Urinary Tract Infections in Children

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Recurring Urinary Tract Infections in 5yr. old

Jan 2009

I have read all of the postings in BPN about UTI's. I still felt I needed to post my request for advice in our own particular situation: My daughter who is 5 years old has had recurring UTI's for a least one and a half years. What happens is not that she complains of pain when she urinates, but rather I notice her touching her vagina a lot. When I ask her what is going on, she says her vagina is ''itchy.'' Sure enough, it turns out to be another UTI.

We have been through all the standard tests, the ultrasound, the VCUG, and all have been normal, which is reassuring. However, she just cannot seem to kick these infections. We have tried everything that anyone ever recommends; no soap in baths, lots of cranberry juice, lots of water, lots of peeing, tips on proper wiping etiquette, etc. It has become a very big issue, unfortunately, although we tried not to make a big deal about it at first. She is at the age where she should know when to go to the bathroom when she feels the urge, but I am afraid she does not always do so, because she doesn't want to stop whatever activity she is doing. We have talked her through this time and time again, and I'm beginning to feel like a broken record. However, there is no real way to know whether this is at all due to her behavioral immaturity, or whether it is purely a physical limitation that she will grow out of.

Fortunately her pediatrician is very empathetic because her own daughter had the same problem years ago for about a year, and she just grew out of it. The problem is that I absolutely HATE to keep giving her antibiotics, but it seems to be the only thing that really works. Unfortunately, though we have to give her two additional medications just to treat side-effects from the antibiotics; antihistimine for skin itchiness, and creams for yeast in her vagina EVERY DAY. It is such a huge pain in the A-- for all of us, her included. We have also tried homeopathy to no avail. Mostly, I just feel sorry for her and want to make it go away.

We are in the process to get a 2nd opinion from a different urologist. The first one told me that it was probably due to constipation, but I do not think that is the problem, because my daughter's bowel movements are quite regular.

I'd love some advice, or support, or whatever.

Thanks, -Peeved

I feel for you. My daughter had this problem and I have two suggestions -- one reassuring, one decidedly not. On the reassuring side, the antibiotics are not ideal, but dealing with the infections is important because it can be painful and dangerous if you don't. My daughted ended up on an prophylactic dose of antibiotic for years and that kept the infections at bay, and although I worried about it, it really did turn out fine and worth it. On the not reassuring side -- I hate to bring this up -- in my daughter's case, after years of this 'mystery', it turned out to be caused by sexual abuse. In retrospect, I was shocked no doctors ever mentioned it. It turned out to be the only ''sign'' that was available to me when she was very young. I hope that is not the case for you, but given that doctors don't seem to mention it, I thought it important someone does. anonymous this time, definitely

I used to get a lot of UTIs as a child and adult, and as a result, did what I could to look up reasons for it. SO, here are a few things that come to mind. One, just make sure she is wiping in the right direction after she goes to the bathroom-- front to back. (I'm sure you're already trying to encourage that with her.) The second, is that she may be allergic to fragrances. That is what I found to be my problem--once I switched to a fragrance free, non-allergenic soap--Dove has a version of this--I have been free and clear. If she is taking baths with bubbly bath/fragrant soap, this could definitely be an issue. The other reason is that it could be food related. Spinach, for example, produces a protein that helps proflagate the bacteria already present for UTIs. Of course, if she's eating tons of spinach, I'd be impressed! But it could be other foods as well. Anyway, I wish you luck with finding an answer! Sarah

Urinary tract reflux surgery on my 3 yr old son

November 2006

My son, it appears, was born with a congenital abnormality in his kidneys and was diagnosed with urinary tract reflux after a few invasive tests. We are now at the point where surgery is the next step. Our urologist informed us about an endoscopic procedure to try to correct the reflux and also told us about the open surgery which can take care of the reflux with a higher success rate than endoscopic treatment. Does anyone have recent similar experiences? Pain afterwards or trauma urinating for the child? I just want to hear about people who've already dealt with it. My son's starting to be very afraid at the mention of seeing a doctor.

Our son also has a urological problem which could be repaired by laparoscopy or open surgery. We have chosen the open repair because of the increased success rate, and the fact that the laparascope still requires 4-5 1cm incisions. The open surgery is one 3-4cm incision- so the difference is really negligible. As our child grows the scar will appear proportionally a lot smaller. In adults, laparascopic surgery recovery time is much less than open surgery. However, in children, it seems that the recovery is just about the same. Best of luck with your decision another mom

