Advice needed! Infant UTI, asymptomatic? What to do??

[Lupena]

My son ( almost 7 months old..)  had been acting fussy for a couple of nights and not really sleeping, in discomfort it seemed, but not huge discomfort ( mewling cries, not high pitched, inability to sleep..) We took him to the doctor, who looked everywhere, could find no symptoms, referred to ped, who also couldn't find anything, but who recommended a urine culture, simply because he couldn't figure out what might be bothering him. Long and short of was, we took him to hospital, where he was shown to have bacteria in his urine. We were there tonight and have the prelim results back but don't know the details. The doc phoned and told me to put him on antibiotics tonight. They prescribed suprax ( cefixime ) which I am supposed to be giving tonight. My question is, why would he have been *so* much brighter today, peeing without any expression of pain at all, happier in general, with no fever at all, if he needs antibiotics right away? Am I screwing up his immune system ( without giving it a chance to fight it off himself... which he might be doing? ) by giving him abx? Doesn't it seem funny that he would have NO other symptom other than fussiness?

Today we only did one dose of ibuprofen and there didn't seem to be any pain, and no fever at all... help...

[Friday13th]

My son is around the same age and he as well as a few other babies that age I know are all sleeping HORRIBLY.  Really, really, awful.  So there might not be anything wrong (other than the usual culprits, teething, developmental leaps, etc)

How did they get the urine sample?  It's possible it wasn't a clean catch and that's where the bacteria came from.  Was he running a fever?  I don't know what to tell you in terms of treatment and I'm just some stranger on the internet anyway, you really need to listen to your mommy intuition.  If that means waiting a few days before you start the antibiotics and seeing if he's ok without them or starting them now just to be on the safe side, I can't tell you.  Good luck.

[Asiago]

It's possible the catch was contaminated, especially since baby did not have a fever (?) despite what the doctor seems to have thought were symptoms of UTI (enough to actually go forward and treat it).

Dr. Sears has an informative page on UTI and deciding when to treat:

http://www.askdrsears.com/html/8/t080800.asp 

You can take off his diaper and observe him for a while to see his reaction when he does urinate, if he shows actual discomfort.

Yes, oral antibiotics do change the gut flora. Unlike the immune system which will target the pathogenic bacteria, the antibiotics do not discriminate and will also destroy the beneficial bacteria.

That said, I do believe antibiotics have their place when the immune system fails to control infection.

Also each individual is different and various factors should be weighed as cicumstances vary for each individual.

[Lupena]

No fever at all today 96.1... seems happier again?? Smiling- a little fussy, slept much more last night. No fussing no fever with no ibuprofen. Tried to get a dose of antibiotics in him today, but he projectile vomited, so I got some/most in with my finger. Don't really want to do it, he prescribed abx before the culture came back, with only the preliminaries?? Now I'm freaked out because if he won't take it orally ( has a powerful gag reflex, no solids yet, he projectile vomited with a bit of banana vomited too! ) will he have to get it by iv?? Trying not to freak out. Putting that stuff in him when he's so obviously on the mend seems wrong but there is the ( doctor fuelled ) fear that it may move into the kidneys. ( Thanks ) Asiagio, the Sears page says that they would definitely have a fever if this were happening? He peed on the doc with a decidedly mild expression.

They used a catheter, way way in to get the sample, so I assume it was clean. He hadn't pooed though, so I wonder if that might influence. THANKS so much for any help. This lack of fever is confounding, it doesn't add up.. the doctor's response was just.." well that is unusual... but it can happen" which doesn't mean anything!

[aphel]

So I am just going to chime in here, because I have some personal experience in this arena. I understand the risk of abx at this age and your hesitancy to use them. But untreated UTIs can very quickly become pylonephritis, or kidney infections, and those can be very dangerous for a little one. I was hospitalized twice as an older child for pylo, and let me tell you, NO FUN. The first time I was hospitalized, I had had a UTI, but the symptoms seemed to disappear. Two days later I was in the ER, blood in my urine, 103.5 fever, and in a LOT of pain. Ended up on IV antibiotics for two days.

Just something to keep in mind. If you don't treat now, watch your LO carefully. Good luck!

[Lupena]

great advice, thanks... can't risk it. But how to get it in my little love. He only vomits when I put them in his mouth... no other vomiting. I'm trying by daubing bits on the inside of his cheek over 20 mins, got in 3/4 of the dose... He starts to make upchucking noises when I give him more. I am so terrified of not being able to get it in him now, I'm feeling slightly addled. Would 3/4 of the dose suffice? Any tips? MANY, MANY THANKS...

[snoopy5386]

If the sample was from a catheter I would agree with the docs that he does have an infection. I would call the doc tomorrow and tell them about him vomiting the antibiotics and see what they say. Have you tried shooting them into the back of his mouth and blowing in his face real hard? That usually gets them to swallow.

