on weight as the excess is converted into glycogen or fat. sandy laird, Edinburgh
  • Related to this discussion – I had a great job as a student picking asparagus. £10 an hour plus tips! PS: I love asparagus and make sure I pee in privacy afterwards. David, Poole UK
  • I have a list. Asparagus, sugar puffs, some fish and corned beef. pam, liverpool england
  • Some humans can smell it but some can’t all humans make the smell I can’t smell it but my wife can smell my urine. John Smith, New York City USA
  • Asparagus also high in antioxidants and boiling it and drinking it as a tea placed in the fridge shortly after with pomegranate or cranberry helps women fight fibroids if drunk twice daily for five to six months. It will drink fibroids naturally. Charlotte Gonzales, Georgia USA
  • i am weird. i quite like the smell after i have eaten asparagus john, erith UK
  • On a similar note, I have noticed that my pee smells really bad after having local anesthetics at the dentist (injection). It’s a similar bad odor to when I eat asparagus. Maybe it’s all related? Greg, Auckland, New Zealand

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  • Believe it or not, smelly urine is often not a huge cause for concern. There can be a number of reasons why a strong odour encases you during a trip to the bathroom – be it dehydration or simply something you ate.

    But there are times when strong smelling urine could be a cause for concern, like if it’s joined by pain or a burning sensation when you pee – or if there’s blood.

    But before you start to panic – pee is usually clear or pale yellow with a mild smell – read below for the most common causes of smelly urine and what it’s trying to tell you.

    Reasons for smelly urine:

    If your pee is dark yellow and strong smelling, chances are you haven’t been drinking enough water and you’re dehydrated. This is the number-one cause of smelly urine and it’s your body’s way of telling you to rehydrate. Drink plenty of fluids, particularly water and squash, until your pee is a pale clear colour.

    You’ve eaten asparagus or garlic

    This delicious green vegetable comes with one very noticeable side effect – it makes your pee smell foul. According to the British Medical Journal, 40% of the population say they can smell “asparagus pee” – which is not pleasant when you’re using a public bathroom and someone rushes into the cubicle once you’ve done your business.

    But it’s not just asparagus that can change the scent of your pee, Brussels sprouts, onions, garlic, curry and even alcohol can change the smell. Unfortunately, the only way to combat this is to stop consuming the culprit. Biology professor Dr Ian Davison also told HuffPost that he recommended cutting off the tips of your aspargus is the smell really bothers you, as this is where most of the compounds that create the odour are found.

    MORE: Your vagina is ageing: a timeline of changes down there, from your 30s to your 60s

    You have a UTI (Urinary tract infection)

    If your pee is cloudy, smelly and it hurts or burns when you pass urine – or if there’s pain in your lower tummy – chances are you have a UTI and will need to see your GP for antibiotics. A UTI isn’t just an infection in your bladder (cystitis) – it can also affect your urethra (urethritis) or kidneys (kidney infection). Kidney infections can be serious, so make sure you seek medical treatment as soon as you start feeling symptoms, to get back to feeling your best.

    You’re pregnant

    Yes, you read that correctly – changes in the smell of your pee can be a sign that you’re expecting. Pregnant women often find themselves needing the toilet more frequently, and many notice a new smell lurking. This is because the hormones produced during pregnancy, especially during the first trimester, can make your urine more pungent. So if in doubt, reach for a pregnancy test or visit your GP.

    You’ve taken certain medicines

    Which medicines make your pee smell? Apparently, if you take certain heart or pregnancy medications, or Vitamin B6, you may notice a bit of scent when you go to the toilet. This is because some artificial flavourings are put into the casing of pills to make them taste better when you take them – the flavourings can also alter the smell of your pee.

    MORE: Menopause supplements: foods, vitamins and herbal remedies to help you cope

    But it’s normally nothing to be concerned about – contact your GP if you notice it alongside any other physical symptoms though.

    You may have diabetes

    First of all, it’s important to note that if you do not have any other symptoms of diabetes, such as feeling very tired, very thirsty, and having blurred vision or itching ‘down there’, it’s highly likely you don’t have diabetes.

    However, if you do have some of those symptoms, and notice a change in the smell of your urine, it could be worth heading to your doctor to get a blood test, to be sure. Diabetes can change the smell of your pee to a slightly sweet scent, as the condition means your body is unable to break down excess sugar (glucose) into energy.

