Urinary Tract Infection in 3 Month Old and VCUG

Updated on April 01, 2011
D.G. asks from Cedar Park, TX
22 answers

My daughter is 3 months old. She had her first UTI when she was 6 weeks and second when she was 12 weeks. Both the times we treated her with antibiotics and she was fine. Doctor has recommended to get her renal ultrasound and VCUG done. I am terrified to get the VCUG done as I have heard it is pretty invasive and hard on the kids and parents and especially because she is so young and will not understand what is happening with her. I am leaning towards waiting and getting it done if she has a third one. Meanwhile, I can get her urine tested every month for few months. Has anyone got VCUG done for such a young child and what do you think about the pros and cons of waiting for the third one before getting the test done.

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So What Happened?

Thanks for all the responses. It is a relief to know I am not alone and a lot of you have gone through similar experiences and have come out fine. I spoke to the doctor again and she recommends waiting on the VCUG since my daughter does not have any symptoms of a kidney infection like high fever, vommitting etc. We are going to keep watching her and testing her urine and hopefully she does not have to go through another UTI again.

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J.L.

answers from Houston on

My son had it done twice while still in the hospital. I had preemie twins and they were in the hospital for the first 4 months of their life. He had two UTI's and so they did a VCUG. It was not that bad. I would do it now while she is younger and before she gets another UTI.

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S.R.

answers from Austin on

I am a pediatric RN. Get it done now. The older you wait, they more difficult it becomes on the kid. Not because it's a horrible procedure, but because of their level of emotional development. IF you wait until they are closer to 5, they will remember being held down. IF your urine cultures were being obtained correctly through a straight cathertization, then they have already had the most unpleasant experience of the VCUG. The remainder is just squeezing some dye inside and taking pictures to see if the urine refluxes. It wont "hurt", they will have a feeling of fullness.

Now, lets talk about your cleaning technique and how frequently you change diapers. I have noticed that many parents use diapers as long term urine collectors. Not a good idea. I know they are expensive, but change diapers frequently. Be careful with diaper cream. Cleaning, front to back. DO NOT reuse wipes for the second wipe. Do not wipe back and forth. It's too easy to contaminate little girls. Get the VCUG, rule out reflux (because the last thing you want to do is screw up your daughters kidneys. They don't grown on trees and you don't want to end up with pyelonephritis aka kidney infection). Your going to do well, and your daughter will not remember it.

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C.H.

answers from San Antonio on

Good morning...my daughter, now 2.5, had her first UTI at 5 weeks old and was admitted to the hospital for a week to have IV antibiotics. She had a renal ultrasound and VCUG. The ultrasound is easy, and the VCUG is probably harder on mom than the baby. I cried the whole time, but it's hard to see your baby having tests done too. All they did was catheterize her to push fluid into her bladder while taking xrays (but it was like live video...so not sure if xray is the right term) to see if the fluid went back to her kidneys. Then it was over...about 10 minutes total I think for the VCUG. She was diagnosed with a Grade 5 on her left side and Grade 2 on the right. (5 is the worst) She has been on daily antibiotics since she was that hospital visit and we have been blessed that she has not had another UTI, but we have had a couple scares (high fever with no other symptoms requires a urine check). She had another VCUG at 18months and the grade 2 cleared (PTL) and the Grade 5 improved to Grade 3/4, so we opted to wait another year to see if she outgrows it instead of surgery. We go in on the 25th to see how she has progressed. I recommend going ahead with it as the risk of kidney damage is great if she indeed does have reflux... Any other ?'s just let me know!

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K.B.

answers from San Antonio on

Hello, My daughter had a VCUG done when she was 5 months old. It did not seem painful for her only scary as she did not really understand what was going on. They put a cathedar in her and put fluids in and then watched on a monitor to see where they went. I would say harder on the parents than anything. We had a great Dr doing the procedure who explained every step. I hope this helps. Let me know if you have any other questions.

K.

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E.S.

answers from Houston on

Hi D.,

My daughter was born with cysts on her kidneys and one of her kidneys actually shrunk until it became nothing. So, now she only has one kidney and we go to Texas Childrens 2 times a year. She had a VCUG when she was 2 weeks old and it did not bother her at all. They put a catheter inside her and put fluids into the cath and took pics of the fluid going in and coming out. My daughter was fine and it was fine for us. She did get cathed a lot before she was potty trained because they wanted her urine to be clean and not have any particles from the bag. If you have anymore questions let me know.

