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Dr. Hive, what do you make of these symptoms?


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I have an almost one month old with these symptoms:

 

When nursing, baby chokes, stops breathing for a few seconds, arches back, screams, and resumes breathing 3-5 seconds after screaming.

 

These episodes occur 1-3 times during a nursing session, but not during every nursing.

 

These episodes occur only while nursing. And baby is a frequent nurser.

 

On one occasion, the baby's face turned blue for several seconds after the scream, and in this case it was three screams of pain.

 

Finally, this all began around two weeks of age.

 

I'll reveal what her ped. said it was. I'm a little skeptical about the diagnosis.

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My daughter did that and she was aspirating -her milk was entering her lungs instead of proceeding to her stomach. The choking, not breathing, arching of her back while drinking/eating were all big signs. We tried reflux medicine and it didn't help. I think her pain came from trying to get the milk out of her airway. Have you tried feeding him in a more upright position to see how he handles it? She did better in an upright position where she could control her swallowing more. The official diagnosis was swallowing dysphasia.

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Reflux or a very strong milk let-down?

 

Dr. thinks it's the former. I was thinking it was the let-down. I was told to give 1ml of malox (sp?). I'm not comfortable medicating for no reason, but I don't want my baby in pain either. Also, the choking sometimes occurs later in the feeding, which points to reflux. But why does she not have reflux symptoms outside of nursing? That makes me think it's the let-down issue.

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:iagree: Sounds more like over-active-let-down to me, since it's happening at the beginning of the nursing session. You could try hand-expressing before the nursing session and see if that helps.

 

Thanks, Mrs. Mungo. I will try pumping a little before feeding to see if that is the problem.

 

This is what I was thinking too. What did the dr say?

 

Dr. thought it was reflux. She said that while the baby was eating, the stomach acids were coming up and causing her to choke.

 

My daughter did that and she was aspirating -her milk was entering her lungs instead of proceeding to her stomach. The choking, not breathing, arching of her back while drinking/eating were all big signs. We tried reflux medicine and it didn't help. I think her pain came from trying to get the milk out of her airway. Have you tried feeding him in a more upright position to see how he handles it? She did better in an upright position where she could control her swallowing more. The official diagnosis was swallowing dysphasia.

 

Hmm, what you describe sounds like my baby. I've tried feeding her in an upright position today, but she still choked three times. I'm going to ask the dr. about the possibility of swallowing dysphasia.

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Dr. thinks it's the former. I was thinking it was the let-down. I was told to give 1ml of malox (sp?). I'm not comfortable medicating for no reason, but I don't want my baby in pain either. Also, the choking sometimes occurs later in the feeding, which points to reflux. But why does she not have reflux symptoms outside of nursing? That makes me think it's the let-down issue.

I've had two with reflux, and it doesn't necessarily sound like it to me, either.

 

I also happen to have a very strong let-down/oversupply issue. It sounds a lot more like that, IMO.

 

Either way, I hope you get it figured out.

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Since I never nurses, I don't know about the let down issues but it could be a swallowing/aspirating thing. Reflux is more likely to come after they eat, not just during. I would check again and maybe see about a swallow study, etc., esp. if there is choking, turning blue, etc.

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My dd had the exact same symptoms, was diagnosed with reflux. It hadn't even crossed my mind, I honestly thought it was from a strong let-down, except I tried pumping/hand expressing and it didn't fix the problem. We tried Mylanta, it didn't help. Put her on Zantac, took care of it right off the bat. She never had another issue.

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Since I never nurses, I don't know about the let down issues but it could be a swallowing/aspirating thing. Reflux is more likely to come after they eat, not just during. I would check again and maybe see about a swallow study, etc., esp. if there is choking, turning blue, etc.

For my dd to get referred for a swallow study I had to raise h^*&. Part of the reason is because I didn't document the symptoms as well as I should have. Make sure you write down all the events during eat and how long they last. Dd didn't choke every feeding, and she didn't choke at the same point in feeding. However, if she was tired I knew it was more likely to happen than if she was fully awake. In case it is aspiration you need to be very dilligent. Aspiration can lead to pneumonia or other respiratory infections. I know you don't want to deal with that at all. At 1 month she didn't stop eating but later she also began to refuse to eat or drink in an attempt to protect herself. We also began to have problems with weight gain because she was using so much energy just to swallow and keep liquids out of her lungs.

 

I hope you find the right answers soon. :grouphug:

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Since I never nurses, I don't know about the let down issues but it could be a swallowing/aspirating thing. Reflux is more likely to come after they eat, not just during. I would check again and maybe see about a swallow study, etc., esp. if there is choking, turning blue, etc.

 

The dr. detected a slight heart murmur, and with the face turning blue episode, she ordered an echo to rule out any heart issues. I'll ask about a swallow study at her next appointment. Doesn't that require drinking barium? How safe is that? I would want to rule out other possibilities first, right?