Hi - I have a suggestion for you if you are interested in trying a non-western route to solve your son's problem. Have you heard of Visceral Manipulation? It's a horrible sounding name, but basically it is a technique developed by a french osteopath, where practicioners have uncanny knowledge of the internal organs and can gently work with your body to bring about healing and restore your body to better health. There is an amazing practicioner who has been doing various body work techniques for 30 years and VM for over 15. His name is Michael Wagner and he is a wonderful man and a master at what he does. He has an office in Albany and in Marin. I'd give him a call and ask him what he could do for your son. 415-457-6392 Good luck! Sirena

Five-year-old son with urinary tract infection

June 2006

My 5 year old son was just diagnosed with a urinary tract infection. Despite not being thrilled to put him on antibiotics, I didn't worry too much about it. This morning, a friend advised that at age 6, her son had a UTI. Her doctor told her that they're quite uncommon in boys and ordered further testing which revealed that his ureter was backing up into his kidney causing damage. His kidney had to be removed. Obviously, I'm trying to follow up with my son's doctor to ask more questions, but wonder if anyone has had any experience with a UTI in a boy that either was/was not more than just that? Thanks!

Our son had a UTI at about 5months. He also had urinary reflux, but it was mild- moderate. We kept him on antibiotics to prevent anymore infections (every infection causes kidney damage). By 18 months, the reflux had resolved itself (it's common for kids to ''grow out of it'') and he hasn't had any trouble since. Good luck Ruth

I don't have experience with UTI in my son, but he was diagnosed in utero with a blocked ureter that caused his kidney to enlarge. We had the ureter surgically corrected when he was 7 months old. One of the symptoms of this can be a UTI, there is also a reflux syndrome that can cause backup into the kidney and infection, enlargement of the kidney etc. I recommend you question your doctor further and think seriously about follow-up since UTI's are extremely rare in boys/men, unless catheterized for some reason. I recommend our pediatric urologist Laurence Baskin, should you need to proceed with further diagnosis and treatment. He practices out of Highland and UCSF and is EXCELLENT. 510-547-1600 (OAK) 415-353-2200(SF) An ultrasound, though expensive, is simple, noninvasive and will tell you immediately if there is any enlargement of the kidney. Good luck Ilana

Daughter, 4, pees constantly - UTI?

January 2006

My daughter is four next week. In November she went through a phase of needing to go to the bathroom (pee) constantly- every five minutes- during the day. Nights were more or less normal. We had her urine tested twice for a UTI and both times it came back negative. No sugar or blood in the sample either. She went on a round of antibiotics after two weeks, and eventually (not immediately after starting) things went back to normal. Last week it started again- and again, two normal pee tests. I have her scheduled for a blood test to rule out diabetes, but, in the meantime, I'm at wit's end. My pediatrician's solution is to just put her on antibiotics, but I can't see doing that again after another two negative tests. I asked him about a disorder I read about but can't spell- basically stress peeing (I read it's more common than UTIs) and he said, very dismissively, that stress causes stomachaches, not peeing. Is that true? Is frequent urination a symptom of any other ailment? (As far as I can tell, there's no more urine, just more frequent visits. She's not abnormally thirsty either.)If it's nothing organic, what techniques can I use to lessen her anxiety? She's super bright, super high-strung and I'm trying to bee really careful not to make a big deal out of this but we literally spend all day in the bathroom. I don't know if this is relevant: she sleeps a lot (3 hr nap + 9-10 hrs at night)& she's off-the-charts tall (we're not)and grows really fast. Also, she's always been healthy as a horse. anon

my son had the same thing. we kept getting him tested(even took him to a pediatric urologist) and could find nothing. Then it just went away gradually over the course of about a year. I would say, if you have eliminated all medical possibilities, and it's not putting a significant hardship on your or her life, it's likely that she'll just grow out of it. good luck!

Have her tested for pinworms. I could have written your post several years ago when my daughter was four. My doctor gave me a kit to test her for pinworms and sure enough that was it. One prescription later and the symptoms were gone. Don't know if the same for your child but it's worth checking out. Good Luck, Diana

My 4 year old daughter is just getting off antibiotics for a UTI. When they tested her urine the test came back negative. The doctor then plated her urine and bacteria grew, which indicated that she did have a hard to detect infection. Our Kaiser doctor said she has seen this type of situation many times in children and has learned to take the testing a step further. I know my child has been very uncomfortable with this infection. Best wishes for a speedy solution. anon

1 yr. old with first time UTI

March 2005

A friend of mine has a 1 year old daughter who was diagnosed with her first urinary tract infection. Her lab results showed E.Coli which I don't think alarmed them but proved that her infection was from feces entering her urethra. She was referred for a renal ultrasound to make sure everything was where it should be. This wasn't painful, but of course, her baby screamed and cried from being held down, and looked quite betrayed. Now they are referring her for a 6 week follow up to get a VCUG catheter so they can inject dye up her ureters to see if they're straight enough to allow things to flow in the right direction. This will be quite an invasive and miserable procedure for this little one year old, and my friend wondered if this recommendation was typical for a baby that's only had one UTI. Is her pediatrician being overly cautious and conservative? Have any of you had an infant with a UTI and is this what your pediatrician recommended as well? Johanna

To answer your question, I do believe it is a pretty standard response to first UTIs, but that said, I don't know that it is the right or only way to go (although I don't have any concrete alternatives, sorry).