    When to see a GP if you have smelly urine:

    Most of the time, smelly urine is totally harmless. But there are some instances where smelly urine may suggest an underlying problem.

    If you are experiencing lower back pain, pain when peeing, and blood in your pee, you may have kidney stones. If your smelly pee is accompanied by jaundice, tummy pain, and nausea and vomiting, you could be experiencing liver failure. In both instances, see your GP or call 111 ASAP.

    These things are much less common reasons for smelly urine however, so if you notice a scent in your urine it’s likely to be nothing to worry about.

    Couple that with the fact that coffee is a diuretic and you could have dehydrated (read: more concentrated) pee that’s already smelly, along with these metabolites. So, if it happens regularly after drinking a cup of Joe, it’s really NBD. But still, maybe it’s best to drink a glass of water before or after your morning (and afternoon, and maybe even night—hey, we don’t judge) cup of coffee, just to head off any dehydration.

    4. You have a urinary tract infection.

    The most common medically concerning reason for smelly pee in women is a urinary tract infection (UTI), according to Dr. Ross. In fact, pee that has a strong ammonia smell, or foul, or slightly sweet-smelling urine is often the first indication that you have a UTI.

    Basically, the strange urine odor is the bacteria’s fault (because bacteria is what causes UTIs in the first place). That bacteria is also what makes your urine appear cloudy or bloody and gives you that telltale burning while peeing sensation, according to the Office on Women’s Health (OWH). If you suspect a UTI, talk to your doctor immediately so you can get started on an antibiotic.

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    Even after you finish those antibiotics, keep a vigilant eye (or..umm…nose) on how your pee smells. About four in 10 vagina-havers who get a UTI will get another one within the next six months, according to OWH. Since off-smelling pee can be the first sign of this particular medical condition, paying attention to your urine odor can get you into the gyno sooner rather than later.

    5. You might have diabetes or pre-diabetes.

    One of the first ways diabetes manifests is in the bathroom, causing you to have to urinate more frequently, says Muhammad Shamim Khan, MD, a urologist at Guy’s and St Thomas’ Hospital.

    Because your body doesn’t process sugar the same way others’ do, you may also have “fruity” or sweet-smelling urine, thanks to the extra sugar being excreted by your kidneys. So if you find yourself running to the toilet more than usual, you may want to get your blood sugar levels checked, says Dr. Khan.

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    Most likely, sweet smelling urine will be a sign of type 2 diabetes—the type that happens when your body doesn’t use insulin well and therefore can’t regulate blood sugar, rather than type 1, which is much more rare and happens when someone’s body doesn’t make insulin at all. Type 2 diabetes is typically diagnosed in adults, according to the CDC, because it develops over many years. So if you’re smelling fruity pee as an adult, it’s possible that type 2 diabetes is the culprit.

    Yet, if you already have been diagnosed with either type 1 or type 2 diabetes (or even gestational diabetes, which can happen when you’re pregnant) and then start having sweet smelling urine, it’s a sign that you’re not handling your disease well, according to the U.S. National Library of Medicine. And you’ll probably want to talk with your doc asap.

    6. You’re still douching—even though you shouldn’t be.

    If you’re still douching, I’ve got one word for you: stop. Not only does douching not clean your vagina, but it can also mess up the microbiome (a.k.a., that environment of healthy bacteria) of your entire genital area, worsening bad smells rather than improving them, says Dr. Ross. And that includes the smell of your pee.

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    Many of the causes of smelly urine have something to do with bacteria, and douching messes up the bacteria that naturally live in and around your vagina. A healthy vagina has a mix of both good and harmful bacteria, according to OWH. When you douche, you risk washing out too many of the good bacteria and giving the bad bacteria an upper hand, which can easily lead to an infection.

    Plus, messing up that delicate environment could actually double your risk of ovarian cancer. If you’re worried about the odor of your vagina, see a doctor immediately to pinpoint the real cause instead of trying to mask it with douching.

    7. You have kidney stones.

    Kidney stones are hard masses that can form in your kidneys when certain chemicals in your urine start to crystallize. If that’s not clear enough, let us spell it out: Kidney stones are made of pee, according to the National Kidney Foundation. So it’s not too shocking that kidney stones are one cause of smelly urine. While a kidney stone tries to make its way out of your body it causes a backup of urine (and possibly a urinary tract infection). That backup leads to foul smelling pee that may also look cloudy.

