RE: Trouble with feeds - vomitting daily

April 3, 2006

Amy,

Your list looks pretty thorough, but have you tried venting his g-tube for

gas? Evan will make gagging noises when he needs to be vented (his Nissen must

be pretty tight, because we have yet to see him vomit).

I see you have tried slowing his feeds down some, but you may want to try

slowing them even more. We have also slowed Evan's feeding rate way down, and

this has helped a lot with the gagging. He gets 130 mL feeding at a rate of

~80-90 ml/hr, so a meal takes about 1 1/2-2 hrs. We went through a pretty

miserble time with Evan, where we were trying to transition him to bollus feeds.

It wasn't working, and he would lay there gagging. Evan's stomach was small to

begin with, and between the Nissen and the g-tube, there just isn't much room

left. I would imagine Ben's is the same way. Stuffing him full really doesn't

help the stomach grow any faster--it's just going to grow along with him.

Hope this helps,

PS I recently visited Ben's page--he sure is a cutie. He and Evan look a lot

alike (Evan has a page now too: http://www.babysites.com/sites/skeybunny/

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April 3, 2006

Dear Amy-

The thing which stood out the most to me is that Ben is eight months old.

When was having extra drool from erupting teeth and swollen gums, he

would tolerate his feeds quite poorly - much like what you describe. Eight

months old was just after his front two lower central incisors erupted and

much of his mouth was swollen with impending teeth. What helped for us was

to give him a 2-6 ounce bolus of clear room temperature water when he first

awoke and then wait at least 20 minutes to give him his first feeding. It

seemed the water helped clear his stomach of any saliva and mucous he might

have built up in his tummy. We would do the same if he was congested. It

seemed (I theorize and speculate wildly here - but I gave it alot of thought

at the time!) that if there were oral and nasal secretions in his tummy,

they would float to the top during feeds and somehow trigger him to retch

and gag. Further validating of my theory is that at times during the water

bolus he would g-tube burp and all matter of bubbly slimy frothy stuff would

come up the tube (we feed by gravity). As I have seen said " your mileage

may vary " )

I hope this helps-

Best of everything-

Yuka

Trouble with feeds - vomiting daily

> My 8 month old son, Ben (Ben has CHARGE, a trach, Nissen, GTube,

> severe hearing loss, small kidneys, enlarged ventricles, and urinary

> trach reflux)started having vomiting issues again. (Last time it

> was related to his GTube being in too far).

>

> Ben started heaving a month ago after his daytime feeds (given via

> GTube over 30 minutes over a pump)until he would finally throw up.

> He would then lay in the bed super still for about 20 minutes

> afterwards like he didn't feel good. After about 20 minutes, he

> would then kick and play like he was ok. We have talked to many,

> many doctors and everything they have suggested hasn't made a

> difference. Ben is now vomiting once during his daytime feeds and

> every now and then in the morning once he's almost done with his

> continuous feeds.

>

> We have tried:

> 1. Feeding him over an hour during the day

> 2. Increasing his Zantac

> 3. Propping him during feeds

> 4. Giving him nebulizer treatments every 3-4 hours

> 5. Switching food to Enfamil AR (Acid Reflux)

> 6. Feeding him less during the day

> 7. Checking his Nissen to make sure it is in tack

> 8. Chest Xrays

>

> Has anyone gone through this? Any suggestions would be greatly

> appreciated. Thank you.

> Amy Russo

April 3, 2006