My daughter had a UTI when she was 9 months (she is now 7 years old). She had the VCUG procedure which indicated stage 1 and stage 2 levels of dialation (fairly minor, but indicating the ureter tubes had slight openings in which the urine could travel up instead of down).

At the time, the advice was to put her on prophylactic antibiotics for 1 year until the ureter tubes matured, ''in case'' she developed another UTI, which could send the offending bacteria up through the ureturs and into the kidneys, brain. We were terrified of that scenario so of course, we followed the doctor's orders.

However, after noticing her immune system weakening (she started getting tons of ear infections), talking with other folks about the dangers of antibiotics, and the low levels of dialation, we decided to take her off the antibiotis and trust that if she got another UTI, it would be evident and that we could get her treated in time.

AT the time we also had a family doctor, not a pediatrician and looking back I don't think their office had the experience to deal with this major pediatric issue.

We did have her rechecked with the VCUG as recommended about 1 year later and her ureter tubes were normal. However, I regret having done both of these procedures. It is super invasive and they do strap your little darling down and it is agonizing. I guess I do not beleive it was totally necessary or that she was at a high risk, but this is just my opinion.

I hope your friend gets responses from folks who may know of alternatives to the procedure. anon

Our daughter had a UTI at 7 months or something like that ... I can't remember. We too were concerned about the VCUG (I think that's what it's called...) Anyway we did a bunch of research on it (and were highly skeptical about it's necessity) so we met with our doctor to talk about why she recommended it. We also didn't like the fact that we had to keep her on antibiotics while it took two months before we could be seen at Children's Hospital.

Anyway, we decided after the research and discussion with our doctor that it was the responsible thing to do. The chances were 30% that there was a problem and if there was a problem we should know about it because it could cause some long term damage to her kidneys. I decided that a miserable afternoon for my daughter (which it was!) was better than a life of dialysis. Of course that is the extreme but I didn't want to live with that. We did the test at Children's and I think everybody cried (except the technician.) But looking back it was much better than other procedures she's had to endure. Kids are so resilient and at that age they don't really remember much. I'm not trying to downplay the horror of seeing your child in so much discomfort and strapped to a table, but it's the small price we pay I think for having access to healthcare which for the most part extends many many lives and protects us from things that used to kill.

In the end my daughter did have a mild mild case of stage one renal reflux. Not enough to warrant keeping her on antibiotics long term. She hasn't had a UTI since and we've been VERY careful about wiping since. I'm glad we did the test. And I'm glad we live in a place that we have access to it. And I'm glad I have access to healthcare insurance so we could have it. And mostly I'm glad that we found out everything was ok rather than waking up at night wondering if there were things I didn't know about my daughters health that I could help prevent.

Good luck with your decision. Anon

The same thing happened to our son when he was 5 months old. He had the ultrasound and then the VCUG. That showed that he did have some urinary reflux that was causing some urine to get pushed back up into the kidneys. That's good to know because every infection can cause scarring and damage to the kidneys, so you don't want to keep having them. He had one more infection a few months later and then at 18 months a repeat VCUG showed that he had outgrown the problem (pretty common, I hear) and he's is a healthy 8 year old now. Good Luck

To answer your question, I do believe it is a pretty standard response to first UTIs, but that said, I don't know that it is the right or only way to go (although I don't have any concrete alternatives, sorry).

My daughter had a UTI when she was 9 months (she is now 7 years old). She had the VCUG procedure which indicated stage 1 and stage 2 levels of dialation (fairly minor, but indicating the ureter tubes had slight openings in which the urine could travel up instead of down).

At the time, the advice was to put her on prophylactic antibiotics for 1 year until the ureter tubes matured, ''in case'' she developed another UTI, which could send the offending bacteria up through the ureturs and into the kidneys, brain. We were terrified of that scenario so of course, we followed the doctor's orders.

However, after noticing her immune system weakening (she started getting tons of ear infections), talking with other folks about the dangers of antibiotics, and the low levels of dialation, we decided to take her off the antibiotis and trust that if she got another UTI, it would be evident and that we could get her treated in time.

AT the time we also had a family doctor, not a pediatrician and looking back I don't think their office had the experience to deal with this major pediatric issue.

