He has me giving sitz baths with epsom salts frequently, no diapers all day, and a cloth at night, and above all watching to make sure he's peeing.
He has not peed since four hours, although he could have gone in his baths. I am very concerned about that, and need to know what options I have if I end up in the ER tonight, or the doctor with no improvement in the morning.
People with infection experience: what treatment options are there? I have been scouring the internet and our doctor didn't do a swab culture. I consider him foreskin-friendly but not sure now.
My only idea is to request a pediatric urologist, but if it is an emergency I may not get one. I want to know there was truly no choice if he gets circumcised. Not peeing is serious, please school me on being prepared if you can. If we must, we must, but I just don't know and won't have time to research a decision.
Please send some healing energy to my little sweetie, healing is the best answer!
What diapers do you normally use? I have heard of a number of baby boys getting swollen and irritated by a prefold being held on by a snappi. The snappi is just in a very bad spot for boys and can restrict the penis causing problems. All of these boys were perfectly fine after mom stopped using the snappis.
How is he otherwise? I'm sure he's uncomfortable or in pain but is he nursing? Is he happy for a time here or there? Does he have a fever?
I hope it's something minor that clears right up.
My son is only 2 months old, but each time we've had to see a pediatric specialist (derm and gastro) we've had same-day or next day appointments. I would definitely try that route before the er or if you want another opinion from what your regular pediatrician gave. I hope your baby gets better soon!
Andaluza (36) & dh (39), married 11 years! M 8/23/12. One
Please write to me personally at firstname.lastname@example.org and I'll do what I can to help. Circumcision is NOT the answer...so, we need to find out what is, starting at what's causing the problem. Since the foreskin is normal, it's not the problem, something is affecting the foreskin. Hopefully, I can help. Sincerely, Marilyn Milos, RN
Also they should take a urine sample if they can to test for a uti as a secondary infection- that can cause problems with swelling/ urinating. But the infection itself can be causen issues with swelling/ hurting to pee. Utis sometimes require a different antibiotics. Ugh. ask what anti-fungals- like nystatin- an 8mo can take with antibiotics- it helps them not get thrush/yeasty. But it sounds like ointment might not be strong enough. Id say do to the dr. asap- not urinating is a sign he needs something more.
I wanted to follow up on my initial post for those of you reading now. This post is detailed, for the worried mamas who are going to come after me in search of help. In brief - last week my eight-month-old intact baby boy woke up with an alarmingly swollen, obviously infected penis oozing pus. (It had looked a little red on the outside the evening before, and I decided to keep an eye on it.) I took him directly to his doctor, who gave me a prescription for oral antibiotics and an antibiotic ointment, and directed me to give him a bath frequently throughout the day in warm water with epsom salts, to go without diapers all day, to stay off his belly, and to wear cloth at night instead of the Naty Baby compostables, give Advil for pain, and come back in the morning. (FYI, this was a good course of treatment in my opinion.) The big concern, according to my doctor, was that the swelling would increase so much urine flow would be cut off (he did an ultrasound in the office that showed the amount of urine in the bladder was OK at that moment). He had me tracking the number of times he peed and watching his stomach for rounding from an overfull bladder and monitoring for a fever, and told me to call immediately or go to the ER if he stopped peeing. This is when I wrote my post asking for help.
We did all that, and my baby slept deeply and was very slightly better by the next day. The doctor told me to continue and come back in two days. By the third day he was clearly on the mend, with very little swelling still visible and totally normal looking by day five. I requested a swab culture, which he didn't do on the basis it wasn't accurate and gave me a urine collection bag to take in to be analyzed instead, and I asked for a referral to a pediatric urologist who was expert on this problem, which there wasn't in our area so he referred to a regular urologist who works on a lot of kids instead.
My doctor, a family practitioner rather than a pediatrician, generally has a liberal outlook on medicine (coming to the home for newborn home births, recommending delayed and selective vaccinations, etc) but made several comments during the various visits that shocked me (and prompted my post for help). That is: 'This problem is why people circumcise their boys' and 'He has a very small hole for the urine to escape, this is going to be an ongoing problem' and 'You are getting by on just the narrowest of margins right now, even though he looks better, and you might be OK for a little while but he just doesn't have a big enough hole for the urine to escape' . His treatment recommendation going forward after it was clear my baby was on the mend: 'I recommend stretching the hole with an instrument until it tears a little, or making a slit to make the hole a lot bigger, or full circumcision asleep under anesthesia by a urologist'.
