infant with UTI

[kateygirl76]

Our little man Kevin (6 weeks old) is in the hospital now with a wicked UTI, spiking high fevers. He is intact and while the doctors have said one UTI does not mean they will recommend circ, they mentioned recurrent ones and I fear I will be fighting this battle soon. I will not circ him.

I am worried b/c they had to cath him to get a urine sample last night, it was a male nurse and he was okay about not retracting much, at least I think he was. Not sure how much is too much.

but they want to d a VCUG which requires another cath. How much damage can they do retracting him? The procedures are unavoidable but I don't want to cause him anymore harm. I live in a circ happy area so not sure how much experience anyone has with intact baby boys.

Anyone been thru UTIs in tiny infants? How did things play out? I'm worried for my baby.

Any advice would be greatly appreciated!

[txgal]

There is no reason to retract him in order to cath, if the doctor doesn't know how to do it ask for a NICU nurse. They are more familiar with cathing intact babies.

[robertandenith]

are you breastfeeding him? if so, PLEASE breastfeed him as much as you can. That will keep him hydrated and will avoid another UTI. He must have been dehydrated poor thing

so sorry to hear that... Protect your son from amputation of the foreskin. Ask them how would they do if a girl has recurrent UTIs and demand same treatment! Amputation will do more harm than anything else, because you will expose the head of the penis to feces and urine. Stand up firm!

[kateygirl76]

He is a twin so he is FF. Fortunately or his brother would be starving right now! He is eating decently but I demanded an IV b/c he does throw up at least once a day. So he has been staying fairly hydrated.

Would they really send down a NICU nurse? I see them being a pain about that. Hopefully the only other cath will be for the procedure so I'll talk to them in length beforehand.

Believe he will not be circed! I just hope to God he doesn't have to go thru this again anytime soon

[Lkg4dmcrc]

My little guy got a cath at 3 weeks. It was really scary because all the stuff on here made me believe that any cath was a horrible thing. It is rare to have a small guy like yours get a UTI and probably really wise to do the VCUG (my son has had one of these and many other tests). I remember thinking that any retraction would damage him for life. We now have to cath him 4 times a day and do it without retraction. We do have to move the foreskin to see where to put in the cath. This is what the nurses are likely doing when they cath your son.

Keep us posted.

[MCatLvrMom2A&X]

I wouldnt do the VCUG after 1 UTI personally because it is a major invasion and it hurts. I allowed dd to have it after 1 UTI and I greatly regret that.

There is not that big a rush on the VCUG but even if you do decide to get it for him be aware it can be done without retraction.

[prairiemommy]

My DS had a UTI at 9 days old and was admitted for a week. He was cathed in the ER and again on his last day there for the VCUG. No one retracted him at all (and I watched like a hawk).

I personally would do the VCUG because if there are any anatomical issues, you will know about it before he has another UTI that could possibly cause damage. UTIs are relatively uncommon in little ones. DS barely cried throughout the procedure - the lumbar puncture in the ER was 1000 times worse that then VCUG. DS also had a u/s to check his kidneys, which were also normal.

Good news is, he's since been UTI-free and is over 2 years old now. His sister had one as a toddler and has been free since. His brother has an enlarged kidney but has never had a UTI. So it goes to show that things don't always work the way they say they will.

Lots of for you - how hard it must be to feel with one baby in the hospital and one at home!! I hope you are getting a little time to take care of yourself too so that you can continue on.

[kateygirl76]

he is doing much better today, they want to do the VCUG tomorrow. I already had a lengthy discussion about retraction and will have another discussion w/ whoever does the procedure before they touch him. I would really like to put off the procedure but saturday night his fever was approaching 105 and his resting heartrate was over 200. If there is a problem, I don't want to risk him getting that sick again.

prariemommy-
his u/s was normal, thank god, and the lumbar puncture was pure hell. the first doc couldn't get it and the head doc had to come and she tried once and couldn't get it so I went insane. she agreed to only try once more and couldn't even get enough fluid for any prelim tests.

Hubby and I are switching off spending nights here. his twin is okay...my heart is breaking for my 2 year old who keeps asking for kevin and whichever parent is not home

[prairiemommy]

That's great news about the u/s!

Yeah, our lumbar puncture was like that too - 3 tries and not enough fluid to get anything done. They wanted to keep going but we told them to stop. It really, really sucked.

Good luck on the VCUG. I hope that you get to bring him back home soon! And you have a toddler too - poor girl. I hope life returns to normal for you all quickly. Keep us posted!

[MCatLvrMom2A&X]

I just realized that no one said that having a foreskin has nothing to do with UTI. There was a study many years ago showing that intact boys where more prone to them but that study was done by compairing pre term infants with circed full term infants. Since pre term babies have a much higher chance of UTI anyway it made the study worthless.