We did have her rechecked with the VCUG as recommended about 1 year later and her ureter tubes were normal. However, I regret having done both of these procedures. It is super invasive and they do strap your little darling down and it is agonizing. I guess I do not beleive it was totally necessary or that she was at a high risk, but this is just my opinion.

I hope your friend gets responses from folks who may know of alternatives to the procedure. anon

Yes, it is part of the work-up to have the VCUG test. My daughter had a UTI at 6 months and the VCUG showed that her ureters (the tubes from the kidneys to the bladder) weren't strong enough to push the urine down completely and that there was some back flushing up the ureters to the kidney. The problem arises when infected urine flushes back up, then you can have a kidney infection with scarring and damage that can affect kidney function later in life. The primary treatment is preventive antibiotics for some time (this is very variable depending on the doctor, but is usually for 6 months or more!). This is a not uncommon condition and kids usually grow out of it by having stronger ureters by age 3, otherwise surgery may be in order. So the main thing is to prevent infection by antibiotic use. When your daughter is older they may use urinalysis and culture for any unexplained fever to catch an infection if you don't use preventive antibiotics. Sharon

My pediatrician also recommended the renal ultrasound and VCUG after my then 2 1/2-year old daughter had her first UTI. Her reasons were these:

1) The type of bacteria found was very plentiful, and very unusual. It wasn't E-Coli, but I'm afraid I don't remember what precisely it was (this was 2 years ago).

2) My daughter had a history of withholding bowel movements, and my ped. thought that she might have had other, ''silent'' UTI's that were masked by the withholding behavior.

Further, this seems to be the protocol. According to the AAP book, ''Caring for Your Baby and Child,'' ''most specialists now feel that after your child's first serious urinary tract infection, further tests should be done (ultrasound, X rays, or renal scanning examinations).''

And you are right, it is invasive and very painful, or at least highly unpleasant. My daughter screamed the entire time. The insertion of the catheter was bad enough, but what was truly horrible was when they filled her bladder with fluid. It was heartbreaking.

As soon as they removed her catheter, she felt fine (though she needed about 10 minutes to recover emotionally). The tests also showed that her body was functioning normally, and all she needed were antibiotics.

In a way I was relieved that we had done this test and it proved definitively that there were no problems. However, I also felt it was over- cautious, and questioned whether the pain and trauma involved was worth it. I'm still conflicted to this day about whether it was the right thing, but as a different doctor friend reminded me, kidney function is too serious to risk. Christine

Dear parents dealing with UTIs and their daughters,

I just had to respond and let you all know that the procedures that they perform on your daughter which are invasive CAN have lasting and very detrimental mental and physical ramifications. I myself had chronic urinary tract and kidney infections as a little girl (started at 4 and finally self-corrected at 11). I had some ''flap'' missing that allowed urine to travel back up.

My urologist at the time repeatedly performed (over 7 years) extremely invasive procedures while I was strapped down and awake. Those were different times and my mother wasn't allowed in the room with me. I had no one to comfort me or hold my hand and because of this treatment I have been unable to have a normal, enoyable sex life--I am so tight and terrified. To the person who thinks children don't remember much, we do. Our bodies do. I wasn't able to see on ob until I was 23 and finally got the courage up to do so because I knew it was important. Pelvic exams are beyond terrifying to me. I've been to a lot of therapy because of this and finally found a progressive urologist who treats people with pelvic disorders. My entire pelvic floor muscles had to ''re-trained'' to release the trauma and tightness. This has been without a doubt one of the most horrible and debilitating issues of my life.

I have a daughter now and have talked with her pediatrician about my issues and asked him if things are done differently now. He told me they were, but when I read that children are still strapped down like that and that the treatment is ''agonizing'' as some of you wrote, I just don't know. I'm not advocating not doing treatments or the VCUG if it's necessary, but please be aware that it can have long term detrimental effects. Be AWARE of any procedures performed on your daughter in treating UTI and BE IN THE ROOM to hold her hand and comfort her in this very scary and vulnerable time.

I wouldn't wish my situation on anyone. anon

Although I have responded to this post before, I feel compelled to answer or dispute some of the info in the last response signed ''I wouldn't wish my situation on anyone''. The details she relays about her own condition in the distant past are similar to mine. I had a supposed narrow urethra that was widened by sticking tubes up the urethra with alot of pain at the time (although no issues to date). That procedure is not effective and was one of probably many used at the time without any evidence of their therapeutic value. I may or may not have had the condition we are now discussing of having ureters that weren't strong enough to push the urine down without some backflushing.

First, the VCUG is not a ''treatment'' but a diagnostic test used in a limited manner to view the ureters and the kidney.

Second,my daughter was strapped in such a way to immobilize parts of the body that might interfere with the test if they were to be flailing around - it was not a gratuitous or mean spirited action. This is the way many tests work and I can't comment any more on this aspect. I could hold her hands and look in her face. YOU WOULD BE IN THE ROOM with her.

Third, this should not cause any long-term damage, either psychological or physical - this procedure is similar to putting a foley catheter in - a common procedure in adults to start urine flowing after surgery, etc. It is uncomfortable, but my daughter DOES NOT remember a thing from having this done 1 year ago. Your daughter will probably have this test done twice before she is four - not frequently.

Good luck, Sharon

Baby boy urinary tract infection

August 2002

My 18 month old boy has been diagnosed with a urinary tract infection. This is quite uncommon. He is uncircumsized. He is on antibiotics and will have to get an ultrasound and a procedure where they inject dye into his penis through his urinary tract to see if his anatomy is working well. Is there anyone out there who has had a similar experience with their boy? Are their any homeopathic remedies? Any prevention? Do you know what causes these UTI's? any advice would help.

My son, now 6, had a UTI at 2 months. Because of his age, he was hospitalized overnight and then took the course of antibiotics. He's had no UTIs since. At that time they told me that though unusual, uncircumcised boys (he's uncircumcised) got UTIs four times as frequently as circumcised boys, but that the frequency of UTIs in boys was so small that statistically this was not enough of a reason to advocate circumcision. At that time, they said they would recommend circumcision for him (which is a much more major event than when the baby is a newborn) only if he had 2 more UTI's within a year's time, which never came to pass...

It sounds somewhat similar to what our son had as a newborn (although he did not have an infection). The VCUG (the x-ray with the dye) is done to check if there is ''reflux'', i.e. if urine can flow back from the bladder to the kidneys which can cause kidney infections.

Here is our son's story: His kidneys were enlarged on the prenatal ultrasounds. So he had a follow-up ultrasound when he was 10 days old. As the kidneys were still slightly large he was put on antibiotics until the VCUG ruled out reflux (don't worry, it doesn't hurt them although he screamed bloody murder when they tried to put the catheter in; he just hated being touched there). We were told if he had reflux it could be fixed by a minimal invasive surgery (if I remeber correctly). We needed to follow-up with more ultrasounds as his kidneys were still enlarged (but getting better; the next ultrasound (the third after birth) will probably be the last one). We were always told that if he doesn't outgrow it, it is something that is fairly easy to fix.

My daughter has ureteral reflux that demonstrated on the dye exam that urine was back-flushing or back-flowing to the kidneys (very high up) when she was 6 months old (she had a urinary tract infection). She was on antiobiotics for only 6 months, and then we just monitored her for any unexplained fevers (which could indicate that she had an infection). Actually at any fever I would get a ''bag urine'' to get a urine culture done to check for infection just in case. An undetected infection with this condition could cause kidney scarring and would be VERY serious. She has never had an infection since the 1st one. This is an anatomical/functional problem that some children grow out of as the muscles get stronger where the ureters insert into the bladder and squeeze tight enough so that back-flow would not occur. I don't see how homeopathic treatment could be effective. It is very common for children to be on short-term antibiotics, although there is very little good evidence to show what the duration should be. Anonymous

our son had a uti when he was only 3 months old. he is also uncircumsized. in order to make sure it wasn't an anatomy problem we did all the procedures you described - - antibiotics, ultrasound and the uncomfortable dye injections. he loved talking the antibiotics (crazy kid!), but the other procedures were uncomfortable for all of us. thankfully all of the doctors (at Kaiser Oakland) that we interacted with were sensitive and kind. he has had no recurrances. we also had questions about the causes, and preventions. we were told that it was more common in uncircumsized boys, but all the numbers were very small. other than that and ''be more diligent about cleaning his foreskin'' we didn't get much info or advice. our guy wasn't eating anything but breastmilk at the time, so i don't know if there are any food/drink remedies for kids. good luck.

My 2 year old son went through the similar experience when he was 7 months old. Unfortunately, he had to have the dye inserted to determine whether he in fact had a UTI. The procedure only took about 30 minutes. The dye was inserted through a catheter which was inserted into his penis. The doctor assured us that it was more painful for us to watch that than what our son experiencing. He didn't cry at all when the catheter was inserted so I felt fairly comfortable that he was telling the truth. When he really started crying was when they began moving all the medical equipment around in the hospital room to view where the dye was flowing. That obviously was a frightening experience for him as he didn't know what was going on.

I was living in Australia at the time and the doctors there said that I could delay having it done but the sooner I found out whether he had a UTI the better. Depending on the various stages of the UTI a further operation may be required to fix the problem. I was told that if a UTI is not detected in time it will cause problems for the individual as their kidneys are effected. The problems may not surface until years down the road, but they will eventually surface. Unfortunately for you, they also recommended having it performed sooner so the experience was less traumatic for our son as he wouldn't be fully aware of what was going on. Therefore, I would definitely recommend you talk to him about it before hand so you can minimise any trauma the procedure may have.

