Every evidence-based protocol/guideline for hydronephrosis includes once daily antibiotic prophylaxis for mod-severe hydronephrosis or any hydronephrosis with VUR (vesico-ureteral reflux).  These infants/children are at extremely high risk of further renal damage with any urinary tract infection.  Daily prophylaxis is a small price to pay for having functioning kidneys as an adult.  I agree that breastfed infants with hydronephrosis are LESS likely to have urinary tract infections, but ANY infection in some of these infants is dangerous.

Nancy

Nancy E. Wight MD, IBCLC, FABM, FAAP
Attending Neonatologist,
Children's Hospital & Health Center, and
Sharp Mary Birch Hospital for Women
Medical Director, Sharp HealthCare Lactation Services



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