MedicMom Posted July 19, 2015 Share Posted July 19, 2015 I'm not one to worry about much, but I've never had a preemie before. It is hot here today(93 at last check) with some serious humidity. The baby has projectile vomited everything today within minutes of eating. He is just a little over 6 pounds and would be 40 weeks gestation now, so we are at term. He is physically and developmentally a tiny newborn. When do I start worrying about dehydration? I am keeping him cool but he is more lethargic than normal. He still wants to nurse but is vomiting it up shortly after or during. He is not over feeding. We go to a small family practice where there is no on call. His ped is a family friend who I happen to know is on the lake today without a cell phone. She likely would just say to use my discretion as far as taking him to an emergency room anyway, especially as we are trying to expose him to as few germs as possible. Quote Link to comment Share on other sites More sharing options...
73349 Posted July 19, 2015 Share Posted July 19, 2015 Are you still getting wet diapers? If output decreases, I would definitely take him in, or if he has a fever. That is very teeny to be handling illness. 2 Quote Link to comment Share on other sites More sharing options...
MedicMom Posted July 19, 2015 Author Share Posted July 19, 2015 No fever but his output has slowed. Only one wet diaper this morning and he usually soaks one every two hours. That's what triggered my dehydration concerns: Quote Link to comment Share on other sites More sharing options...
AnnE-girl Posted July 19, 2015 Share Posted July 19, 2015 Since he's a premie, I would probably take him in to be safe. 5 Quote Link to comment Share on other sites More sharing options...
Ethel Mertz Posted July 19, 2015 Share Posted July 19, 2015 I'd probably err on the side of taking him in too. Our ER takes newborns in immediately and maybe yours will too - especially if you state he's a preemie. Quote Link to comment Share on other sites More sharing options...
Ottakee Posted July 19, 2015 Share Posted July 19, 2015 I would err too and take him in. Pyloric stenosis can develop about that age as well. 3 Quote Link to comment Share on other sites More sharing options...
texasmama Posted July 19, 2015 Share Posted July 19, 2015 I don't disagree with taking him in, but you can nurse him just a little and see if he can keep that down rather than an entire feeding. I did this with one of my babies who had RSV at the age of six weeks. He vomited every full feeding but could keep down a bit at a time. Quote Link to comment Share on other sites More sharing options...
MercyA Posted July 19, 2015 Share Posted July 19, 2015 Pyloric stenosis can develop about that age as well. That was my first thought, too, but hopefully he just has a virus. I'd probably take him in. :grouphug: 1 Quote Link to comment Share on other sites More sharing options...
MistyMountain Posted July 19, 2015 Share Posted July 19, 2015 I would take him in since he is a newborn and was a preemie. I would try smaller feelings too to see if that helps. 1 Quote Link to comment Share on other sites More sharing options...
purpleowl Posted July 19, 2015 Share Posted July 19, 2015 Pyloric stenosis would be my concern as well, as little as he is. If other family members have been vomiting as well, I'd assume virus, but if that's not happening, then I'd take him in. For dehydration, the signs I've always looked for are wet diapers (none in 6-8 hours is a bad sign) and lack of tears when crying. You can also feel inside his mouth to see if it's wet like it should be. A couple of months ago when I took my DS to the ER because I thought he might be dehydrated, the doctor pushed on his fingernails to see if the color would return quickly - if it doesn't, that can indicate dehydration. But I don't know if that one is applicable to tiny babies or not (DS would have been about 13 months at the time, I think). Quote Link to comment Share on other sites More sharing options...
Paige Posted July 19, 2015 Share Posted July 19, 2015 I had 2 preemies and they both had very bad reflux. They're 11 now and we still give them meds or they'll literally spit up; thankfully not projectile anymore. Reflux is common in preemies. If he is still having wet diapers, his skin pinches well, and he still has tears when he cries, then I wouldn't worry about dehydration. One of my babies didn't have tears until she was about 5months old. I don't remember if she was one of the preemies or my other DD, so I wouldn't rely solely on tearing unless you recall that he's shown the ability to produce tears in the past. I'd just nurse him as much as possible and expect the puke. If you push for meds, you may want to ask about something more effective than zantac. My girls were spitting up around the clock every 5 minutes or less before we got them on meds. (I actually timed it). With the meds, they were puking maybe every 10-15 min around the clock- but they were more comfortable and the volume decreased. 2 Quote Link to comment Share on other sites More sharing options...
BlessedMom Posted July 19, 2015 Share Posted July 19, 2015 I too would err on the side of caution and take him to emergency. Quote Link to comment Share on other sites More sharing options...
