When you’re changing multiple diapers a day, it can feel like you’re a robot on a strange bum-wiping conveyor line.

1. Unfasten dirty diaper.
2. Wipe that booty.
3. Reposition new diaper.
4. Refasten diaper.
5. Next!

So when an abnormally strong whiff of urine jolts you from the standard diaper-changing routine, it can be alarming. Most of the time, there isn’t cause for concern, but it’s good to know the signs to look for in case you do need to head to the doctor.

Urine is mostly made up of water, though it also has salt, urea, uric acid, and salt in it. It gets it yellowish color from something called urochrome, which collects when your liver processes dead blood cells. Properly hydrated and healthy people have urine that is clear and copious, though the exact color and smell depends on the person and the person’s diet. If your child’s urine suddenly develops a dark color or a strong smell, there are a variety of different explanations.

Dehydration

Especially if this is the first time you have noticed the strong smell of urine, you should probably start by doubling up your kid’s fluid intake. Strong urine smell could just mean that the urine is concentrated to the point it’s getting a little stinky. Check to see if there are any other symptoms of dehydration, such as a baby that:

• Is more sleepy than usual
• Has had less than six wet diapers over the 24 hours
• Has dry lips or a dry mouth
• Is more irritable than usual
• Has a sunken soft spot on the top of his head

It seems a little counterintuitive, but if your baby is dehydrated, he might not be interested in breastfeeding, taking a bottle, or drinking from a cup, so you may need to get creative to boost his fluid intake. Stay away from drinks that are high in sugar and sodium. Instead, offer frequent small sips of clear fluids such as soup, Pedialyte, extra water, milk, diluted juice, popsicles, or ice chips. Before you take any measures, however, you should call your child’s pediatrician to know whether or not you should bring your baby into the office. What works to rehydrate an older child may not work – or could even be dangerous – for a young baby.

Food Interactions

What your child eats can influence how his urine smells or looks. Beets, for instance, can make urine a dark red color, and asparagus can make it smell strongly. Similarly, if a child is breastfed and the mother takes Fenugreek (a supplement to help milk supply), it can make the baby’s urine smell sweet. If you have given your child new medicine, vitamins, or food in the last day or so, this may be contributing to the odd smell. If it lasts more than a day or has any other side effects, it’s best to call the doctor.

Urinary Tract Infection (UTI)

A UTI is another somewhat common cause of stinky pee, though the smell isn’t always a reliable indicator. UTIs happen when bacteria gets into the urinary tract and causes inflammation and infection, and they’re more common in girls than boys. They can be very painful and can even cause severe damage to the kidneys if left untreated, so if you’re worried it may be a UTI, take your child to the doctor right away. The symptoms for UTI are inconsistent, but some that you may observe include:

• Pain during urination or unexplained fussiness after all other needs have been met
• Fever over 100.4° F
• Blood in the urine or cloudy urine
• Vomiting
• Smelly urine
• Frequent need to urinate without passing much

Your child’s doctor will need to collect a urine sample either by having your child pee into a cup (if he’s old enough), or securing a special bag to his body inside of his diaper to collect enough fluid. Unfortunately, since children don’t urinate on demand, you’ll probably spend quite some time in the doctor’s office, making your kid guzzle water or juice until he releases enough liquid. Fortunately, though, UTIs are easy to diagnose and also easy to treat with a round of antibiotics.

Maple Syrup Urine Disease (MSUD)

MSUD makes a child’s urine smell strongly of brown sugar or maple syrup (hence the name). It is highly unlikely your child has this disease because it’s pretty rare (only 1 in 185,000 kids worldwide have it). MSUD is usually diagnosed right at birth, and it’s inherited. It happens because the baby’s body doesn’t break down certain amino acids the right way, so they build up in the body and can cause severe damage if untreated or poorly managed. MSUD can be managed through a low-protein, carefully measured diet and quick access to care when sick or through a liver transplant.

If you are concerned about your child’s urine, the best thing you can do is take him/her into the doctor to get checked out. Many times, the solution is as simple as beefing up his fluid intake, but there could be serious underlying problems. It’s always better to be safe than sorry when you notice a change.