I apologize for the late responses on both of these threads!
I am dreadfully far behind in reading lactnet , due at least partially to
breaking my foot a few days ago while playing tennis!
In response to Pat's initial post regarding reflux and her assertion of the
seeming absence of reflux greater then 10yrs ago, I can attest to reflux being
alive and well in the early 80s, anyway. Working at the time on an infant
unit, we saw many babies readmitted with reflux and not too few who were scheduled
for a surgical procedure called a fundoplication meant to ameliorate the
symptoms. At that time diagnosis was made based on the amount of spitting up, I
recall one mother telling me that the baby spit so badly that she had to buy
all new furniture (formula of course!). I don't remember there being alot of
pain involved in these cases, however.
As someone else mentioned, reflux IS the diagnosis of the day, taking the
place in many instances of what would have been termed colic (or something else),
10 years ago. I always cringe when consulted with a difficult reluxer because
the cases are usually multidimensional, no easy fix with a positioning change
etc.!! I do believe food sensitivities or allergies play a big role but
usually are not the only answer.
In regards to Ann's baby who at 40hrs of age was picked up with hypernatremia
and her question of "nl" specific gravity......Its important to remember that
SG levels are going to vary based on hydration. We would expect a newborn
to be drier at 40hrs of age verses 1hr and this variation may be more marked in
an infant who has less in reserve at delivery or one who has taken less
colostrum. I would venture to guess that any baby with uric acid crystals has a
high specific gravity but the fact is we don't normally test these values. That
is we don't know if the dry appearing baby with ua crystals also has an
elevated sodium level. Thus in the case of Ann's baby, the "sick" episode led the
neos to search out the culprit. Although newborns can be funky and
unpredictable, I would guess that if the baby was simply dehydrated, IV rehydration would
have resulted in almost immediate resolution of the problem. The fact that
this baby was continuing to require blow by O2 in order to maintain oxygen
levels while po feeding, suggests a "bigger" problem.
BTW, cyanosis around the lips is termed circumoral cyanosis. :)
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
