What Causes Vomiting And Breathing Difficulty In A Premature Baby?

Posted on Sat, 11 Jun 2016

Question: My brother's wife gave birth to a premature baby(33 weeks) on march 1st. The delivery was done through operation as according to the doctor the water around baby was not sufficient for the baby in the mother's womb. she was born with only 1100 gms. The doctors kept her in the nicu for about 15-20 days and released her after she gained about 150 gm. The doctors did all the blood tests scanning, reports are very normal. After keeping her for 10 days in only warm condition at our home baby was showing positive improvement. she was only given mother's food. Yesterday she started vomiting continuously and was having problem in breathing. We have admitted her to another hospital and they have again kept her in the nicu and stopped the breast feeding. They r keeping her only in the saline water and again took the blood samples. What to do? I am really confused. What would be the the best treatment for her??? she weighs 1350gms now.

Answered by Dr. Deepak Patel (1 hour later)

Brief Answer:
Probably septicemia or pneumonia due to aspiration

Detailed Answer:
Hi,
Welcome to HCM.
Can understand your concerns.

In premature babies with very low Birth weight there are more chances of getting infection. There are also increased chances of aspiration during vomiting.

Since the child has still very low Birth weight, it is better to admit the child. During admission, child is given fluids and intravenous antibiotics.

According to the current situation of your child, I think that this is the best treatment that he is getting. Blood samples needs to be taken at the time of admission to rule out infection.

You have to keep some patience.
Keep us updated with daily reports and medication so that we can help you in a better way.

I hope this will help you.
Wishing your child good health.
Take care.

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Deepak Patel (3 hours later)

Sir I have talked with the concerned doctor and he said that the child condition is stable. According to todays reports her haemoglobin is low 9. There is some infection on her blood also. Doctor said that there is nothing to worry and she must be in nicu until she weighs 2000 grams. Doctors have started giving antibiotics. He also advised for mother's milk in every 3 hrs. I hope the treatment is going on a positive way. We don't want to risk this time.

Answered by Dr. Deepak Patel (5 minutes later)

Brief Answer:
Treatment is correct.

Detailed Answer:
Hello and welcome once again to this forum.
Can understand your concerns.

I think that the treatment of your child is going in right direction. when the weight of child is very low, there are chances of infection.

And during infection, antibiotics needs to be given. When the weight increase above 2 kg, chances of infection becomes less.

I hope this will help you.
Take care.

Above answer was peer-reviewed by : Dr. Deepak

Follow up: Dr. Deepak Patel (45 hours later)

Thanks for answering,sir. Due to less heamoglobin doctor is saying for extra blood. He saying he will treat with antibiotics atleast for 10 days. On the first day he was saying only 5 days. Today hes saying fr extra 5 days. Please show me the right path.

Answered by Dr. Deepak Patel (5 minutes later)

Brief Answer:
10 days will be better

Detailed Answer:
Hi,

Since, child is very small, it takes more time for the infection to settle.
If all things improves, then only 5 days treatment can be given.
Since, blood is also low, it suggests that infection is more and child will need blood transfusion.
Considering all the facts, it will be better if treatment is given for 10 days.
Review with blood culture and crp levels report.

Take care.

Above answer was peer-reviewed by : Dr. Deepak

Follow up: Dr. Deepak Patel (25 hours later)

Hello sir, Yesterday child has some seizures problem. The doctor has again tested the haemoglobin and the haemoglobin is normal according to the doctor. There was some swelling on her face yesterday. Doctor is saying shes not responsive and now hes saying for brain scanning. I don't know where the treatment is going so we r deciding on shifting her tomorrow. THe infection on her blood is also decreased according to the doctor.

Answered by Dr. Deepak Patel (51 minutes later)

Brief Answer:
Brain Imaging should be done

Detailed Answer:
Hi,

If there is seizure than definitely situation is not good and child is not responding to the treatment.
Cause of seizure could be non responding infection, hypoglycemia, brain ischemia.
Brain Imaging is mandatory to see if there is any brain injury.
You should enquire about the cause of seizure from doctors.
If child is not responding to antibiotics then they should be upgraded according to blood culture report.

Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Patel (2 hours later)

The child was responding very well when she was here at home. After keeping her in that hospital everything is normal in the report. The only problem is that she is not responding well. Sir we are very much tensed and thinking of shifting her to another hospital.

Answered by Dr. Deepak Patel (1 hour later)

Brief Answer:
Shift to a better hospital

Detailed Answer:
Hi,

First of all, don’t be in tension. Tension will not help you in anyway.
If you feel that treatment is not correct or care of child is not upto mark, you should shift the child to a better hospital.
First, ask the doctor of current hospital to give a summary of treatment, investigations. Go and show the summary to other hospital doctor and then shift the baby.
Don't worry, everything will be allright.
Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Patel (49 minutes later)

I have uploaded some reports..please see and draw some conclusion

Answered by Dr. Deepak Patel (5 minutes later)

Brief Answer:
Infection or metabolic cause

Detailed Answer:
Hi,

I have seen the report that you have attached.
Crp and tlc count is raised which suggests infection. But Crp levels earlier were higher and now they are lower, suggest improvement but still it is raised.
Lactate and ammonia is also raised suggesting metabolic cause.
Cause of seizure could also be metabolic.
Further investigation is necessary.

Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Patel (12 days later)

Sir a bad news the baby is no more. She died on april 20 due to infection. Sir last sunday the baby was very critical. The doctor gave her 3 doses of bp on monday and she survived. Then after monday she was gradually improving. In between he gave her extra blood 1 packet and plasma 3 packets. She was improving according to the doctor till friday. The baby started showing positive symptoms. On saturday the baby was not urinating and again infection started. The doctor again gave her some medicines and extra blood on sunday. The baby condition got worse on monday and she developed some wounds near eyes and on the hands. We took her to the amri hospital XXXXXXX on monday. There the doctor really coperated well and he said the previous doctor did not use central line for the testing. I think the previous doctor been only experimenting on our baby. He is very renounced doctor in XXXXXXX We should have taken her to amri before. He did so many tests on her. He did blood gas,IM test,he took fluid form her spinal chord and many blood tests. How can a doctor do this??? Really dejected

Answered by Dr. Deepak Patel (39 minutes later)

Brief Answer:
Very difficult to comment upon

Detailed Answer:
Sir,
I am really sad for your demise.

Sir, it is very difficult to comment whether the tests that were done were necessary or not. It is the treating doctor who knows the actual condition.

For me it is very difficult to comment about it.

Take care.

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Above answer was peer-reviewed by : Dr. Yogesh D