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Expert Q&A:
Why does my 10-month-old's urine have a strong smell?

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Stephen Muething
Answered by Stephen Muething M.D.
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"I love being a pediatrician," says Stephen Muething, medical director of the Pampers Parenting Network. "Through my special role, I get to partner with families in the very important job of helping children develop and grow. My task is to help parents raise their children to be as healthy, happy, and successful as they can be." 

Dr. Muething received his B.S. degree from the University of Notre Dame and his medical degree from the University of Cincinnati College of Medicine. After completing his pediatric residency and chief residency at Cincinnati Children's Hospital Medical Center, he served as the lead physician of a five-pediatrician practice in Southeast Indiana for 13 years.

Dr. Muething is currently the associate director in the Division of General Pediatrics, Cincinnati Children's Hospital Medical Center, leading a team that performs more than 60,000 primary care visits and cares for more than 3,500 inpatients annually. He is also the director of the Diagnostic Clinic for Cincinnati Children's Hospital. Since 2001, Dr. Muething has served as one of the key physicians in the Pursuing Perfection initiative at Cincinnati Children's, funded by the Robert Wood Johnson Foundation in conjunction with the Institute for Healthcare Improvement. Dr. Muething is now a graduate of the Advanced Training Program in Healthcare Delivery Improvement at Intermountain Health Care in Salt Lake City, Utah.

Dr. Muething has been a co-leader for the Acute Care Team at Cincinnati Children's, which has focused on designing an evidence-based, family-centered care system for children in the Cincinnati area. Results of the work have been presented at the annual meetings of the National Association of Children's Hospitals and Related Institutions (NACHRI), the National Initiative for Children's Healthcare Quality (NICHQ), the Institute for Healthcare Improvement (IHI), and the Pediatric Academic Societies (PAS).

As "Dr. Steve," Dr. Muething hosts two radio programs for families in the Cincinnati area and is the pediatric consultant for The Health Show, a nationally syndicated radio show. Other community activities include serving as moderator for the "Centering on Families: Tools for Practical Parenting" series at the Cincinnati Museum Center.

Family life is central for Dr. Muething and his wife, Meg, both of whom were raised in large families. They have four children—ranging from elementary school age to college graduate—and more than 40 nieces and nephews.
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Question


My 10-month-old baby girl has very strong smelling urine. Every time she pees you can smell it through the diaper, and on more than one occasion the smell has been mistaken for a dirty diaper by friends and family. Why does her pee smell so bad?

Answer


A strong urine odor is actually quite common and usually not a health problem. Certain foods and herbs can cause a change in the urine odor. Also, concentrated urine will have a much stronger odor. Finally, some bacteria in the diaper area can create ammonia from urine by-products, which also can create a pungent odor.

If your daughter is doing well overall, this odor is not likely to be a health problem. I would recommend increasing the amount of water she drinks each day, which may decrease the amount of odor in her urine. If the odor remains, I would mention it to your daughter's health care provider at the next checkup. Her provider may want to check a urine sample to make sure there is no sign of a urinary tract infection. Although this possibility is not likely, you may want to take this extra step to be sure.

Thanks for asking the question and allowing me to share this advice with so many families. Good luck with your daughter.
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