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J.K.

answers from Austin on

I would absolutely go ahead with the VCUG. My daughter had her first when she was 9 months old and yes, it was horrible. She cried, I cried. But, she has absolutely no memory of the event at all. It's pretty quick. We found out that she had grade 4+ urinary reflux on one side and 2 on the other. We kept her on antibiotics until she was 2 when she had surgery on just the one side (the other resolved). If we hadn't done the VCUG, that could have set her up for another kidney infection, possibly resulting in kidney damage. I didn't have to worry about her kidneys being damamged with another bad UTI or dealing with a sick baby. I think the VCUG could give you peace of mind and greater knowledge of the best course of treatment you need to take. Also, how is your doctor getting the urine samples? If it's with a catheter, by doing the VCUG you'd only have to do one more catheter instead of one every few months.
I see that you're in Cedar Park. We are, too. If you need a pediatric urologist, we used Dr. Seremetis and thought he was great. By the way, since urinary reflux tends to run in families, my other daughter had to get a VCUG when she was about a month just to rule it out in her. Again, not pleasant, but she has no memory either. My older daughter has had a couple in her life because of her diagnosis and it's easier the younger they are.

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M.B.

answers from Austin on

Hi there,
I can feel your pain and anxiety. My little daughter got infected with UTI when she was 9 months old. We got her VCUG done at Austin Radiology assocition at braker and stonelake. Well..the technician did their job but my little one was terrified seeing that many people surrounding her, in that x-ray room with that many unfamiliar objects and nurses holding her, etc..I was holding her knees while they placed the catheter in. I was in tears...But this is what APA recommends and you got to do it. Those 20 minutes were terrible but we were relieved once it was over.
your daugher is very young. Looks like it's recurring infection.
With VCUG test doctor wants to make sure that the infection is in UT and not further upto the bladder and check that her bladder's functionality is normal.
I'd say wait until you are comfortable because you are the one who will be watching her and standing by herself. So you need to be firm. Good Luck!

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S.M.

answers from El Paso on

Hi D.,
While I do not have experience with a young child that had UTIs, I got them myself very often as a teen and I had the VCUG test done. I was curious if you have tried changing her diaper brand. For me, when I use certain feminine hygiene products I tend to get more UTIs. You may try changing brands or using cloth diapers for a while to see how that helps.

I would tend to wait on the VCUG test until she was a little bit older, unless the doctor has expressed specific concerns that he would want to take care of while she was younger.

Good luck,
S.

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M.R.

answers from San Antonio on

HI D.!
If your doctor is recommending it than do it don't do it because you don't want her to go through the discomfort. My 3 year old has had 2 UTI infections and complains that is hurts down there. She did not have any symptoms like fever,vomiting or anything just red. She had a culture done the first time and a antibiotic was recommended, it cleared up so I thought. That was in May 2009 here it is Nov. 2009 and she still complains but I see nothing just maybe a little red so I took her in last week for a uti test and it did not come back with uti infection but it did show some bacteria but they could not tell me exactly so today I took her in for a renal ultrasound and found out that they would be doing the VCUG as well. I was getting upset because I read of the horror stories some people posted but all in all it was the best thing. My daughter was such a big girl, cried for a minute while they put the cathader in and the rest was easy, they filled her bladder with iodine and took pics and than with her bladder empty. We found out that she has a diverted bladder, when she pee's it does not empty and goes back up into her bladder, she explained it like a balloon effect so now we are being referred to a Pedi. Urologist. Thank God we took her, we almost thought she was in the clear because she got a shot for the UTI we thought she had and she seemed better. I would do it all over again. She will have to have some procedure done but I do not know when or how it's done, I do know it will be a minor surgery to correct it. Hope this helps. BLessings!

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K.D.

answers from Houston on

I'm a nurse and transport babies from our nicu to radiology for vcug's often. The procedure is definately harder on the parent!! Your baby will be fine.....the big discomfort is the insertion of the catheter and that's just a brief period. Good luck and I hope all turns out well for your little one

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S.A.

answers from Austin on

D. -- my son had a VCUG at four YEARS old, and it was a terrible experience for all involved (my husband nearly fainted!). However, had he been an infant, I honestly don't think it would have been as difficult. Okay, yes, hard on the parents, and your baby won't like it, but she will have no memory of it at all, and should get over it very quickly. As terrible as it was on all of us, it turned out to be a lifesaver -- not only did my son have the urinary reflux problem, but he had a partial blockage in the ureter to his left kidney. Since they found it, they were able to do surgery and fix the blockage, so no more problems for him. Without that information, he might well have ended up with a full blockage and a dead kidney. We are SO grateful that didn't happen! (He's 16 now and doing just fine!)

