Question

A 1 day- old neonate has not passed urine since birth. What is the next step in management?

• A. Continue breast feeding not observed
• B. Admit to NICU’
• C. Start artificial feeding
• D. Start intravenous fluids

Answer 1

The Correct Option is A

The diagnosis of a 1-day-old neonate who has not passed urine since birth involves evaluating the most common reasons for this condition. It is crucial to understand that it is relatively normal for some neonates to take up to 48 hours to pass their first urine, provided there is no underlying pathology.

In this case, the most appropriate step in management is: Continue breast feeding not observed.

Here are the detailed explanations and reasoning:

1. Neonates often have delayed urination due to physiological factors; it is imperative to ensure that the baby is adequately hydrated.
2. Breastfeeding is the most natural method to ensure the neonate receives sufficient hydration and nutrients. Discontinuing breastfeeding at this early stage could potentially exacerbate any existing feeding or hydration issues.
3. Since the neonate is just 1 day old, and considering the absence of any critical signs or symptoms suggesting acute renal or urinary tract problems, continuing breastfeeding while monitoring the neonate is typically advised.
4. Other options such as admitting to the NICU, starting artificial feeding or intravenous fluids are more invasive and are not indicated without further evidence of underlying issues.

Conclusively, continuing to support the neonate with breastfeeding contributes to resolving the issue naturally, while ensuring close monitoring for any new symptoms or signs of distress.