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Kidney experts please - prophylaxis really necessary?(5 Posts)
Dd is 27 months. Had pyeloplasty at 3 months, cystoscopy and JJ stent at 6 months and JJ stent removed at 15 months. She was in daily trimethoprim prophylaxis from birth changed to Nitrofuratoin after a uti at 17 months following a vomiting virus. Only other infection was found on the stent after removal though she had no symptoms.
Consultant said if no infections between last appt in oct and next in July then we can stop it as kidney doing well and function is as good as it is likely to be.
Anyway dd now for past week absolutely refusing her nightly Nitrofuratoin. We have tried everything short of pinning her down and holding mouth open. She is just being a toddler and pushing boundaries but my inclination is that as we'll probably stop in July anyway to stop now.
What do you think any kidney experts on here please? Alternatively any good advice re taking meds. We've tried bribery and punishment and cajoling etc. we've gone through phases like this before but she was young enough to force it or syringe it in while asleep unlike now when she forces her mouth shut or makes herself sick.
If relevant - also potty training at moment. Going well and she often holds her wee 4-5 hours even when given opportunity to go hourly. Does this have potential uti implications?
I wouldn't worry about her holding urine. It's a normal stage, and unlikely to cause issues. Just keep giving her plenty of regular chances to go.
As for the medicine - I'd give it a really good go. Would she take it wrapped in ham, or with special chocolate, or anything? A reward chart?
Don't really upset her by force feeding her, but coming off it in July would be ideal, if it is possible.
I'm glad she's doing well!
NOT an expert but I think that whilst it is critical not to risk further damage to her kidney, it's also important to recognise the other long term issues here. If she needs to take meds in the future then she needs to come to that without the baggage, for all of you, of being forced to take it now iyswim. Making a huge issue of meds taking - as is almost inevitable with string willed toddlers, can do damage to. I suspect 4-5 hours between wees is ok but you do need to make sure she's drinking enough. Most children actually don't so I would really encourage lots of drinks so you know there's plenty of through-put Finally I would see if you can get the appointment moved up to May? Then you can discuss the overall situation with the consultant. If course if you suspect she has a uti before then you need to seek urgent medical advice.
DD was on 'thoprim for roughly the same reasons (prophylactic) and we had similar issues with refusal. We started mixing it with yoghurt, she loves petit filous and will happily polish off an entire little pot so when she started refusing the meds we just measured the dose and stirred it into the yoghurt. She scoffed it down
Does she have a favourite food that you could mix the medicine into?
I wouldn't stop just like that without speaking to the consultant first, even over the phone if not in person. The chances of a further infection are low but is it worth the risk? He/she will be able to offer professional advice.
I have to say though that some days we were quite mean and did hold her head for the five seconds it took to squirt the medicine in and wait for her to swallow it.Yes, it was unpleasant and she had a good old tantrum afterwards but it was over quickly, she doesn't remember it and it was for her own good.
Good luck for July
Well since you are potty training what about them giving you some strips to dip? Early warning about an infection and relax on the prophylaxis
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