Before I had the operation my pediatrician had another doctor review the results to ensure the procedure was absolutely necessary. They also told me that it was an uncommon thing for little boys to get UTI. My son is also uncircumsised and they assured me the UTI did not have anything to do with that fact. Apparently, it is not uncommon thing for little girls to have.

I was told there really wasn't any other way to detect with absolute certainty whether my son had a UTI. He had had many urine test and I became an expert at catching his pee in a cup during that time, but you don't know with certainty until you have this procedures (the exact name escapes me at the moment). They told me the effects probably wouldn't surface until he was a middle age man, but if he had a UTI they could fix the problem now rather than 40 years later.

Luckily, our son didn't have a UTI after all. It was a good feeling knowing with certainty that everything was okay.

Good luck to you and your son!! Florinda

My son who is also uncircumcised had a UTI at age 23 months. The infection wasn't treated long enough and recurred 3 days after we stopped the antibiotic. We switched to a different antibiotic which cured him. He is 3,5 years old now and hasn't had a UTI since. He is also out of diapers which might perhaps helps to prevent it. After the UTI we gave him cranberry juice for a couple of months.

He saw a Pediatric Urologist who recommended the IVP (insert a catheter, inject dye ,take an X-ray of the kidneys and urethers etc...) even though his ultrasound was entirely normal. The urologist told us that the insertion of the catheter could cause scarring of the urethra which might require surgery later. Also our son might need general anesthesia during the IVP if he wouldn't hold still and she recommended to do a circumcision at the same time. (Blaming the fact that my son is uncircumcised for the UTI.) I guess you can tell that we weren't pleased with her advice. We decided to be pleased about the normal result of the noninvasive ultrasound and forgo the 'trauma' of the IVP until he had at least a 2nd UTI which he never got. We did this in agreement with his Pediatrician. Good luck, Karin.

Hi Yancy,
This is not really uncommon. My son was diagnosed with the same thing at 7 days old. He had a very high fever -shy of 104- and we had to go through the VCUG's (dye by catheter), ultrasounds and everything. My son was born with a defect. One of the pipes that go from the kidney to the bladder does not close completely which makes the urine -at the time to empty out- shoot back up to the kidney creating a reflux. If the urine got into contact with bacteria, the kidney gets infected and

damaged. This doesn't mean that your son has the same thing. Sometimes the pipes connecting the kidney to the bladder have different distance from each other creating an imperfection; they can also be connected the wrong way. It can also mean that his urine was infected somehow and it will be his one-time experience and that would be the end of story. Which I truly wish it is.

My son is still on antibiotics and that would be until he has surgery. He is schedule for his third VCUG at the end of this month. Is sad but is the only way he can keep his kidney growing.

Hopefully this information will be useful for you. If you have any questions please feel free to email me.

We took our daughter to the emergency room when she was nine months old- she had a high fever and projectile vomiting. They determined she had a UTI and admitted her to Children's Hospital. She had to stay for 3 days until they could culture the urine and determine the exact strain of infection. This was done to determine the appropriate antibiotics. I was told that she would have to undergo a procedure to determine if she had ''ureter reflux'' a condition where the ureters are dialated and urine shoots back up towards the kidneys. The fear is that another UTI could send a baterial infection up to the kidneys and ultimately the brain if there is reflux. We scheduled the procedure for the dye, xray, etc. If was very traumatic for all of us and broke our heart to see our baby girl in so much fear/pain. The result was she DID have a very minor reflux- stage 1 in one ureter and stage 2 in the other. Stage 5 is where the ureter is quite dialated (I am not a doctor or medical professional, so my description may not be entirely accurate, but I think it's close).

Anyway, the ''treatment'' for the reflux was to put her on prophalactic antibiotics until she outgrew the reflux, thus in case she got another UTI, the antibiotics would kill off the infection before it got to the kidneys. As new and concerned parents, we followed the doctor's orders at first. Then, of course, it seemed she was getting sick alot with colds and ear infections. We decided to take her off the antibiotics and ''wait and see,'' feeling we would know the symptoms of another UTI and could act accordingly. Of course, she never got another UTI. After about a year or so, her immune system recoved and now she rarely gets colds (she's 4.5). Unfortunately, she has had some weird disharge from her vagina and know one could figure it out. We took her back to the uroligist who said we should first rule out the reflux (we were supposed to have rechecked her anyway after about a year, but we hadn't). Again, we were afraid so we did the test . It was just as horrible the second time and my husband and I are now furious that we submitted to the pressure of retesting her.

Anyway, it is hard to know what to do in these situations when your child is ill. My only advice is to do what you think is best. I just wanted to share my story in the event it might help. I would love feedback from others on this issue.

