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Child turning blue when crying, passing gas, given Colicaid. Chest X-ray showed enlarged heart size. Should we get second opinion?

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My son has recently turned 50 days. he sometime cries inconsolably during night for last 1-2 week. he folds her legs on tummy and passes lot of gas as well and every such episode makes her cry in daytime as well. Earlier he had stool frequency of 5-6 times a day till 3weeks.since 1-2 week he is passing stools 1-2 times a day, may be that too creates lot of gas. Some time it felt that some cough is stacked in his chest while he breath. we showed him to a pediatrician who advised following medicines:
Colimex, Emeset, Colicaid & some nasal drop

Post this he felt some comfort, after one week we stopped medication. However, whenever he shows such symptoms we use to give 2-3 drop of Colicaid - twice a day.
My wife breast feed him but the amount is not sufficient for him. So we use to feed Lactogen milk 2-3 times a day and rest breast feed.
Moreover, someone suggested to my wife & she started cow milk to feed him. (since 2-3 week)
Couple of days back we faced an critical situation, when it seems like that he was feeling hard to breath. His body turned bluish, he started crying, we immediately approach the nearest Pediatrician and get checked him. he checked and asked for chest x-ray.
When he analyzed the x-ray, he told us his doubt about bit large size of heart and suggested us to visit Specialist immediately. We were too horrified since something XXXXXXX was mangling the mind.
Finally, we visited the Specialist Pediatrician-- He diagnosed with emergency condition by putting him on oxygen and other oral intake. he get some cough out from his chest and diagnosed with other medicine. He prescribe us following medicines.

Calshine P, Ziprax 100, Fevago

Also, he get various test done, blood (TLC, DLC, Hemoglobin, ESR, HCT ) as well as urine test but rejected the x-ray claim made by earlier doctor. I requested him but he even rejected the requirement of ECG or ECO test. He told us this cause due to overdose of medicine and feeding with cow milk.

Now my fear is regarding x-ray issue, it seems like it was heart defect (as i heard) the earlier doctor talking about. Because, while he feed he tries very hard, it seems like he is putting extra effort during feeding (mother feeding) Do i need to bother and go for second opinion and other regress tests or it does not require? Are these symptoms of heart defect?
Posted Fri, 21 Sep 2012 in Child Health
 
 
Answered by Dr. Santosh Kondekar 19 hours later
TDear XXXXXXX
I have reviewd this case as per your description… the painful symptoms in past were related to infantile colic which will respond to the therapy adviced and will not last beyond few months.
The blueness on crying you described is likely to be related to one of two things … first is breathholding spell in which child will hold breath on crying and then he will turn blue… in this case no xray needed… the second case is a cyanotic spell in which child will cry and turn blue but breathing is faster… in this case there is likely hood of heart disease XXXXXXX that may need x XXXXXXX or echo. If the situation is due to faulty feeding… child may also be coughing a lot.
I hope this answers your query and if any further issues… get back to me.
Thanks
Above answer was peer-reviewed by
 
Follow-up: Child turning blue when crying, passing gas, given Colicaid. Chest X-ray showed enlarged heart size. Should we get second opinion? 2 days later
Thanks Dr. XXXXXXX for reply!

However, I was anticipating your cross questioning to make out root cause & for replying effective answer. (May be, I was able to present case effectively or you have just responded based on assumption!)

You can understand my worries; despite of getting him diagnosed with a Pediatrician (Dr. XXXXXXX Rastogi, MD-Paed. @ Meerut) I am still feeling uncertain about him. My worries are that my child might not have a serious medical disorder. (Tentatively as told by you ‘cyanotic spell’) This is only because the obscure doubt XXXXXXX in earlier X-ray. While, I wish this should not be the case, but doubt still persist.

Therefore, I have couple of quires related to the same, please resound in-line.

•     Usually, he folds her legs on tummy and passes lot of gas. Is it usual or we can somehow help him?
•     Currently, he is passing stools 1-2 times a day only. Is it okay or we needed to take some diagnosis?
•     This is the second time; he got infection since birth (about 1.5 month). Is it usual in case of infant and what precautions we can take to avoid the situation?
•     While mother feed, he seems to put extra effort and get exhausted. Is there any specific cause for the same? As I told earlier, since my wife begins breastfeeding to him, she isn't producing enough milk which resulting dependency on powder milk. Is it affecting something?
•     Currently he weighed 4.5 Kg, though he is about to complete 2 month. Is it normal?
•     Can you please suggest about specific colic-management techniques.
•     Could you please tell me some major symptoms arise in case of ‘cyanotic spell’?
•     What type of preventative measure, we should consider to keep his infection at bay.

Last but not the least; I am grateful in advance for your comprehensive response on above quires.

