There was an interesting refluxer I did treat. Mom had called me at about
4-6 weeks about a stuffy nose. I gave basic don't worry and
use some nasal saline advice. Then came the call about some gagging with
feeds. Basic over active let down
advise given.
A short time later mom came in with the older sib for a sick visit.
At the end of the visit mom says "Can I show you something about the baby?"
HCPs (ouch I used the term!) hate 'By-the-ways' gets you
a few hours behind be the end of the day. Of course I say yes some mom
begins breastfeeding the baby who suck-pauses-swallows a
few times then begins gagging then comes off the breast and continues to gag
and cough.
I tell mom maybe its reflux and start telling her about mechanical
treatment. Baby continues and cough is sometimes an almost choke.
(I know you can't choke on a liquid). In spite of my telling the baby she
can stop b/c I'm impressed she continues. I went from ordering
a barium swallow to rule out a TE fistula to changing it to an upper GI with
small bowel follow through and giving her a
cisapride prescription right there.
Then I had to get the chart and document it.
UGI was normal and baby did great on cisapride. Her nose cleared too.
-Rob

Rob Cordes, DO, FAAP, FACOP
Wilkes Barre, PA
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