Bladder Reflux in 2.5 month old

July 2002

My son was born with a condition called bladder reflux, he is now 2.5 months old and without infection. Does anyone else have experience with this? We found this out serendipitously through a VCUG (looking for PUV which didn't exist) days after he was born. He is currently not on any antiobiotics and we don't want to circumsize. I would love to hear your story and what worked and didn't work. So far, we are doing nightly baths and he is taking a homeopathic remedy to boost his immune system overall. I've also tried cranial-sacrial work for the same reason. We are working with a great doctor through UCSF named Dr. Nguyen whom I would highly recommend. w

My son was born with the same condition. Doctors talk about several levels of it. My son is in the higher ones. Some kids repair themselves as they grow. My son is 20 months old and he will be rescheduled for another VCUG in august. His doctor is Dr. Paul Lee from Kaiser. He is an excellent doctor, he is the head of the Urology department at Kaiser and he also teaches at Stanford. He says that there is another way of treating this reflux. This is a Laser operation that inserts cartilage (previously grown from the recipient) into the bladder creating a smaller hole that would be able to close to avoid the reflux. But it is only a research that is going on at Stanford and they do not know the risks. He says they have been doing it in England for years but in USA is more difficult to go ahead because of these unknown risks.

My son has had two infections. The first one, when he was seven days old after his circumcision. The second one when he was three months old. He was not on antibiotics, now he is on them everyday. He has two scars in his left kidney (the reflux occurs on the left side of the bladder) which had make the kidney smaller. One more bacterial infection and he has to go to surgery. We are really tired of the whole VCUG and antibiotics dosages but it is the only way to avoid surgery and maybe a miracle can happen. g

2-year-old diagnosed with UTI

Feb 1999

My two year old daughter recently had a kidney infection caused (we think) by a UTI. The doctor at Childrens' has suggested a VCUG. I am reluctant to put her through another invasive procedure--she was already catherized once in the hospital. On the other hand, I don't want to take this too lightly. Has anyone had experience with this procedure and can advise me on it's effectiveness and whether it is warranted after just one UTI? Thanks in advance for any light anyone might shed! (By the way, I have already reseached some of this at a GREAT web site at www.icondata.com/health/pedbase. It is a database of pediatric diseases.)

From: Stephen (2/99)

Our 10 month old daughter was diagnosed with a UTI, which is extremely rare in such young children. Our pediatrician suggested an ultrasound and then a VCUG to determine if there were any physical abnormalities that may have caused the UTI. The ultrasound, done at 11 months, was negative, and then we had the VCUG done when our daughter was 12 months old. The procedure was quite quick and easy, and the radiologist assured me that the older children report only minor discomfort when the catheter is inserted, but not after it's in. Our daughter was quite young when she had the procedure done, and the worst thing for her was having to be held still for the x-rays (and not being allowed to reach down and grab the tube.) The procedure lasted about five to eight minutes, which is a little longer than it usually takes because it took a little while for our daughter to urinate the second time her bladder was filled with the contrast. Fortunately, the tests came out negative, but we were still glad we had it done just to be safe (especially since it was quite quick, safe, and painless.)

From: Alexandra (2/99)

I looked into this subject when we thought our son had a urinary tract infection. There is some debate in the medical profession about the whole question of diagnosing and treating uti's and kidney infections. An article that was very informative (which unfortunately I don't still have) was in Kidney International, July 1996, Volume 50 (1) p. 312-329, Asymptomatic Bacteriuria and Vesicoureteral Reflux in Children by Michael Linshaw, M.D., worth reading if you have access to a medical library (I think you can use Children's Hospital's library with a note from your doctor; you could call to see if they would have this journal). The article gave me a lot more information than I was able to get from our doctor, and showed me that different doctors dealt with this issue in very different ways.

As far as I understand, the purpose of the VCUG is to look for reflux, as reflux has been associated with an increased risk of kidney infection. Then there is the question of what one does if there is reflux. If it is severe enough, many doctors recommend surgery to correct it, in order to reduce the risk of damage to the kidneys from any future infections. Some studies, though, show that the surgery doesn't actually reduce the risk of damage to the kidneys due to infection. Of course, there are various risks with the surgery. Also, some studies show that in many children with reflux, even severe reflux, the situation naturally corrects itself as the child grows up. There are risks with the VCUG too: a small percentage of children die, and another small percentage become very sick, from reactions to the dye they use; the catheter carries a small risk of damage to the urethra and of introducing infection into the bladder; real risks from the x-ray radiation aren't completely known; and of course there's all the emotional stress too. So, before doing the VCUG, it seems important to weigh the possible benefits - which would be finding an abnormality that, when treated by surgery or in any other way, really does reduce the risk of damage to the kidneys - versus therisks. There is also some disagreement about the typical use of antibiotics with uti's or apparent uti's. Some studies have shown that, if there is bacteria in the urine but no other syptoms of infection, it may be better not to give antibiotics, as killing off the existing bacteria may leave the child open to a more virulent infection. Also, many doctors put children on prophylactic antibiotics for long periods when the child has had repeated infections, but there is some question in the medical field about the wisdom of doing this also, both in terms of the actual efficacy in protecting the kidneys, and in the effect on the child's health overall.

