Hi,
Greetings from Quetta, Pakistan!
Just a thought as bub had respiratory distress at birth, and now has reflux
is he still having little apnoea attacks and kicks himself back into normal
resps. Sometimes this is happening post feeds it could explain both the
vomiting and the crying sessions.
I have seen a couple of bubs like this and further testing revealed this
also they wint onto Cisapride and into a Frazer chair
(45 degress to almost upright) after feeding and it seemed to disappear.
Hope this suggestion of use!
Robyn J Aulmann,RN.RM.
-----Original Message-----
From: Jeanette Panchula [mailto:[log in to unmask]]
Sent: Tuesday, 12 September 2000 10:30
Subject: New case - Reflux
I only get the doozys on Fridays or Saturdays! This mom has had 8
children, the last 5 with GER (or GOR). However, this last baby, born at 6
lbs 5 oz and now at 4.5 months weighs 11 lbs 4 ounces - having lost 4
ounces the last three weeks.
Baby has had every test in the book, The only report she was able to give
me clearly (very stressed out mom and hysterical baby in the background)
was she had 70% residuals an hour after feeding. Pediatrician now
treating her with Reglan - and coincidentally has lost weight during the
last 3 weeks since the Reglan (metaclopromide) was started.
Baby has been crying unconsolably from 30 minutes after a feed for 2 - 2.5
hours, then sleeps for an hour or two, then eats and back to the crying
again 30 minutes after eating.
I got called only because they needed a pump - to see if mom had enough
milk, the pediatrician said... ;-(
So I had to ask lots of questions gently, and try to direct mom about
pumping not reflecting either what she was making or what the baby was
taking... Thanks to all the vomiting.
I've recommended contacting the Lactation Center at UC Davis, as there is a
Pediatric Gastroenterologist, Dr. Michael Haight, who is the MD there, but
she does not know if they will be able to go as the insurance company may
not pay and they already have $30,000 in bills for care in NICU (baby had
respiratory distress at birth) and tests since discharge.
I did suggest breast compressions, letting baby suck at the breast to
maintain a little longer the peristaltic movement of the gastrointestinal
tract, but this is not my specialty - luckily I did hear the tape on GER
prior to talking to her, so I was a little more knowledgeable. But I can
hear the fear and desperation in her voice. Exhaustion! She even tried
some formula - threw it all up, of course.
Today mom called to tell me she was finding that baby was arching and slept
best (if by this you mean 30 minutes at a time between crying spells) while
leaning on mom or dad's chest (she didn't want to admit to putting baby
prone due to the risk of SIDS).
Tomorrow she goes to the MD to see how the baby is progressing with her
weight. I would love to hear from you what you would recommend r/t the use
of Reglan and how to help this mom.
Jeanette Panchula, RN, IBCLC
Vacaville, CA
***********************************************
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
|
