Catch Me If You Can: A Parent’s Guide to Collecting Urine Samples in Malta & Gozo

Before you start, you need the right tools. Visit your local pharmacy (spiżerija) and ask for:

1. An Urine Container:

   • Rule: If your doctor ordered a "Culture", the container must be sterile.

   • Pro Tip: Buy two. Accidents happen, and you don't want to lose a hard-earned sample because a lid dropped on the floor.

   • Important Note:  Never use a jam jar or food container from home. Even after a dishwasher cycle, microscopic residues remain that can invalidate medical tests.

2. Pediatric Urine Collection Bags:

   • Usage: These adhesive bags are helpful for non-potty-trained infants, but only for general urinalysis (dipsticks). I generally advise against using them for cultures because they pick up too many bacteria from the skin.

Scenario B: Urine Culture (Kultura) – The "Clean Catch"

• Goal: To identify the specific bacteria causing an infection and choose the right antibiotic.

• The Problem: Bags collect bacteria from the skin, not just the bladder. This leads to "contaminated" results, which might mean your child takes antibiotics they don't actually need.

• Method: sterile container. 

• The Solution: The "Mid-Stream Clean Catch."

1. Wash the genital area thoroughly with plain water. If you use soap, rinse extremely well; soap residue can sometimes interfere with the chemical "dipstick."

2. For girls, clean carefully between the labia. For boys, gently rinse.

Note: Do not force the foreskin back if it is still attached (which is normal until age 3 or older).

3. Attach the bag to the genital area (don’t worry—the bag comes with instructions). The urine needs to go directly into the bag. Put a loose nappy on and check every 15 minutes.

4. When your baby pees, collect the urine right away in the urine container.

For Girls (Always wipe front-to-back):

1. Ask your child to sit comfortably on the toilet (or potty).

2. Gently separate the folds of skin (labia) around the urinary opening.

3. Using your clean cloth or gauze dampened with mild soap and water, wipe the area from front to back (moving towards the bottom).

4. Rinse the area well with clean, lukewarm water to remove all soap residue, and pat dry with a clean, dry towel.

5. She is now ready to collect a urine sample directly into the urine container (see ‘clean-catch’ instructions below).

For Boys (Remember the foreskin, if applicable):

1. Have your child stand in front of the toilet (or sit on the potty).

2. Using your clean cloth or gauze dampened with mild soap and water, wipe the head of the penis (gently pulling back the foreskin if your child is uncircumcised). Use a gentle, circular motion.

3. Rinse the area thoroughly with clean, lukewarm water to remove all soap, and pat dry with a clean, dry towel.

4. He is now ready to collect a urine sample directly into the urine container (see ‘clean-catch’ instructions below).

1. Position: Lay the baby on a changing mat with the nappy off. Since this can be messy, I often suggest doing this inside a bathtub or a clean plastic basin—it makes the cleanup much easier!

2. The Trick: Rub a piece of gauze soaked in cold water in gentle circles on the baby’s lower tummy (the suprapubic area).

3. Trigger & Catch: This cold sensation often triggers a bladder reflex. Let the very first drops fall onto the mat/basin, then catch the "mid-stream" in the sterile cup. Try not to let the cup touch the baby's skin.

1. The Start: Ask your child to start peeing into the toilet.

2. The Middle Catch: After a few seconds, once the stream is flowing nicely (this first part washes away any residual germs), quickly slip the sterile container into the stream.

3. The Sample: Collect about 30 mL (or enough to fill the container halfway).

4. The Finish: Carefully remove the container from the stream and allow your child to finish peeing into the toilet.

1. Seal It Up: As soon as the sample is collected, screw the lid on tightly. Remember to only touch the outside of the container and the lid!

2. Add the Details: Label the container clearly with your child's full name, date of birth, and ID card number (if available) or the child’s hospital number. This is super important for the lab.

3. Keep It Cool: Place the sealed container in a clean plastic bag and pop it straight into the refrigerator (at 4°C - 8°C). Keeping it chilled helps keep the sample fresh until it can be tested.