 

My dd had the exact same symptoms, was diagnosed with reflux. It hadn't even crossed my mind, I honestly thought it was from a strong let-down, except I tried pumping/hand expressing and it didn't fix the problem. We tried Mylanta, it didn't help. Put her on Zantac, took care of it right off the bat. She never had another issue.

 

thanks for sharing your experience. Your baby only experienced sympoms/pain during feedings? It is reassuring to k ow that medication can eliminate the apparent pain i see in my DD.

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I've had two with reflux, and it doesn't necessarily sound like it to me, either.

 

I also happen to have a very strong let-down/oversupply issue. It sounds a lot more like that, IMO.

 

Either way, I hope you get it figured out.

 

It sounds like aspirating to me. My fourth baby did the same things. She also had reflux though and ended up throwing up a lot. It is upsetting and frustrating regardless. I hope you get it sorted out very soon.

 

I hope to find the answer soon too. Thanks to the hive, I have a lot more information to help. I'm going to try all your suggestions and keep records to see what helps.

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For my dd to get referred for a swallow study I had to raise h^*&. Part of the reason is because I didn't document the symptoms as well as I should have. Make sure you write down all the events during eat and how long they last. Dd didn't choke every feeding, and she didn't choke at the same point in feeding. However, if she was tired I knew it was more likely to happen than if she was fully awake. In case it is aspiration you need to be very dilligent. Aspiration can lead to pneumonia or other respiratory infections. I know you don't want to deal with that at all. At 1 month she didn't stop eating but later she also began to refuse to eat or drink in an attempt to protect herself. We also began to have problems with weight gain because she was using so much energy just to swallow and keep liquids out of her lungs.

 

I hope you find the right answers soon. :grouphug:

 

Thanks for the advice. I was planning on starting a diary for the baby so that I can communicate better with her dr. I also was thinking it would be helpful to get some video footage of what it looks like. I'm sorry you had such a hard tine getting your daughter a swallow study. If you don't mind sharing, did the study determine that your daughter was aapirating?

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You said not at every nursing? If it is only on one side, I'd take a trip to the chiropractor. My kids got like that when their necks were out of alignment.

 

Rosie

 

That's one I would never have thought of. I didn't even know babies could be out of alignment. I wonder if my insurance would cover it, or if it would have to be out of pocket. Thanks for sharing the possibility (and that's not meant in a sarcastic way-I always have to clarify my tone for my 7yo-it's a habit).

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That's one I would never have thought of. I didn't even know babies could be out of alignment. I wonder if my insurance would cover it, or if it would have to be out of pocket. Thanks for sharing the possibility (and that's not meant in a sarcastic way-I always have to clarify my tone for my 7yo-it's a habit).

 

Oh yeah, the birth process can put them out, particularly if forceps are used. Getting clonked over the head by their older siblings, that sort of stuff. Excessive vomiting can also be a chiropractic issue. My daughter only vomited when her neck was out, so it was a clear sign for me. My boy chucked anyway, even when his neck was aligned. It's nice when they grow out of stuff like that, isn't it? :D

 

Rosie

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Thanks for the advice. I was planning on starting a diary for the baby so that I can communicate better with her dr. I also was thinking it would be helpful to get some video footage of what it looks like. I'm sorry you had such a hard tine getting your daughter a swallow study. If you don't mind sharing, did the study determine that your daughter was aapirating?

The swallow study did show that she was aspirating. She was 12mo for the first one. What we did was not feed her for several hours before the study. Our appointment was in radiology at a Children's Hospital that is very experienced with these. She was placed in a special chair like a car seat and I began feeding her barium mixed foods and liquids of different consistencies. An x-ray video camera was on one side of her and a TV screen on the other. They had it set up so they could see from her nose to her diaphram in a side view. As I began feeding her you could see how her tongue worked, and exactly where what we were feeding her went. There was not a doubt that it was going into her lungs. Sometimes when she coughed you could see the milk come back up out of her lungs and then go into her esophagus. I was shaking by the time the first one was over.

 

The whole process lasted maybe 30 minutes and most of that was spent with the speech therapist and radiologist making new mixtures to check thickness. I had results within an hour. For the next year we had to thicken all of Princess's liquids to a honey consistency so that she could control them with her tongue. Now we don't have to thicken at all.

 

I didn't like the baruim at first but within 24 hours she pooped it out. It looked like pink chalk sticks in her diaper.

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I had overactive letdown and it would produce similar results in my dc when they tried to nurse. What finally worked well for me was to only nurse on one side for a longer period of time (4-6 hours). So I'd nurse on one side for the morning, switch sides for the afternoon, switch again for evening, and once more for middle of the night.

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