upset and need insight

[Artemnesia]

DS is 3 months old and intact. Yesterday he was diagnosed with a UTI. The pedi says this isn't common and he needs to have his kidneys and bladder checked by xray and ultrasound. He's on abx now and seems better; happy and no more fever.

Concerns-- when they took his urine (by catheter ) they pulled back his foreskin. I had told them I didn't want it retracted and the nurse said, "Well we have to pull it back a little to put in the catheter." Which makes sense but now I'm very worried that this has caused harm.

Today at the follow-up visit the pedi also pulled it back a little to look at the opening, he said. I told him I had read that it wasn't a good idea to pull back the foreskin and he said generally you don't need to but that sometimes it's necessary and doesn't usually cause a problem. Is that right??

He mentioned that if DS keeps getting UTIs that we can "talk" about the "c" word. I said I wouldn't consider that, I thought it was extremely drastic and he said he didn't think there were good reasons to circ routinely or many medical reasons to do it anyway and that this was probably just a one-time thing...and that it was all up to me...so he appeased me somewhat.

I am so upset about this whole thing.

[Lil Bit's Mummy]

I have to cath my uncut 5 week old, twice a day. Was 6x a day for the first month. And I've NEVER had to pull the foreskin back to get a cath in. It is usually a straight shot from the opening in the foreskin to the urethral meatus and then into the bladder. The nurse should have been able to do it practically blindfolded, baby boys are so easy to cath (unless they pee all over you first! BTDT! LOL)

I can understand the pedi's concern wanting to see the meatus (end of the urethra) to check for irritation or inflammation, though. And they're right about UTIs being unusual in boys. HOWEVER, it might not be a true UTI since it was just a dip, not a full culture (takes two to four days for results). A dip checks for the presence of ANY bacteria, and some of us have an abundance of naturally-occuring normal flora in our urine. Every time I have a urine check, they have to culture it because it always comes up positive. The culture almost always comes back as normal. I wouldn't get too worried about the unusual-ness of the UTI until you have confirmation from the urine culture about what kind of bacteria it is.

The x-ray and ultrasound are no big deal, and unless you have to pay out of pocket for them, I'd not argue. IF there is a problem, it's much better to find it early and prevent damage from it than to wait until things get bad enough to need more intense correction.

[chaoticzenmom]

What does kidney reflux have to do with circumcision??? Girls have it too. It happens before the pee even gets to the opening,it's all up inside. Also, it clears up on it's own by 6yrs old and the treatment is a low dose antibiotic for years at a time. I'm upset for you.

Also, I've read that the catheter itself can cause positive UTI results.

The foreskin is a useful organ. I'm glad you've told them that circ. is not a treatment option.

[tennisdude23]

From what I have read, foreskin has nothing to do with UTIs. If there is any protection from circ., it's only in the first year of life and frankly that's doubtful. What if you circumcise and he has another UTI after that, will they then cut off the whole penis . Do they cut off girls' labias to treat UTIs, no! Circumcision should not never be considered as a serious surgery to guard against UTIs. I don't think you should be worried too much about retraction. Foreskin is a very durable organ, but it does not need to be fiddled with for a cath.

[MCatLvrMom2A&X]

The Dr. should NEVER push the foreskin back especially when a possible infection is thought to be present. It can cause the infection to spread.

Even a tiny bit of retraction can cause micro tears allowing bacteria to enter. So it just makes sense to leave it alone.

Here is 2 stickies you should read:
A Warning To Parents of Intact Sons
The Definition of Retraction & Why it is BAD

No the foreskin is not made of glass and will break easily but there is absolutly NOTHING they need to see under there so why allow it in the first place?? It can and does cause issues when it happens so why not be cautious? It is far easier to prevent a problem than to fix one once the damage is done.

As far as the UTI myth and being intact that all started with a flawed study back many years ago that compaired preemi intact boys to circed older boys. Being a preemie alone means a higher risk of UTI.

[perspective]

Originally Posted by Artemnesia

I am so upset about this whole thing.

Wow so much to respond to.

First you need to inform your doctor on what he/she is SUPPOSE to do, here is a good place to start.

from the aap site:
http://www.aap.org/publiced/BR_Uncircumcised.htm

Yesterday he was diagnosed with a UTI. The pedi says this isn't common and he needs to have his kidneys and bladder checked by xray and ultrasound. He's on abx now and seems better; happy and no more fever.