Best regards,
XXXXXXX
91-0000



 
 
Answered by Dr. Santosh Kondekar 50 minutes later
Hi XXXXXXX
Thanks for complements but my preciseness wouldnot have been possible without your detailed query. Here are the answers to.fresh questions.
1.passing gas with raising or folding legs is normal… more so with formulafed babies. You may help the infant by patting on his back gently but what works best is colimex df drops… often may be needed intermittently for weeks.
2. Crying excess but consolable is a part of normal infantile colic.
3. Having two motions a day.is normal… even motions with feeds id normal at this age.
4.infections with fever upto 6…8 times is normal in first year of life but two in first two months is unusual. Every fever or every loose motion neednot be an infection. Bottle feeding has high risk of infections. Infection is best prevented by handwashing and avoiding crowded places and visitors.
5.putting extra efforts and exhaustion while feeding is often seen with some heart diseases… so is forehead sweating… large heart size in infants can be normal. Getting an echo done may benefit.co
Colics are normal but best treated with meds. Cyanotic spells has to have blue lips and limpness.
Weight of child is normal. Infection control already explain.
Feel free to ask further…
Thanks
Above answer was peer-reviewed by
 
Follow-up: Child turning blue when crying, passing gas, given Colicaid. Chest X-ray showed enlarged heart size. Should we get second opinion? 2 days later
Thanks much Dr. XXXXXXX for reply!

1) Earlier, i forgot to upload his discharge summary and test report. Now i have uploaded the the, please review the same as well.

2) Second, since discharge from hospital, he seems fine but nearly all nights since 25th Aug 2012 ( The day he was discharged), The body's temperature fluctuates throughout the day. Mostly, during day time he remains normal. However, typically the body's temperature is highest at night and in the evening hours. Sometime it flown to 99.4 F. Please tell me if it normal during current situation related to infection and current medicine perception advised in enough.

3) Moreover, i don't have much knowledge of medical terms Please help me understand the discharge summary as well.

4) Last but not the least, would you like to suggest some way to increase breast milk quantity. As i told you earlier, my wife isn't producing enough milk which resulting dependency on powder milk.
She' having Nestle 'Baby and Me' and daily 2-3 glass of milk.

Actually, currently my wife is at her home where desirable medical facilities are not available. Available Dr are of average facility. Nearest, Dr where he was admitted earlier is about 80 KM away. That is why, i am keeping update on everything and getting advice of specialist like you.

Hoping, i didn't bothered you much. Please share your input on above quires as well.

Best regards,
AAAAA
 
 
Answered by Dr. Santosh Kondekar 15 hours later
Hi there again
I appreciate your queries but getting to much into medical jargon will make u confused than well understood as half knowledge is always XXXXXXX Medical knowledge is half studied half researched and less understood and practiced depending on the perceived problem and the experience of a given doctor in given community and environment settings.. by trial and error.
trust your doctor, they are always for your good.
The reports you provided are normal.reports are not done t5o confirm a problem but to rule out any obvious serious issue. reports are often normal and its good to have reports normal, tests are not available for each and every condition.

here are the explanations of your fresh questions:

1) Earlier, i forgot to upload his discharge summary and test report. Now i have uploaded the the, please review the same as well.
============ they just mean that child had some minor issues, treated with precautionary medicines and discharge on persistent request. Doctors suspected it to be a viral illness. which cant be proven easily.,. as is most common. reports can be considered as normal for time being... to call any report abnormal we may need further follow up of case.

2) Second, since discharge from hospital, he seems fine but nearly all nights since 25th Aug 2012 ( The day he was discharged), The body's temperature fluctuates throughout the day.
====== children often have warmth in body.. but if child is comfortable we need not worry much. newborns are often kept wrapped that can cause some rise in peripheral temperature even changing with time.

Mostly, during day time he remains normal. However, typically the body's temperature is highest at night and in the evening hours. Sometime it flown to 99.4 F. Please tell me if it normal during current situation related to infection and current medicine perception advised in enough.
=== currently the child needs wait and watch. 99.4 is fever, though mild; needs to be reseen with treating doctor if affects feeding or doesnt settle after antibiotic course. often such fevers may be due to tight/warm clothings and if it settles in 30 minutes keeping child open, may be thats what is needed.

3) Moreover, i don't have much knowledge of medical terms Please help me understand the discharge summary as well.
=== please ask specific words or phrases not understood. I discourage getting into medical jargon,you may google for it.. but since you are paying me i can explain them for sure with caution.

4) Last but not the least, would you like to suggest some way to increase breast milk quantity. As i told you earlier, my wife isn't producing enough milk which resulting dependency on powder milk.
She' having Nestle 'Baby and Me' and daily 2-3 glass of milk.
==== best way to increase milk is keep baby close to breast more often and for longer periods.... this causes rise in milk production after a week of such practice..if the baby has good weight gain with breast feeding , it means you have false perception that milk is not enough. it is very common as a good weight baby will empty breast very fast. stopping formula feeds or powder milk helps increase breast milk in 7 days.
most of my patients do not need medicines for milk if they practice above. if any medicines, they need to be judged after examination of breast, baby, feeding pattern and weights.

Actually, currently my wife is at her home where desirable medical facilities are not available.
==== the mothers who delivered 3 decades back.. situation would have been worse.


Available Dr are of average facility.
=== acumen of doctor and need to understand care is more important than facility.

Nearest, Dr where he was admitted earlier is about 80 KM away. That is why, i am keeping update on everything and getting advice of specialist like you.
=== thanks a lot .. i do understand your difficulty in accessing a doctor... but i suppose currently you dont have any choice.... sometimes being very close to a doctor/clinic too can create multiple issues.


I am sure you wont hesitate asking further question,. Please do so, Thank you,
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