Hello,
I am hoping to get some advice. Any feedback is great.

I have a 3 sons. My breastfeed, 21 pound 5 month old, born at home (assisted), uncircumcised and having “reoccurrent UTI’s.”

On all his prior urinalysis, his specific gravity has been low (less than 1.001) and his WBC has been very high. This was true even on when his cultures came back negative. He has on 3 occasions had periodic discharge in his diaper- which trigger my doctor visits- 2 times confirmed uti 1 time negative culture). I am guessing this discharge is puria?

The one time he was hospitalized for a UTI (his first one at 2 months, 100.4 fever, no other symptoms) his discharge looked like green snot. Looking at his lab work from that hospital stay, he has high WBC and low SG and only “rare” bacteria.

We have had a voiding cystourethrogram, show no abnormalities, an US which showed kidneys normal sized (one slightly larger- I assume that’s normal) no US on bladder.

I took him to a specialist who did not even bother to look at his lab results and said we should do a circumcision.

I feel like there is something being missed. Any ideas? Am I worrying too much? Should I press for more test, do a circ, see a different specialist?

Thanks for any help!
Amanda

Hi Amanda

Sorry to hear about your concerns over our Little one. I found this article which may help:

UTI occurs in infants, both boys and girls, as a consequence of some abnormality that they maybe born with. This, is many cases, has to be surgically corrected.

For proper treatment of UTI in children the first step is to establish whether it is there or not. For this purpose a sample has to be collected in a particular manner that will lead to a correct diagnosis indicating whether bladder infection treatment or urinary tract infection cure is required or not. A sample of urine collected in a sterile cup without ensuring that it is free from bacteria from skin does not always give a correct report in the lab investigation.

A proper sample is available only on controlling urine for a while, cleaning the entire area around meatus with an antiseptic, and then letting out some urine before actually collecting a sample in a sterile cup. Infants and children are not likely to cooperate in this procedure. For toddlers and young children a different method is employed. One way is to tape a bag to the meatus and genitals but again, this does not ensure that the sample is not contaminated with skin bacteria.

Another method is that the doctor collects urine sample directly from the bladder using a sterile catheter, The second method sounds cruel but is the best and the only way to collect a sample of a child’s urine that will ensure proper diagnoses and correct urinary tract infection cure.
Recent studies have shown that children who get repeated UTI’s lack proteins called immunoglobulins which fight infections. Maybe in future scientists will be able to develop a vaccine which will prevent the frequent occurrence of UTI in children.

I think that it may be that your boy;s symptoms will settle in time but I can see that you are worried. Do you feel strongly about the circumcision? Is it something you are against? If not I think it might be a good idea, but maybe discussing the pros and cons with an expert in the field would help?

Let us know how you get on.