MedicMom Posted July 19, 2015 Author Share Posted July 19, 2015 Nobody else is vomiting. He hasn't had bad reflux but my other kids had it and this seems different. He is also extremely fussy, but as I said it's very hot and humid here, so I thought maybe the heat was just bugging him. I am going to take him into the ED tonight at shift change if he's not better. I've already talked to the ED doc coming on about my dehydration concerns. He's not quite dehydrated yet but it can come on so quickly with these tiny ones. 2 Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted July 19, 2015 Share Posted July 19, 2015 You've got good instincts. Zofran & prevacid solutabs were my best friends during those early preemie weeks. 2 Quote Link to comment Share on other sites More sharing options...
Ewe Mama Posted July 20, 2015 Share Posted July 20, 2015 I'm glad you're taking him in. Our hugs and prayers go with you. Please let us know how he's doing. :grouphug: Quote Link to comment Share on other sites More sharing options...
RKWAcademy Posted July 20, 2015 Share Posted July 20, 2015 Could still be reflux. My preemies had terrible reflux for a year. But they were diagnosed and put on meds before they were discharged from the hospital. Your little guy went home much earlier than mine (born at 28 weeks, discharged at 40 and 41 weeks corrected). One of mine threw up like you are describing for the better part of the entire first year. We can look back and laugh about it now but it made for a stressful year. If this is new, I might take him in. But exposing a preemie to the germs that lurk in the ER might make me hesitate, too. Hard call. Glad you're taking him to be certain. Quote Link to comment Share on other sites More sharing options...
athomeontheprairie Posted July 20, 2015 Share Posted July 20, 2015 Hugs. I read many responses, and I'll just throw this out there, if it helps, great. If not, leave it.. Are you nursing? My oldest dd was allergic to my milk. If I ate pork, or had ANY diary projectile vomiting ensued. Figuring out the causes was a little difficult but once I stopped consuming those foods (for nearly 15 months) it stopped. 1 Quote Link to comment Share on other sites More sharing options...
Ellie Posted July 20, 2015 Share Posted July 20, 2015 I'm not one to worry about much, but I've never had a preemie before. It is hot here today(93 at last check) with some serious humidity. The baby has projectile vomited everything today within minutes of eating. He is just a little over 6 pounds and would be 40 weeks gestation now, so we are at term. He is physically and developmentally a tiny newborn. When do I start worrying about dehydration? I am keeping him cool but he is more lethargic than normal. He still wants to nurse but is vomiting it up shortly after or during. He is not over feeding. We go to a small family practice where there is no on call. His ped is a family friend who I happen to know is on the lake today without a cell phone. She likely would just say to use my discretion as far as taking him to an emergency room anyway, especially as we are trying to expose him to as few germs as possible. :grouphug: :grouphug: :grouphug: Take a bath with him. When y'all are finished, just put a diaper on him, and if possible, lie down with him and nurse. It is possible that he is reacting to something you have eaten. Dairy is the most likely. The tiniest bit of dairy in your diet can cause him to vomit. You could try eliminating dairy, but be aware that it can take upwards of a month for dairy to be completely out of your system (and his), so give it a whole month. 1 Quote Link to comment Share on other sites More sharing options...
zoobie Posted July 20, 2015 Share Posted July 20, 2015 I hope he's improving. :grouphug: I also wonder about an intolerance to something in your diet. I had to eliminate many things with my last nursling. The boards at infantreflux.org were very, very helpful to me in researching. She wasn't refluxing really; she was vomiting out intolerances. Once I eliminated them, the spit up stopped. 1 Quote Link to comment Share on other sites More sharing options...
Lolly Posted July 20, 2015 Share Posted July 20, 2015 Hope things are better. On the reflux idea...babies with mild reflux often will start projectile vomiting when things are a little off (virus/possibly high heat). You may find that he only projectile vomits when he is ill in some other way. The rest of the time, he may just spit up a lot. Quote Link to comment Share on other sites More sharing options...
Ottakee Posted July 22, 2015 Share Posted July 22, 2015 Any updates? 1 Quote Link to comment Share on other sites More sharing options...
Tammyla Posted July 22, 2015 Share Posted July 22, 2015 Air conditioner? You mention the heat and humidity as possibly getting to him. If you don't have AC, consider finding a place with one and see if he improves. In such a little one, I'd er on the side of caution. Hope the little guy is doing better this morning. Quote Link to comment Share on other sites More sharing options...
MedicMom Posted July 22, 2015 Author Share Posted July 22, 2015 Sorry. I took him to the ER and it would be over an hour wait for a room. It wasn't a triage issue; just that no rooms were open. I wasn't willing to sit in the Petri dish of a waiting room for that long with my six pound ex preemie so I just came home. He seems to be better. We have a/C throughout the house it was just struggling to keep up. But he hasn't been throwing up since then so hopefully it was just a passing thing. 3 Quote Link to comment Share on other sites More sharing options...
Ottakee Posted July 22, 2015 Share Posted July 22, 2015 Glad to hear he is better. Quote Link to comment Share on other sites More sharing options...
trulycrabby Posted July 22, 2015 Share Posted July 22, 2015 I am glad he is feeling better. Thanks for the update! Quote Link to comment Share on other sites More sharing options...
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