[tutucrazy]

Having foreskin has NOTHING to do with UTI. Caths and retraction are causes for recurrent UTI, NOT FORESKIN!!! Please read our stickies about forcible retraction. Your son does not need a cath for a urine sample you can have him bagged instead. Even if they cath him it is totally unnecessary for them to retract. They must no know what they are doing if they are trying to retract him.

Get him on some probiotic supplement if he is going to be on any antibiotics. You don't want him to get a secondary yeast infection. Make sure they bag him for future urine samples as caths often reintroduce bacteria and cause UTI.

Please keep us posted. Remember that a circ is completely UNNECESSARY. The studies that said intact boys were more likely to get UTI were incorrect. A foreskin actually protects from UTI if it is cared for properly, meaning leave it alone. Here is a link about how foreskin protects against UTI:

http://www.nocirc.org/statements/breastfeeding.php

Read about half way down.

[tutucrazy]

I wanted to add that being premature and/or having an immature kidney function is the real cause for his UTI, not his foreskin.

[Cheshire]

I hope he is all well soon and home with your family.

When my son was 4 yo he got a nasty UTI and three docs suggested circ. Each time I just got into the habit of saying "it's not an option." The last doc, a urologist, worked with us to find an antibiotic that finally cleared it up.

UTIs are no reason to circ and you may have to try a few different doctors to find one that won't look at you like you have three heads but you can find a doc that will at least help find a cure.

The urologist we used was not an intactivist - he probably would have circ'd if we'd agreed. But, he didn't push it once I told him it wasn't going to happen.

Best wishes. It can be so tough but it is worth it to stand up for your baby.

[mysticmomma]

Why can't they bag his penis instead of the cath?

[MCatLvrMom2A&X]

Some Dr. say that because of the bacteria on the skin there is no way to get a clean sample with a bag. Some Dr. always do bag first so it seems to be more of a preference for each individual Dr.

[Cheshire]

Why can't they bag his penis instead of the cath?

If they are going to perform a VCUG you have to cath to insert the dye into the bladder. This is where the NICU nurse can really help if the tech can't do it.

[prairiemommy]

Originally Posted by MCatLvrMom2A&X

I just realized that no one said that having a foreskin has nothing to do with UTI. There was a study many years ago showing that intact boys where more prone to them but that study was done by compairing pre term infants with circed full term infants. Since pre term babies have a much higher chance of UTI anyway it made the study worthless.

Goodness, I think the reason that I didn't say anything about that is that around here, circs are not nearly as common anymore so not one single person suggested it to us while DS was hospitalized. I forget that other areas aren't so lucky.

Originally Posted by mysticmomma

Why can't they bag his penis instead of the cath?

A bag does not give you a clean catch. It can, when done exactly right, but that's extremely difficult to do. Very, very extremely difficult! No matter how well you clean the surfaces, something always ends up touching something else - I've done the bag thing enough to know that they make the hole too small to be really practical.

In some ways, the bag was harder on my DS than the cath - the cath was fast and got results right away. The bag was sticky, hurt to put on, hurt to have on and had to stay on a while. Never mind pulling it off - extremely painful because it is very, very sticky. I wouldn't want that adhesive down there, personally. And then you have to transfer the urine out without contaminating it. It's really a circus of an ordeal.

I hope to hear a good news update soon!

[kateygirl76]

Thanks everyone for all your well wishes and advice. It had really helped

we're home! : The VCUG was done today and I talked to the tech beforehand, she did not retract him at all but the little guy still hated it. Good news, no reflux!

I live outside Philadelphia and circumcision is pretty common. But all of our boys are intact and are going to stay that way.

Have to follow up with his ped in a few days and hope he doesn't get sick again!

[Night_Nurse]

Thanks for the update! Hope your son is feeling better soon!

[Cinder]

Originally Posted by robertandenith

are you breastfeeding him? if so, PLEASE breastfeed him as much as you can. That will keep him hydrated and will avoid another UTI. He must have been dehydrated poor thing

dehydration is far from the only cause of a UTI, since he's so young, I'd think kidney reflux is more likely.

Anyway, no advice, my dd had 5 UTI's in her first year, we did the vcug and they found nothing, and she outgrew it, she hasn't had an infection since 9 months old. But, what they would of done for her had she had reflux is prophylactic antibiotics, most likely bactrim, low dose taken every day, to prevent future uti's...

The vcug wasn't hard on her as a newborn, but when she had a repeat one at 18 months, just to be sure, she hated it (thought, not as much as she hated having x-rays done).