Infant NG Feeding Tube and Vomiting

[KristenLilysMom]

Hello All,
My daughter is 7.5 months old, we have been supplementing her with tube feeds for almost 2 months trying to get her into the 50th percentile. Recently, since colds and flus have really taken off (runny nose etc), she has been vomiting her feeds. There appears to be lots of mucous in it so we are happy about that, but lots of formula also comes out. My question is, isthis a common problem, and if so any suggestions to try and get the food to stay in her. Also what order is most effective for airway clearance and feeding...ie Neb, PT, then eat...and how long to wait between treatments and eating.
Thanks!

 

[KristenLilysMom]

Hello All,
My daughter is 7.5 months old, we have been supplementing her with tube feeds for almost 2 months trying to get her into the 50th percentile. Recently, since colds and flus have really taken off (runny nose etc), she has been vomiting her feeds. There appears to be lots of mucous in it so we are happy about that, but lots of formula also comes out. My question is, isthis a common problem, and if so any suggestions to try and get the food to stay in her. Also what order is most effective for airway clearance and feeding...ie Neb, PT, then eat...and how long to wait between treatments and eating.
Thanks!

 

[Ratatosk]

I'm assuming you've been suctioning out her nose?

DS developed bronchitis at 2-3 months old and I was forever holding him over sinks due to spit up. Never had an issue with CPT causing him to vomit, it was everything else -- put him in the car he'd vomit, put him down for a nap, vomit... I would bathe him twice a day to try to get things in his nose moving. He was also a horrible burper and was on zantac for reflux. Reflux is also a common issue.

We would usually due CPT and nebs and then feed ds.

 

[Ratatosk]

I'm assuming you've been suctioning out her nose?

DS developed bronchitis at 2-3 months old and I was forever holding him over sinks due to spit up. Never had an issue with CPT causing him to vomit, it was everything else -- put him in the car he'd vomit, put him down for a nap, vomit... I would bathe him twice a day to try to get things in his nose moving. He was also a horrible burper and was on zantac for reflux. Reflux is also a common issue.

We would usually due CPT and nebs and then feed ds.

 

[Mommafirst]

Reflux could definitely be an issue here. ITs always best to make sure the kid has not eaten in the last 30-45 minutes before doing nebs and PT (order of those two will depend on which nebs -- albuterol and pulmozyme can go before -- but pulmicort goes after), especially if they seem to vomit because of it. YOu may have to wait a bit longer.

Does Lily cough a lot during PT or not really? If it stirs stuff up and produce some coughing, you should probably wait a little bit before feeding for everything to settle.

It will get easier when she doesn't swallow the mucus...but my daughter just turned 6 and I'm still trying to figure out how to get her to spit it out.

 

[Mommafirst]

Reflux could definitely be an issue here. ITs always best to make sure the kid has not eaten in the last 30-45 minutes before doing nebs and PT (order of those two will depend on which nebs -- albuterol and pulmozyme can go before -- but pulmicort goes after), especially if they seem to vomit because of it. YOu may have to wait a bit longer.

Does Lily cough a lot during PT or not really? If it stirs stuff up and produce some coughing, you should probably wait a little bit before feeding for everything to settle.

It will get easier when she doesn't swallow the mucus...but my daughter just turned 6 and I'm still trying to figure out how to get her to spit it out.

 

[KristenLilysMom]

I don't think reflux is the problem. She is on a PPI (Previcid 15 mg OD), she occasionally will vomit immidiately after a feed - usually if she starts coughing. The issue is this past week she has been vomiting 2-3 oz hours after eating. She doesn't cough during chest pt or during the neb but she does cough a lot when she lays down. The Dr is wondering if her motility is slow and has started her on a med to increase her gastric emptying. I was wondering if she's lactose intolerate, has anyone else been diagnosed with another issue with digestion that not related to CF?

 

[KristenLilysMom]

I don't think reflux is the problem. She is on a PPI (Previcid 15 mg OD), she occasionally will vomit immidiately after a feed - usually if she starts coughing. The issue is this past week she has been vomiting 2-3 oz hours after eating. She doesn't cough during chest pt or during the neb but she does cough a lot when she lays down. The Dr is wondering if her motility is slow and has started her on a med to increase her gastric emptying. I was wondering if she's lactose intolerate, has anyone else been diagnosed with another issue with digestion that not related to CF?

 

[Ratatosk]

DS was on a PPI as well, but would still spit up long after he'd eaten. We had the end of his crib elevated.
We suspect now that it was an issue with slower digestion due to his surgery for a bowel obstruction shortly after birth. Took awhile for his digestive tract to normalize after a difficult surgery.

Could it be post nasal drip or sinus issues causing him to cough?

DS coughed quite a bit at 2-3 months and his local cf doctor mistakenly told us that it was normal, that's what "they" do; however, turned out he had bronchitis. But in that case he coughed quite a bit, but not usually at night.

 

[Ratatosk]

DS was on a PPI as well, but would still spit up long after he'd eaten. We had the end of his crib elevated.
We suspect now that it was an issue with slower digestion due to his surgery for a bowel obstruction shortly after birth. Took awhile for his digestive tract to normalize after a difficult surgery.

Could it be post nasal drip or sinus issues causing him to cough?

DS coughed quite a bit at 2-3 months and his local cf doctor mistakenly told us that it was normal, that's what "they" do; however, turned out he had bronchitis. But in that case he coughed quite a bit, but not usually at night.