I will admit that the VCUG is a barbaric way to get this information (at least for older kids), but until they come up with something else ...

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L.C.

answers from Houston on

My daughter had the same issue. We went ahead and did the VCUG. It was not any big deal. Dad and I were WAY MORE stressed out about it than we needed to be. -I am a nurse so I always say "well what if........." and none of the what ifs happened! Get it done... wouldn't you rather be informed and know forsure that your daughter is fine? Just Do It!!!

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E.L.

answers from Houston on

I HIGHLY recommend you take her for a second opinion. I had a daughter who came back with six or seven uti's but she started at 12 mo. and when she was five I did the renal testing, staying ith her the entire time and not crying (most moms cry acc. to the nurses and I can see why) but I thought that if I cried then she'd cry more....okay, I just really think you need to get a different ped. office checking the urine levels. AND you need to do research on the levels and if she's barely at the threshold they'd recommend her (which is debatable)....after time and time again of all these UTI's it turned out that her system was totally fine. Then the THIRD ped I went to told me that the other offices probably didn't even do correct urine testing, and they said that the urine test is the most incorrectly done thing in a ped's office. Mind you, all three offices had ped's I loved and trusted, but now I can see how this happened. So I think the age of your daughter is WAAAAAAY to young to do a renal test because it sounds like it's more of a way to cover their hiney rather than to use more sound judgment....also, you really need to do some research as to alternative cures for uti's IF your daughter actually has them....and the natural causes of them. I strongly feel, after kids and years, that there are superior natural remedies to antibiotics for many things. And with a young infant this would be the most important time to look into these facts and researched-based studies (yes, there are studies for more than antibiotics). Good luck.

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L.F.

answers from Houston on

My daughter began this process when she was five. She is now 14 and continues to be monitored by her urinary tract specialist. If I were you and know what a horrible experience the UTIs are, I'd do whatever I could to make sure those don't happen again. While the procedure is somewhat invasive and hard on the parents as well as the child, at least your child is at an age where she won't remember anything. The continued UTIs absolutely mean there is something else causing them. My daughter did end up having surgery when she was 8 due to urinary reflux, but all seems to be well now. Good luck.

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B.S.

answers from Houston on

Pretty much the same response as everyone else - my son had urinary reflux - grade 4 (or 3...I can't remember anymore). He had 2 VCUGs and they were awful but they had to be done. He never had a UTI but has an enlarged kidney. His first was before 6wks old and his second was a little over 1 yr old. His reflux resolved on its own after about 2 1/2 yrs. He was on prophylaxis everyday - which caused cavities when his baby teeth came in. We no longer have to see a urologist, he is 5. When your child has to undergo medical procedures it is scary for everyone involved for sure. However, sometimes we have to do what we have to do for their health and safety. My son has had numerous medical procedures and surgeries for different reasons and he doesn't like them of course but he wouldn't be with me today without them.

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A.W.

answers from Victoria on

D., you need to do as your doctor recommends. Our daughter was diagnosed with bladder reflux at 6 months old. She got ecoli sepsis and her kidneys began to shut down. The VCUG can determine whether or not your daughter has this condition and then you can address it. The test may be invasive but she will not remember it and it would be much better to find out what is causing her to have repeat UTIs now than her condition to worsen. I don't mean to alarm you but we nearly lost our child and I certainly don't want anyone else to have to go through that. It was a horrible experience. She evidentually had to have surgery when she was 20 months old. It was amazing. After the surgery her color dramatically improved and within 6 months she grew unbelievably! She is now eight and doing great. There is a small scar on one kidney and some very slight decreased function but its okay. Please have the test done.

On a lighter note, as a result of her condition, Hannah potty trained very quickly. She learned if she could potty in the cup when asked she would not have to have the sample taken via cather!

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N.R.

answers from Waco on

I've never had the VCUG done but I work in x-ray and have had to help perform these exams. the most invasive part is the catheter. It is uncomfortable because contrast is pumped into the bladder to see if it refluxes and after the bladder is full we wait for the child to pee (that young takes time bc they don't understand). The hard part is seeing your child cry, struggle and they have to be held still (a couple of techs & they might ask you to help). I suggest the stronger & less emotional parent to be present.
Hope this helps.

