Help! Is it possible to EC a 12 month old for medical condition?

[jennica]

Hi. I have never had much interest in EC and we tried it a couple times when my daughter was first born and it didn't work out (she would hold her poop for a few hours if we tried holding over the toilet and I wasn't comfortable with that - and honestly just not interested enough to keep trying). However, she tested positive for kidney/urinary reflux. I had this as a child too, so my children have a strong genetic risk which is why they are tested as newborns. The standard treatment is low dose antibiotics, but we opted for probiotics (one promising study showed these were just as effective at keeping infections at bay) and breastfeeding instead. She did great for a year, but then she got an unexplained fever and we had to take her in. The problem is that in infants their preferred method of testing for a bladder infection is doing it by catheter. Doing a bag gives a high rate of false positives (50%), and a significant rate of false negatives (10%). With her condition those are not acceptable rates. The problem with a catheter though is that the procedure is invasive and traumatic. When I took her in I asked what they do to protect the child from distress and the doctor said, "nothing, we hold them down and hold their legs apart and they scream and cry, and we do it as fast as we can". I told the doctor that these procedures traumatized me as a child and she said, "I can understand that, but it has to be done". I asked for sedation and was told the risks were too high. Then I asked for Nitrous Oxide and was told that was a possibility but they had to see if a certified nurse was on staff. I ended up waiting 40 minutes for a nurse to come on shift who could administer the Nitrous Oxide. The whole thing went very well and they did the catheter without her barely noticing, and they had to draw blood and start an IV and the Nitrous swelled her veins a bit so that was easier to do too. The only problem is that she fought the mask and seemed distressed that it was being held over her face. I feel that is better than fighting a catheter, but of course if I can prevent both I'd like to try. So that brings me to the question of EC. I looked up methods of collecting urine and an accurate method is called a "clean catch" method. This involves sterilizing the infants bottoms and catching the urine midstream. Do you think that is even possible with an older baby? It says to do this after a feeding, but it's not like at 12 months old she really has a "feeding" anymore? Is it possible to EC her at this age? I would like to be able to test her urine without doing an invasive procedure on her. She is on antibiotics for 10 days now and then we have to retest. The nurse said we could do a bag collection, but looking at how bad the rates of a false negative or positive are, it might be nice to try to do a clean catch instead.  

[heatherr30]

That's good the first collection wasn't as traumatic as you'd feared.  That would break my heart watching that.  I wonder if someone else could bring your DD to the dr if it has to be done again? (My DD is "braver" around DH but tends to cling to me.)

As for EC/ PT I think it is definitely possible for a 12 month old to pee in a potty but I'm not sure if this would give you the clean catch you are hoping for?  I got a urine sample from my DD when she was 3 and had been PT for 1 year--it was hard even then for her to pee in the cup but she did manage it--and I can't remember if I got a "mid-stream" sample or not tho this would be more up to the parent to hold the cup out at the right time!  It is hard for them to relax and pee when the environment is a little different than they're used to so you might want to do practice runs at home in a cup to know when she's ready. 

12 months is the age when I first bought my DD a potty (we did not do EC with her.)  She peed in it 1-2 X a day from the very beginning. (upon waking up in the morning and after her nap.)  It was very easy to get her to pee in the potty at these times but we did not make other catches till she was 2.  As well as looking into EC principles, you might also want to check out the Montessori method for PT which involves taking advantage of a sensitive period during 12-18 months to help your child toilet train (I believe they are supposed to be self motivated at this age.)  If EC did not work for you, this might be more your style.

[isabchi]

It's definatelly posible to EC a 12 mo baby. It's absolutly possible that you can get a clean catch witha baby that is familiar with her potty practice. But , for what I see you just need to catch an ocasional pee and not necesarally go for all what is EC practice. I'm glad that you're looking for a more gentle and less thraumatic aproach for the urine samples that you need.

You can offer the potty just after she wakes up in the morning, maybe do the shhhhhhhhhhhh sound or run  slowly water faucet. After she start pee for a couple day in the morning, maybe you can place the cup for the sample inside the potty bowl.. Good Luck!