You make this sound like its serious? UTI's are quite common in girls, and happen to boys sometimes too. Usually a simple round of antibiotics are given to clear things up. One UTI is one UTI and this doctor is mentioning a whole series of tests and even mentioning the possibility of surgery!

To say this doctor is overreacting is a understatement. Also DO NOT let them retract his foreskin again. If you want real penis problems for your son, repeated forced retraction (even just "a little) is a great way to start it.

[Yulia_R]

Originally Posted by MCatLvrMom2A&X

The Dr. should NEVER push the foreskin back especially when a possible infection is thought to be present. It can cause the infection to spread.

Even a tiny bit of retraction can cause micro tears allowing bacteria to enter. So it just makes sense to leave it alone.

Here is 2 stickies you should read:
A Warning To Parents of Intact Sons
The Definition of Retraction & Why it is BAD

No the foreskin is not made of glass and will break easily but there is absolutly NOTHING they need to see under there so why allow it in the first place?? It can and does cause issues when it happens so why not be cautious? It is far easier to prevent a problem than to fix one once the damage is done.

As far as the UTI myth and being intact that all started with a flawed study back many years ago that compaired preemi intact boys to circed older boys. Being a preemie alone means a higher risk of UTI.

: (especially the bold part).

[Artemnesia]

Thanks so much for the info and support. I really appreciate it.

I will never let that happen again. I hope nothing bad is going to happen. He seems better and his penis looks okay so hopefully nothing was seriously harmed.

I was thinking and I realized that three or four days ago I put my toddler-age daughter's bubble bath into his bathwater. Probably a really bad idea-- I know you have to use that stuff sparingly even with older kids because it can cause irritation. Maybe that's what happened.

I think I'm going to find a new pediatrician. Aside from the retraction thing he told me that with the UTI my DS should get some extra water. Water?? He's 3 months old. My boobs don't make water.

[yarngoddess]

I would find a new ped. You have been give too much bad advice, or ideas by this one. Hope your DS feels better soon! And yes, the bubble bath was NOT a good idea for DS. Hang in there!

[MCatLvrMom2A&X]

Odds are your ds will be fine and no harm was done.

It takes a over and over kind of thing to cause permanant harm. Still when something can potentually be harmful why risk it is how I think of it.

Yeah I think a new ped. might be in order especially since he is saying give a 3 mo water

I always say if you like your Dr. then it is worth it to educate them. But if you are not a good fit with him/her then it is best to move on. But it couldnt hurt to give him some print outs on proper intact care and the fact that UTI and foreskin are totally unrelated.

[perspective]

Originally Posted by Artemnesia

Aside from the retraction thing he told me that with the UTI my DS should get some extra water. Water?? He's 3 months old. My boobs don't make water.

I think he/she meant you should make sure to give him extra liquids to help flush out his urinary tract.

[Oubliette8]

Here is some information I found on the topic of UTIs and circumcion and on catheterization-

" The belief that the foreskin is slightly increases the chances of a boy having UTI is highly controversial and, more importantly, unproven. Members of the medical profession in Europe do not accept it. Medical research proves that UTIs are most often caused by internal congenital deformities of the urinary tract.2,3,4 The foreskin has nothing to do with this. Even if it could be proven that circumcision slightly reduces the risk of UTI, it is an absurd proposal because UTIs in boys are extremely rare and are easily treated with antibiotics. Breastfeeding, too, helps prevent UTIs. Child-friendly doctors advocate breastfeeding not penile surgery." http://nocirc.org/articles/fleiss2.php

"The risk of a urinary infection in the first year of life is less than 1 in 100, but they do occur. Even so, you made the correct ethical choice when you kept your son intact. Treatment by antibiotics is usually all that is needed, same as would be true for girls (who, lifetime, get many more urinary tract infections than boys ever do.) Circumcision is NOT the ideal solution." http://www.doctorsopposingcircumcision.o...

Article with links to medical journal articles about UTI and Circumcision- http://www.cirp.org/library/disease/UTI/

"Would my son’s foreskin
need to be retracted if he were
catheterized
for a urinalysis
or medical treatment?
No. A catheter can be inserted when the foreskin
is retracted just enough to see the meatus (urinary
opening). If the foreskin’s opening is too small to
retract far enough to see the meatus, a cathether
can be inserted through the foreskin’s opening
and into the meatus “by feel.” The foreskin should
never be retracted by force for any reason." http://nocirc.org/publish/6pam.pdf