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D.A.

answers from Houston on

i had 2 boys born with hydronephritis (diagnosed while i was pregnant), enlarged kidneys. one was due to reflux and blockage in the valve, and the other eventaully outgrew it. I spent the majority of the first 6 months of my oldest sons life in and out of the hospital with reoccuring infections, each infection has the potention to severely scar the kidneys.they both had procedures done immediately after birth and regular follow-ups as needed. The VCUG, although quite tramatic for moms, does not hurt the child nor do they have any memory of it being as how they are so young. It is neccessary to help diagnose and treat the problem. In my oldest sons case it meant surgery to repair both problems. (Sorry- i don't want to scare you but i want you to know how important it can be to get these test done early.) my oldest son had surgery when he was 7 months old and has not had a problem since and my second son outgrew it by the time he was 2.

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S.J.

answers from Austin on

I'm an expert in this situation. My daughter had her first kidney infection at 3.5 months and we did the VCUG within a couple of weeks. She came back with Stage 3 reflux and was put on antibiotics daily. She had another VCUG at ages 11 months and 26 months then had the Deflux surgery July of '08 to correct, which was successful. Saying that, the easiest of the procedure was the first time when she was so young, couldn't resist and didn't remember a thing; it was by far the least invasive emotionally on all involved.

At the 11 month mark, the reflux had progressed to stage 4 but they allowed her body more time to outgrow it which turned out to be the best thing. At 26 months, it had decreased (with lots of prayers in her honor) to stage 2 which allowed for them to do the Deflux procedure.

Since then, she has had 3 UTI's, not kidney infections, because she would hold her urine when potty training b/c or her experiences. It's been an ongoing battle but we are finally getting out of it after 3.5 year.

Saying all of that, I would not wait for a 3rd UTI to do the procedure. At this age, you will be more affected than she will. They will have to do a catheter, which you may have already experienced with the infections, put dye in her little body then wait for her to void to take pictures. She will not be able to hold that amount of fluid but a couple minutes so she's so young for it to be a pretty quick procedure.

They always told me the fear is to damage the kideys and the more infections, the more of a chance that can happen.

Your life will be different around fevers, etc, from here on out if they find that she has reflux but it's a fixable problem with healthy childhood.

You are welcome to contact me with any questions and I hope everything goes well.

God Bless,
S.

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S.W.

answers from Houston on

Please don't get the VCUG and ultrasound done just yet. Some other things you can do right now. First analyze her diet. Are you breastfeeding? If not, switch formula to dairy-free. Bathe your daughter is epson salt, rather than bubble bath that has fragrance. (A company can put any chemical in their product and call it fragrance).

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S.E.

answers from New York on

My daughter was diagnosed with a uti at about 8 months. We went through a battery of test with a great amount of anxiety but ultimately decided to do the vcug as a uti in someone so little usually means vesicourteral reflux (basically the urine backs up to the kidneys and can cause kidney damage if not treated). It turned out she did have grade 3 reflux on both sides which isn't supposed to reverse itself without surgery or a procedure to get the flat to close therefore avoiding urine backup (its a steroid injected into or onto the flap from what I understand). My daughter without any form of surgical / procedural intervention has gone from a grade 3 reflux to a grade 1 reflux. The vcugs are horrible as they get older. This last one at 3 1/2 was brutal for both of us. The one at 2 was bad but she doesn't remember that one or the one before. The last test which showed her at a stage 1 was a few days ago & I still feel horrible about it.

You can keep monitoring your little ones urine. Just keep in mind every time she gets a fever you must immediately bring her in to check it. Everytime my daughter got a fever or was acting not quite like herself I brought her in to her doctor just to check her urine. Sine the specialist had put her on macrodanin when she was diagnosed she has not had any breakthrough infections. Now that she has been downgraded to a grade 1 reflux, the specialist is taking her off the meds, but just have to make sure she pees every 2 - 2 1/2 hours to make sure her urine isn't sitting around and giving it time to back up. I am keeping my fingers crossed .

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L.N.

answers from Austin on

my daughter was 6 weeks old when she had her first uti and was on antibiotics for her first yr. after that we had her tested and found out her valve was not shutting properly after she urinated. She had a 1% urinary reflux disease and out grew this; therefore, did not have to have any surgery.
Good luck and always get a second opinion!

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