I was horrified at the very thought that a problem could be so severe I would be forced to circumcise my dear little guy, and desperate to find out if there were some alternatives to bring us away from that extreme, and to confirm my doctor's opinion. Basically, I wanted to be 100% certain, without a shred of doubt, that circumcision was absolutely a necessity and the only solution for the problem my baby had before I considered it.
I didn't get replies to this post right away, so I boldly called the number on the NOCIRC website and got no less than Marilyn Milos herself (and she commented on this thread above, I later saw) on the phone at the first ring early in the morning. I badly needed to get some experienced information about WHEN a circumcision is absolutely required. She talked over everything I noted above with me, and made it clear that there is virtually no situation where a circumcision is required, and then put me in touch with someone else with an anti-circumcision group in my own city, Rio Cruz, who I then called in turn. He got back to me twice with two different foreskin-friendly pediatricians in my city, and also offered a lot of great information. I am grateful to them both, and that they were available so immediately when I needed help so badly and had a very sick baby and potentially would have to decide what to do in short order if he stopped peeing altogether and we went to the no-mans-land ER.
We have appointments to meet the two doctors in my city who have a reputation of being foreskin-friendly, those haven't happened yet. My little guy is clearly perfectly fine now. Marilyn Milos pointed out that the doctor framed it as being a chronic problem, but this hasn't actually HAPPENED yet, just one incident, it is being treated, he is recovering perfectly, no saying if it will be a one-off or no.
I wanted to know how an infection like that could have happened; nobody can say, and little research has been done into the hows. My suspicion is some fine sand he ate recently at the beach came out in his poop and a tiny grain got in and couldn't get back out, causing an infection - but that is a wild guess, of course. Both my husband and I did notice the 'head' of his penis was visible through the skin in outline the week before and remarked on it, like 'how interesting, I guess that is how it grows as they get bigger?' but now I assume it was starting to be a bit inflamed. We don't do bubble baths, soaping, etc and only bathe him once a week so some of the big triggers are absent.
The too small hole thing seems to be bosh. Which is logical; I knew a friend's baby with a hole so tiny, the urine was under so much pressure he could pee across the room regularly! And he didn't have any need to have the hole cut bigger. I got an internet education on this one, probably surpassing his doctor who I think was well-meaning but is old and beginning to reduce his practice and didn't feel on confident ground to me dealing with this particular problem.
I definitely feel like the mom of a BOY this week after reading about penises all week! With our girl, I was already kind of an expert being a girl myself. I am humbled by how little I knew about intact boys, although I grew up in a family of them. All I knew was 'wash it like a finger and don't retract'. In some way, I'm glad to know an intact boy has a sensitive system akin to females, I always wondered why my (circumcised) husband had it so easy while I had to be careful with soap, sand, washing, etc etc etc! (Among many others, I found this article and the website in general a good source: http://www.drmomma.org/2010/01/common-questions-regarding-normal.html) A mom of four boys I know said one of hers has this problem occasionally, and some warm sitz baths with Manuca Oil always did the trick for them at the first signs of a problem, so I bought some to have on hand for the future.
OK, that ought to cover all the angles I can think of! Thanks for your support, all, and good luck to any researching mamas coming this way down the road. I will post again in this thread if I learn anything of significance with the new pediatrician visits.
I'm glad everything has turned out well for your little boy and was relieved when I saw Marilyn Milos' post as I was wanting to direct you to the NOCIRC website for information. From your second post, it sounds like you now have some doctors that you can trust and to get advice from if any other problems arise. Any part of the body can get an infection and we don't amputate it, we treat it with antibiotics, the foreskin is no different. Many doctors (especially the older ones) in the U.S. and here in Australia are not used to treating foreskin problems and don't know what to do, so they recommend circumcision, you were so wise to be wary of his comments. Please do yourself a favour and arm yourself with knowledge about tight foreskins, just incase your baby has one later in life, Marilyn or the other doctors may have already advised you on this, but if he has one after the foreskin has come away from the glans (which can be any time up to about 17 years, but usually by adolescence), just some stretching exercises a few times a day over a few weeks will loosen it enough to retract back over the glans. Please don't be tricked into thinking circumcision is the only answer. Circumcision is usually never the answer for any foreskin problem. The NOCIRC website have excellent pamphlets on how to deal with foreskin challenges. Your son is so lucky to have a sensible, level headed mother and he will thank you immeasurably for keeping him intact when he is older. Best of luck for the future.