It's a complicated issue. In the worst cases, kidney infections with few symptoms can cause serious permanent damage in children, which is the reason that the doctors act so aggressively with the situation, and a good reason for parents to take the matter seriously. However, as you noted, some of the tests are very invasive, and some studies are in fact calling into question some of the medical protocol. Our pediatrician is Robin Winokur in Berkeley. She seems pretty knowledgeable about all this, and relatively uninvasive in her approach in general. It might be helpful to get a second opinion since you're unsure about the VCUG.

Also, I have heard that some people have good success with treating and preventing uti's and kidney infections with homeopathy. Hahnemann Clinic in Berkeley takes care of lots of children, and they also have m.d.'s on staff. Christine Ciavarella there is quite good. Homeopathy could be a good alternative to doing nothing or doing invasive tests. For myself, I don't have a medical background and am just a concerned parent who's done some reading and talked to a couple of people and considered all this for our own child; if you have any questions about what I've said, though, you are welcome to call me, Alexandra. Good luck.

Frequent UTIs in 8-year-old girl

June 2001

My 8 yr. old daughter has had four urinary track infections in the last 8 months. We just had a test taken at Children's Hospital and they couldn't find anything wrong structurally, so we're still searching beyond the obvious (improper wiping, bubble baths, etc.) Has anyone had experience with this in themselves or their children. I'd appreciate any feedback. Thanks.

I had very frequent UTIs until I saw a urologist, who said I probably had not been treated long enough for any of my infections. When this happens, the bacteria simply burrow deeper into the lining of the bladder, which makes them even less likely to be reached by the next course of antibiotics that is taken. While taking antibiotics the symptoms would abate because the amount of bacteria was reduced, but then the population would just regrow in what should normally be a sterile environment. Also some people, like me, have bladders where the neck is bent over more than usual, which is conducive to infection as well. His solution was to put me on Keflex for a really long time -- I think it was 6 weeks -- and this did the trick. Didn't have another one for many years.

I also get frequent UTIs and what I do is drink lots of water (1-2 large cups at a time). When I was younger, my mother always warned me not to sit on warm or hot places or I will have pain urinating. I always make sure that I have something cool to put on top of my car seat when the weather is hot. Maybe reminding her to avoid sitting on hot surfaces and drink lots of water (not juice or soda). mey

When I was in my 20's, I went through a several year period of frequent (perpetual?) UTI. After finally getting kidney infections (later turned into septicemia), I figured out how to avoid the UTI - I push fluids all day long. I think what happened (not confirmed by any doctors) is that I had heat stroke once during a strenuous athletic event and since then, had problems with UTI unless I kept myself WELL-hydrated. So, I drink a 10-cup coffee pot of water every morning and every afternoon at work, then I drink another 1-2 thermosful at home in the evening (depending if I have a glass of wine which is a diuretic.) I can feel bladder and urethral irritation when I haven't had enough water. One of my daughters tends to not drink enough and she occasionally gets some irritation when not well-hydrated. So, without knowing anything about your daughter's situation, you may want to see if she is not drinking enough and therefore, not emptying her bladder enough causing enough buildup to produce UTI. Best of luck to you, and I hope it gets cleared up REAL soon. Write if you feel the need to talk.

The British Medical Journal 2001:322:1571 just reported the results of the following study:

In a randomized study of 150 women with a history of UTI, the investigators asked one group to drink 50 mL of cranberry-lingonberry juice daily, another to drink 100 mL of a lactobaccillus drink 5 days/week, and a third to drink neither beverage. In the cranberry group, the number of episodes of UTI was reduced by about half at 6 months, while the lactobaccillus drink was ineffective.

Overall, 16% women in the cranberry group, 39% in the lactobacillus group and 36% in a control group had at least one UTI during the year-long study, Dr. Tero Kontiokari of the University of Oulu and colleagues report. The finding suggests that this popular remedy could be a good way to prevent recurrence of the painful infections and reduce the need for antibiotics, Dr. Tero Kontiokari, of the University of Oulu in Finland, and colleagues report

Since cranberry juice is a natural food product and readily available, it seems a useful means for self administered prevention of urinary tract infections, the authors conclude. Lynn