Can anyone help?

Sorry in advance for the long post!!

Here is our situation: One of my DS (28 weekers) throws up a lot (very randomly) and is not gaining a lot of weight. We have a GI who has him on prevacid. We have done an upper GI, endoscopy, blood tests-all fine. He did say his pyloris sphincter is a little tight but not so tight to do anything about b/c things still pass through--said could contribute maybe to throwing up, but I dont't hink he is convinced. We have seen 3 OT specialists who also say it's not a gag reflex issues, not a swallowing or chewing issues, an not sensory issues. It was a behavioral thing for a bit, but we worked on that, and that is fixed.

Basically, he throws up very randomly. Sometimes beginning of feed, sometimes middle or end. Sometimes on fingered foods, sometimes textured food and sometimes purees. No consistentcy to what he is eating (we kept a food journal) so don't think it is an allergy. He throws up somtimes once a day, sometimes twice a day. He will usually burp or do a gagging thing (even with purees) and then it will all come up. He will cry for a couple of minutes and then calm down. We will then refeed him and he will eat without a problem. The problem is what he is losing in calories is not at much as he is taking in, so my DS is very small. He is 1 year adjusted and not even 18 lbs--he hasn't gained much in the last 6 months--not even on the adjusted age charts. My gI said as long as he is gaining --even a tiny bit, he would not put in a feeding tube. Only if he loses weight, b/c a feeding tube will just make the problem worse. He is developing fine--walking and doing all that he shoudl for a year adjusted. So I try not worry, but I know something is wrong with him, but don't know what else to do. I cry a lot b/c it is so frustrating never knowing what is going to make him throw up. We barely give him anything more than purees b/c of this also. His brother on the other hand eats aeverything and is about 3 1/2 lbs bigger than him (and he was baby B). I am worried about his weight gain,b ut know he is okay, just more concerned about the vomiting and why there is no explanation. The OTs did say that sometimes babies just throw up. I don't know how i feel about htat as being an answser, but what else could it be??????

Sorry for the long post, but anyone with any insight would be sooo appreciated!!!

 

Also, just to clarify, we do give him only pediasure and we boost his calories in everything he eats!!! butter, cream, oil, etc.....

 

:hug: wow how difficult for you! You mentioned that you kept a food journal, do you by any chance keep a daily journal? Maybe it's something he does before he eats, playing outside for example or maybe even rolling around.. Just a thought.
It's great that you're so on top of the doctors but I think I would keep finding new doctors until I found one that said "I don't know why he's throwing up but we're going to figure that out together." The throwing up doesn't sound normal but my dd wasn't any bigger then yours when she turned a year. She is now 27 months and weighs 23lbs. She did drop on her chart at a year old but since then has gained little by little and the doctor isn't worried.
Good luck and keep us posted on how he's doing.

 

:hug: to you. I agree with Brigette, I would see about seeing another doctor just for another opinion. I am sorry that you are dealing with this and so worried about your little guy :grouphug:

I just checked my two's records at a year my DD was 17 lbs and 15 oz and DS was 18 lbs and 9 oz. Neither of them had problems throwing up though but I did the same that you are doing, giving them fattening foods for extra calories and I also added Carnation Instant Breakfast to their milk for extra calories (my two did not like Pediasure). Keep us posted!

 

I'm so sorry you're going through all of this! :hug: It must be terribly frustrating; I've had weight-gain concerns as well, but nothing like what you're dealing with.

Does your DS *make* himself throw up (with his fingers or with lots of heaving and gagging) or is it more like spit-up? Is he walking? Nate spit up *a lot* up to the point where he started walking, then he was upright a lot more and it pretty much just stopped overnight. (My guys also make themselves throw up when they're bored at the dinner table, but that's another story. <_< )

Do you always spoon-feed him, or are you letting him self-feed? Is there any difference in the frequency of throwing up when you spoon feed him vs. when he feeds himself? I have read that some kids with sensitive gag-reflexes and texture issues do a lot better when feeding themselves. Can you ask to work with a nutritionist or speech-language pathologist (who also sometimes handle feeding issues)? It might be worthwhile to have someone evaluate your DS from the behavioral/mechanical point of view, as well as the medical one.

I really hope you can find some answers. I think feeding issues are about the most frustrating thing about parenting! :hug:

 

I'm not sure if this book will help your situation --- Child of mine: feeding with love and good sense but it is a great book nevertheless. My daughter is 2.5 and weighs not even 23 pounds. It wasn't the weight of your son that concerned me but the fact that YOU are concerned. I just feel really strongly that the mother often will have good instincts about her children. I think we often can't quite describe what is going on, but it is a "feeling" which really is because of what we have seen 24 hours with our child. I think I'd be worried about continuing purees at this age as you might have a harder time transitioning into fingerfoods. If he is going to vomit anyways it might as well be solids.

I have known other children who vomit even until 1 yr of age and there was no concern.... but I think you should follow your gut instincts and get a second opinion. Hard when they are 1 yr adjusted age.

Heather

 

I don't have personal experience with this, but I have a good friend whose twins were born at 30 weeks and both have feeding issues. Her son pukes like yours and her daughter has texture issues. Her pediatrician thinks it's because of all the tubes down the throat during their NICU stay. Both babies get PT, OT and speech therapy thru EI; but it's the speech therapist who specifically addresses the feeding issues and they have had success. Maybe your ped could refer you to a speech therapist for an evaluation and/or consultation? Good Luck!

 

Thanks for all of the responses! As many of you said, i am trying not to focus on the weight, but the vomiting is just so horrible! We saw our GI agian today and I really felt like he listened and we are going to try some new medications now. But basically he did say that as long as he is gaining--even a tiny amount, then that's really what he cares about. Although the vomiting sucks, we know it is not harming his insides. As for some of your questions, yes, there is no rhyme or reason when he throws up. Spoon fed, feeding himself, finger foods, etc--all of it makes him throw up. We think there is an issue with the emptying of his stomach. I also am looking into getting a referral for a speech pathologist--but what I am old is our OT who deals with feeding issues, probably won't be much different. Our OT actually specialized in feeding/behavioral stuff, so we have gone down that route. Anyway, thanks for the responses.

 

It sounds like you're doing everything right, and doing all you can. :good:

I just also wanted to throw out one other thing. I used to have terrible stress and digestive problems, to the point where I literally couldn't eat for months. My SIL who is a naturopath, told me that the sphincter at the top of the stomach doesn't close until the stomach acid gets to a certain level. If the acid production is not sufficient, that sphincter won't close, and the stomach contents can come back up. She suggested taking apple cider vinegar or HCI pills to increase the acidity of my stomach, plus enzymes to aid digestion. It did help.

This may not be sound medical advice (a random person in the Internet quoting a naturopath ), but it's something to think about and perhaps ask the GI. ardon: