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Premature Baby Spitting Feed, Vomiting, Loose Stools. Is It Ok For Child To Vomit Constantly?
Question: Hi all,
My child is premature born in 31 weeks. I got him home at 36 weeks at the weight of 1.8 kg (his birth weight). From the last 4-5 days, he is spitting his feed (from 20% to almost full) almost after every feed. He keeps having constant vomiting sensation too. His stool frequency is almost after every meal, sometimes loose, sometimes paste like. My doc has given Perinorm, Ferronia XT (bcoz he has low Hb level), vitamin drops, and Bonnisan (Himalya Drugs). I wanted to ask is it ok for my child to have constant vomitings? if not, please guide me about his medicines and how to reduce his vomits.
Also, can we give him soothers if he cries constantly. Please also suggest if medicines can be changed for reflux, if any.
Thanks a lot
My child is premature born in 31 weeks. I got him home at 36 weeks at the weight of 1.8 kg (his birth weight). From the last 4-5 days, he is spitting his feed (from 20% to almost full) almost after every feed. He keeps having constant vomiting sensation too. His stool frequency is almost after every meal, sometimes loose, sometimes paste like. My doc has given Perinorm, Ferronia XT (bcoz he has low Hb level), vitamin drops, and Bonnisan (Himalya Drugs). I wanted to ask is it ok for my child to have constant vomitings? if not, please guide me about his medicines and how to reduce his vomits.
Also, can we give him soothers if he cries constantly. Please also suggest if medicines can be changed for reflux, if any.
Thanks a lot
Dear XXXXXXX,
Thank you for your query.
I congratulate you on the successful arrival at your home of a preterm baby.
I think that the vomiting could be a physiological weakness of the valve at the lower end of the food-pipe. While Perinorm is a good drug, it can cause some very unpleasant side-effects. If I were to be the treating doctor, I would prefer to switch over to oral Domperidone (Baby Domstal drops) - about 2-3 drops of it may be given 10-15 minutes before his feeding time, at least 3-4 times a day. I wish you to discuss about this with your pediatrician and may change the medication under his/her supervision.
You may continue the iron drops, but there is no need to give him vitamin drops and Bonnisan. Bonnisan may be causing the increased stools in him.
Passing one pasty or slightly watery stool after EVERY FEED can be a normal thing as long as he is putting on at least 20-25 grams of weight per day (i.e. about 150-200 grams per week). I wouldn't worry about his stools. Neither would I be concerned about his vomiting as long as he is getting the aforementioned weight gain.
If there is poor thriving (he is not putting on weight), you might want to speak to his pediatrician about a further work-up, such as a radio-active milk scan or a barium swallow study. The milk scan, if available, is safer and more accurate in picking up the abnormal valvular competence I mentioned in my earlier paragraph. However, there is no call to do it immediately. One must see the next 2-3 months' weight gain trend before worrying about this - unless he does not put on any weight or unless he LOSES weight in the coming month.
One additional recommendation and then I am done: please ask the pediatrician to start Vitamin D drops or oil if it isn’t yet started. This is a fairly new recommendation from the American Academy of Pediatrics, as there is evidence that supplementing the right quantity of Vitamin D is protective to the baby against many infections; in short, it improves the immunity of the baby.
Hope I have helped with you good and useful information. Please accept this answer if you do not have any other queries. I will be glad to address any of your doubts which you may have though.
With warm regards,
Dr. Taher Kagalwala
Thank you for your query.
I congratulate you on the successful arrival at your home of a preterm baby.
I think that the vomiting could be a physiological weakness of the valve at the lower end of the food-pipe. While Perinorm is a good drug, it can cause some very unpleasant side-effects. If I were to be the treating doctor, I would prefer to switch over to oral Domperidone (Baby Domstal drops) - about 2-3 drops of it may be given 10-15 minutes before his feeding time, at least 3-4 times a day. I wish you to discuss about this with your pediatrician and may change the medication under his/her supervision.
You may continue the iron drops, but there is no need to give him vitamin drops and Bonnisan. Bonnisan may be causing the increased stools in him.
Passing one pasty or slightly watery stool after EVERY FEED can be a normal thing as long as he is putting on at least 20-25 grams of weight per day (i.e. about 150-200 grams per week). I wouldn't worry about his stools. Neither would I be concerned about his vomiting as long as he is getting the aforementioned weight gain.
If there is poor thriving (he is not putting on weight), you might want to speak to his pediatrician about a further work-up, such as a radio-active milk scan or a barium swallow study. The milk scan, if available, is safer and more accurate in picking up the abnormal valvular competence I mentioned in my earlier paragraph. However, there is no call to do it immediately. One must see the next 2-3 months' weight gain trend before worrying about this - unless he does not put on any weight or unless he LOSES weight in the coming month.
One additional recommendation and then I am done: please ask the pediatrician to start Vitamin D drops or oil if it isn’t yet started. This is a fairly new recommendation from the American Academy of Pediatrics, as there is evidence that supplementing the right quantity of Vitamin D is protective to the baby against many infections; in short, it improves the immunity of the baby.
Hope I have helped with you good and useful information. Please accept this answer if you do not have any other queries. I will be glad to address any of your doubts which you may have though.
With warm regards,
Dr. Taher Kagalwala
Above answer was peer-reviewed by :
Dr. Prasad
Thanks for your answer, sir!
I have some other questions as below:
1. Our doc has also prescribed Nestle Pre Nan. Is it ok to five my child this formula milk 3-4 times a day? He is almost 39 weeks now.
2. He is 2.4 kg now. We got him home about 2.5 wks ago. Is the weight gain appropriate?
3. Is is ok to use soothers if he cries a lot.
4. Doc has also prescribed Ostocalcium+Vitamin D and B12 syrup twice daily.
5. Also, could you please educate me about the humanized milk (one doc told me about this fpr my baby at NICU).
I have some other questions as below:
1. Our doc has also prescribed Nestle Pre Nan. Is it ok to five my child this formula milk 3-4 times a day? He is almost 39 weeks now.
2. He is 2.4 kg now. We got him home about 2.5 wks ago. Is the weight gain appropriate?
3. Is is ok to use soothers if he cries a lot.
4. Doc has also prescribed Ostocalcium+Vitamin D and B12 syrup twice daily.
5. Also, could you please educate me about the humanized milk (one doc told me about this fpr my baby at NICU).
Dear XXXXXXX,
Nestle pre-nan is a good formula for a preemie, and you can use it for at least another few months. Humanising milk means removing the fat, adding sugar, and using this for feeding the baby ... this is usually done with cow's or buffalo's milk ... but I would not recommend this for now. You should continue with Pre-Nan for the time being.
Use of soothers is generally not recommended in India as we have a very germ-filled environment. However, if you take proper sterile precautions, it may actually be beneficial as it helps the baby's development of mental processes as well as helps to mature the gut.
You may continue with the Ostocalcium syrup. No problems.
His weight gain is 600 grams in 20 days, which is very good, as it adds up to about 30 grams per day.
Take care,
Dr Taher Kagalwala
Nestle pre-nan is a good formula for a preemie, and you can use it for at least another few months. Humanising milk means removing the fat, adding sugar, and using this for feeding the baby ... this is usually done with cow's or buffalo's milk ... but I would not recommend this for now. You should continue with Pre-Nan for the time being.
Use of soothers is generally not recommended in India as we have a very germ-filled environment. However, if you take proper sterile precautions, it may actually be beneficial as it helps the baby's development of mental processes as well as helps to mature the gut.
You may continue with the Ostocalcium syrup. No problems.
His weight gain is 600 grams in 20 days, which is very good, as it adds up to about 30 grams per day.
Take care,
Dr Taher Kagalwala
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Yogesh D
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