[Lupena]

thanks, that's a good tip... the blowing. He will swallow but he vomits right away... He peed last night, a regular torrent, no diaper, with no pained expression, still no fever. The pee was totally clear, caught in my hands, no odour at all! The hospital never called me back with the true results of the culture, didn't respond to my calls. So I guess I have to stick with my cheek daubs, whatever I can get in. I feel so horrible sticking that stuff  in him, hope he doesn't hold it against me. If the risk wasn't emphasized so much, I would not do it, and assume this had been a cold, dad has one, or teething ( he got his first tooth yesterday!) and let the poor man heal on his own...? Does anyone know why the antibiotic ( suprax ) would be 10 days? Seems sickeningly long. Thanks so much again, mamas...

[Lupena]

Sick with worry now, the emergency finally called back after I harangued them enough. Said he's never heard of any baby throwing up antibiotics, that it was a technique problem. Then he said that I had to talk to my doctor about further tests, this from a ( not very high level of ) bacteria in his urine. It is that awful test where they inject them full of dye, I'm shaking too much to remember the name now.. and put them on antibiotics for 5 YEARS. I have a ridiculously conservative ped, I won't do this test, after one UTI?? I keep doing  searches no info. Sometimes I just hate doctors.

[PatioGardener]

Was this what he was talking about?   It helps me to have as much info as possible before talking to the doc! hope this helps. http://www.childrenshospital.org/az/Site1962/mainpageS1962P0.html

[Lupena]

Thanks PG, that's the one, horrifying! And then to prescribe abx for FIVE years!!!! It makes me think, they assume UTI's are so rare in babes under a year, but realistically, if my ped had not ordered a test due entirely on my reaction to a couple of nights of fussiness and minor discomfort, we would never have had had this diagnosis. Meaning, he would be (IS!) recovering nicely and we would be none the wiser. So, are UTI's really that rare? And in need of such an  extreme testing response ( in cases either responding to abx  immediately, or going without diagnosis entirely...) ?   I mean, I think they are uncommon because they are LARGELY undiagnosed and disappear on their own, without any meds.

Someone reassure me that their LO had one and it never came back. The forum search has changed. When I search UTI's and antibiotics under life with a babe I get just a bunch of idividual posts that aren't on topic, argh. It's me, I know.

I shouldn't say I hate doctors, I hate the rigidity of the profession! To so many of them,there are no individuals, only symptoms.

[orca]

My oldest son was born with hydronephrosis, which may be what the doctor was referring to. We endured a battery of nuclear testing etc. after ds was diagnosed with a UTI at 3 weeks old. His primary symptom was blood in the urine, but no fever. We stayed in hospital for a week until they sorted it all out (ds had various allergic reactions to the antibiotics). The standard protocol for hydronephrosis is to keep the child on antibiotics until he is toilet trained. The cause of ds' condition was unresolved and I refused the antibiotics once we sorted out it was not reflux causing the initial infection. He still has the hydronephrosis, but it is mild and not a worry. We also live in Vancouver. BC Children's has an excellent nephrology clinic that we visit once a year for his checkup. Ask for a referral there if your babe ends up with this diagnosis. So, all this is to reassure you that our son had a BRUTAL UTI as an infant, but has never had one again :)

[brennan]

Have you gone in to talk to your dr?  Most drs in Canada will not talk to you over the phone (and could explain why the dr was so pissy and what kind of dr has never heard of a baby throwing up abx?  seriously?), so I would make an appt asap.  I would talk to your dr about how he is having a hard time taking the abx and if there was something else you could do.  Or what about calling the nurses line?  They can be pretty helpful (sometimes)

Hugs mama!

[Lupena]

Thanks so much everyone, truly. Orca, did your wee man ( poor you and he going through that so young.. and you had such wonderful resolve, they really try to take that from us..) take antibiotics at all or no? Did he recover from his UTI without them, or did he just have them the one time? His poor foreskin wasn't even loose, that must have been so sore. How do these things happen? My little man got a swollen penis ( with pus ) last week from a hair torquinet ( stupid momma changing a diaper in the semi-dark ) but no one seems to relate them, and again don't elaborate. What a great clinic recommendation, too.

It's just such a tough call when he's getting better on his own, pee clear and mild as water, cheerful, no fever and still trying to put that stuff in him, when every part of me wants to stop, due to his great  appearance before even a smear of abx, and his huge thrush rash from his one dose! When I told the doctor today this - his lack of fever and clear pee - he didn't even comment!

Brennan, yes, I'm sure the er doctor was a tad reluctant.  I went to the ped on Friday, and will hopefully get an appointment with him tomorrow to discuss.  Generalizing wildly - I'm sure he's likely to encourage the use of abx whenever there's even a suggestion of need. Maybe this isn't fair, though as I have only been there once.

Thanks for all the great support, I am settling...

[PatioGardener]

my friend's boy got a uti at 2 months old.  he was diagnosed with (urine) reflux that was a result of leaky valves where the 'tubes' from the kidneys attach to the bladder.  he had the dye test and a kidney scan.  he was on antibiotics for 6 months because of the high chance of another uti that could damage the kidney (grade 4 reflux).  then after 6 months they tested again and it had cleared enough to not need any more antibiotics (grade 2)and last test he got it was gone!  Not all kids who have a uti have this issue (that's why they do the scan to see) and many who do have it grow out of it way before 5 years old!

  I hope you can find a ped you can trust!