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Child delivered with grunting and birth asphyxia, now on tube feeding, no able to breast feed. What line of treatment to be done?

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Dear Doctor, My wife delivered a Baby boy on 10th May'12 in a hospital set up. It was a prolonged labour, baby was delivered normally and baby showed signs of grunting, birth asphyxia, he was shifted to NICU immediately. He was started with necessary treatment immediately. Till now he didn't show any signs of complications or compromised organs including brains, heart and kidney etc. According to the local pediatrician he has shown 100% recovery. Now the baby is on tube feeding in the NICU only, he is off all supports like C-PAP, ionotropes etc. and maintaining good heart rate, respiratory rate and O2 level since 15th May'12. However baby is still not able to take breast feeding on regular basis, he is sucking finger when tried by paediatrician, baby was given breast feeding on 15th, he takes breast feeding for three-four times a day and then on 5th feeding he gets tired. Hence doctor has again put him on tube feeding. Please suggest is what steps, line of treatment to be taken. What signs to be watched for future to prevent any complications. Baby has good CATS.
Posted Tue, 5 Jun 2012 in Child Health
Answered by Dr. Santosh Kondekar 2 hours later
I would like to know weight, maturity that is expected date of delivery.
Premature or babies having sepsis or any probable affection of heart function like low hemoglobin or undetected heart disease that may be common reason for easy fatigue.
As the baby had probable birth asphyxia, its likely that there may be some sequalae of damage to brain.this may not be detectable now but needs early intervention therapy.
Many such issues can't be cured hundred percent but are modifiable.
I request you to check hemoglobin,sepsis status and any issue related to congenital heart defect.
I hope this answers your concern, reply back, with details. Thanks.
Above answer was peer-reviewed by
Follow-up: Child delivered with grunting and birth asphyxia, now on tube feeding, no able to breast feed. What line of treatment to be done? 47 minutes later
Dear Doctor,

The weight of baby at the birth was 2.8 kg, the baby was full term and delivered at 39 wks, two days after the EDD. There was no sepsis, the count was 14,000 when done on 14th May'12. The CBC done on 14th showed normal HB level. Doctor suspects the Probable pulmonary hypertension. The anomaly scan done in third trimester had not detected congenital heart disease. We are worried about the any long term complications, are there any tests that can be taken to detect the same and prevent/modify the same. If not tests, what signs we should keep a watch on in case to detect the probable issues.
Answered by Dr. Santosh Kondekar 38 minutes later
Dear XXXXXXX I donot really want to scare you but it all is multifactorial.
Heart,diseases are commonly missed on anomaly scan.
They do often get false diagnosed as asphyxia. If the child had normal neurology
Or normal sarnath score from birth, I would say its not pure asphyxia.
Neurological signs are earliest one to pick up and may manifest any time from birth
To 8 month age and there is a follow up program for such high riskbabies called
Early intervention therapy that can bring about change over years. What can be done right now
Is monitoring for feed intolerance and sepsis and also to confirm or rule out cardiac issue.
Also look for low tone , low calcium etc that may have feeding issues.
The tests may be needed repeatedly whenever dr finds the newborn sicker
And refusing feeds or feeding slower. Thanks. You may ask any further issues.
Above answer was peer-reviewed by
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