So no, no retraction was needed, and circ is highly unlikely to cure even repeat UTIs. Next time I would tell them that if they can't cath without retracting, to find someone who can. And the retractingt can actually cause issues. As for the ultrasound and xrays, this sounds rather drastic. Generally they are only recommended for girls when they have repeat UTIs. Your son has had one. I've also heard, if its a voiding cystogram they want to do, that the test can be painful. Frankly, I think the chances of them interpreting the results of such a test into something that they think would necessitate a circ are higher at this point than the test actually giving results that show your DS has a real issue. The UTI is gone now, you've identified a potential culprit (the bubbles), I would be inclined to wait and see if he gets any more instead of putting him through more tests at this point. -Oubliette

[Yulia_R]

The only "water" your baby needs is exactly what your boobs make . The ped is SO wrong suggesting giving water to a 3mo (NOT a good idea, to put it mildly).

Bubble bath is known to trigger UTIs.

Hope you will find a new good ped and hope your lil one feels better very soon.

[perspective]

Originally Posted by Yulia_R

The only "water" your baby needs is exactly what your boobs make . The ped is SO wrong suggesting giving water to a 3mo (NOT a good idea, to put it mildly).

Bubble bath is known to trigger UTIs.

Hope you will find a new good ped and hope your lil one feels better very soon.

Why is it a bad idea to give water to a baby?

[Yulia_R]

Originally Posted by perspective

Why is it a bad idea to give water to a baby?

their body isn't ready for that. I don't remember the details as it's been a while since I did this research, but I remember the bottom line that it is very much not a good idea. Little babies can actually die from too much water (their body sort of drowns in it).

[MyBoysBlue]

Here's why water is a bad Idea.

http://www.kellymom.com/nutrition/so...aby-water.html

# Too much water can lead to a serious condition called oral water intoxication.
# Water supplements fill baby up without adding calories, so water supplements can result in weight loss (or insufficient weight gain) for the baby.

[perspective]

Originally Posted by Yulia_R

their body isn't ready for that. I don't remember the details as it's been a while since I did this research, but I remember the bottom line that it is very much not a good idea. Little babies can actually die from too much water (their body sort of drowns in it).

Thats true, and is true for anyone. (there was a case of a teenager who died from water poisoning because his friends dared him to drink as much water as possible) Its just in the case of babies since their smaller, its a lot easier for it to happen, so its important to be careful.

In the site Myboysblue put up it even says "Breastfed babies do not need water - keep in mind that breastmilk is 88% water." So again water is fine, its just like with everyone, its the amount thats important.

The site goes further on to say "Supplements (water, glucose water, formula, and other fluids) should not be given to breastfeeding newborn infants UNLESS ordered by a physician when a medical indication exists..."

So a VERY small amount of extra water might not be a bad idea in the OP's situation to help her boys UT wash out the bad stuff. Just do not give him very much.

[Artemnesia]

I got the name of a new pediatrician.

It's much better to give a sick baby breastmilk rather than water (or pedialyte.) I think the pedi just forgot that I BF. He often did that. I should have dumped him years ago when he told me to start my 4 month old DD on solids. : He was nice but apparently old-fashioned.

I feel much calmer today; DS is back to his old self, it doesn't look like any damage was done, and if he does have kidney reflux then we'll deal with it. I will tell this new pediatrician that I'd prefer to wait and see if the UTI recurs rather than immediately subjecting him to the xray with contrast or whatever you call it. For that they'd have to cath him and apparently there's only a 1/3 chance he has the condition based on having a single UTI. But if it does come to pass that he needs the testing then I'm going to be very specific and assertive about them NOT retracting to put it in.

[Yulia_R]

Originally Posted by Artemnesia

I got the name of a new pediatrician.

It's much better to give a sick baby breastmilk rather than water (or pedialyte.) I think the pedi just forgot that I BF. He often did that. I should have dumped him years ago when he told me to start my 4 month old DD on solids. : He was nice but apparently old-fashioned.

I feel much calmer today; DS is back to his old self, it doesn't look like any damage was done, and if he does have kidney reflux then we'll deal with it. I will tell this new pediatrician that I'd prefer to wait and see if the UTI recurs rather than immediately subjecting him to the xray with contrast or whatever you call it. For that they'd have to cath him and apparently there's only a 1/3 chance he has the condition based on having a single UTI. But if it does come to pass that he needs the testing then I'm going to be very specific and assertive about them NOT retracting to put it in.

Great, I'm glad your lil one feels better.
Since your ds has to take an antibiotic, just make sure you are giving him a good brand probiotic for about a month or so to bring good bacteria back into his gut. I know Nature's Way has a powder one for infants.