    If your pee is smelly and is accompanied by cloudy urine and pain in your back or side, see a doctor to get that kidney stone out of there ASAP.

    Unfortunately, there may not be too much you can do to prevent kidney stones in the first place, as infections and family history of kidney stones are one cause. But the National Kidney Foundation says that drinking too little water, exercising either too little or too much, and too much salt or sugar (especially fructose) could also contribute to kidney stones. If you’ve had one stone and don’t want another (cause why would you), adjusting those lifestyle factors might help.

    8. You have a yeast infection.

    Itchy yeast infections happen when a naturally-occurring fungus that lives in your vagina gets a chance to grow wild. Some ways yeast gets the hint that it’s party time are when you take antibiotics, you’re pregnant, you have uncontrolled diabetes, you have an impaired immune system, or you start taking either hormonal birth control or hormones prescribed for menopause, according to the Mayo Clinic.

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    Yeast infections come with a distinctive “yeasty” smell, thanks to the imbalance of vaginal bacteria, says Dr. Ross. While, yes, yeast infections are technically in your vagina, because your urethra is so close, your urine can pick up the scent as well.

    9. You actually have an undiagnosed genetic disorder.

    This is probably the least likely scenario here, but certain genetic disorders are associated with a bad urine odor. If your pee smells “foul,” “sour,” or “fishy,” you might have a medical condition called trimethylaminuria, which gives you terrible body odor no matter how much you brush your teeth, shower, or bathe.

    According to the National Human Genome Research Institute, trimethylaminuria is more common in women, and symptoms can worsen or become more noticeable around puberty, before or during your period, after taking oral contraceptives, or around menopause. There’s no cure for the disorder, but by working with your doctor, there are lifestyle changes you can make to reduce the smell.

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    For example, doctors may suggest avoiding food that include trimethylamine and certain other compounds, such as: milk, eggs, peas, beans, peanuts, and brassicas (which include foods like Brussels sprouts, broccoli, cabbage, and cauliflower). They may also suggest certain supplements as well as taking low doses of antibiotics to reduce the amount of bacteria in your gut.

    11. You’re pregnant.

    Here’s a fun fact: The hormone changes that make it possible to grow a baby—estrogen and progesterone—can make your pee smell a bit different…to you, at least.

    “Urine can have a more pungent smell from the hormones produced during pregnancy, especially during the first trimester,” says Dr. Ross—but it’s not necessarily a huge change in your pee; rather, your ability to smell it (women tend to have a slightly increased sense of smell during pregnancy).

    Unfortunately, there’s not much you can do to counteract the smell in this case. Maybe just plug your nose when you pee?

    10. You’re ovulating.

    The same hormones that gestate a baby (again, estrogen and progesterone) are also at work during your regular cycle, albeit on a smaller scale, says Dr. Ross. That means you may be more aware of the scent of your own pee when you’re ovulating — though there’s actually nothing off about your urine’s odor.

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    Again, the hormones aren’t necessarily changing the odor of your urine itself, they are amping up your ability to smell it, making the ammonia scent more noticeable to your super-sensitive sniffer.

    12. You might have an STI.

    As if sexually transmitted infections weren’t enough fun (sarcasm, clearly), some of them can also cause foul-smelling urine, says Dr. Ross.

    Chlamydia is the most common culprit, followed by trichomoniasis, a sexually-transmitted parasite. If you even suspect you have one of these diseases, Dr. Ross says to get screened immediately. Both often show no or very mild symptoms at their onset (which is why it’s so important to regularly get tested for STIs)—wait too long and they could progress, making smelly pee the least of your problems.

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    When they do show symptoms, chlamydia can cause abnormal vaginal discharge and a burning sensation when you pee, while trichomoniasis can also cause a change in vaginal discharge and uncomfortable urination as well as itching, burning, redness, or soreness in your genital-area, according to the CDC.

    13. You just started taking supplements.

    Some supplements, vitamins, and medications can cause changes in your urine smell, says Dr. Ross. Artificial flavors are put in some pill coatings to make them more palatable, but they can also change the scent of your urine.

    The most likely offenders? Pills high in vitamin B6, including some multivitamins, heart, and pregnancy medications. It’s not particularly worrisome, says Dr. Ross, but be sure to mention your urine odor to your doctor if you’re concerned about it, if it changes suddenly, or if you experience other negative side effects along with the smell.

    Korin Miller Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more.

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