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Infant vomiting continuously, has lot of gas and takes out milk when burps. Advised to give periset injection

DOCTOR OF THE MONTH - Feb 2013
Feb 2013
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Pediatrician
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Hi, my kid is 6 weeks and from last 5 days he is vomiting continuously..wether it is my feed or Nan 1 feed..he has lots of gas and everytime he burps he takes out milk..also..while sleeping I have noticed that whenever he tries to burp small amt of milk keep comin in mouth..I think it is indigestion and so we gave him gripe water but no help..we went to doc but he said its ok..my family doc has advised to give him periset injection(half ampule)..please help me what to do..waiting for ur reply..
Posted Tue, 18 Jun 2013 in Child Health
 
 
Answered by Dr. E Venkata Ramana 2 hours later
Hi,

Thank you for your query on Healthcare Magic.

It seems your child is having gastroesophageal reflex due to which he is having vomitings.

This is a common problem in early infancy and it decreases as the child grows.

Gastroesophageal reflux subsides in 80% of children by 6 months of age, another 10% by the age of 1 year.

Nothing to worry if the child is gaining appropriate weight, passing adequate urine, and thriving well.

If the vomitings are persistent, prokinetic drug like domperidone drops can be given in prescribed dose.

Give small quantity of milk feeds at frequent intervals.

After feeding, hold the child in upright position for 5-10 minutes followed by burping.

For gas problem oral drops like neopeptine will help to relieve the discomfort.

I advise you to give exclusive breastfeeding to the child till the age of 6 months.

If the vomitings are persistent, or child not gaining weight, hungry after vomitings, the pathological organic causes like pyloric stenosis and other metabolic problems should be investigated with your pediatrician advise.

Therefore at present I advise you to consult pediatrician for physical examination to assess the hydratio, weight gain, to look and evaluate for any abnormal signs of any organic problem, and for prescription of medication for vomitings.

Hope I have answered your query, if you have any clarification please let me know.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Infant vomiting continuously, has lot of gas and takes out milk when burps. Advised to give periset injection 1 hour later
Hi..thanks for the reply but from last 2 hrs my kid is not taking ors solution also and vomiting anything that is going in his mouth..I am really worried as doc is saying that his weight gain is good so no need but I am really worried as he is not taking anything and vomiting ors water also..plz advise..thank you
Also can I give him cow's milk instead of nan 1 feed..as I am not having good amount of feed and after taking my feed he still asks for more feed..is it ok to give him cow's milk or packaged milk..plz advice..
 
 
Answered by Dr. E Venkata Ramana 8 hours later
Hi,

Thank you for getting back.

If the vomitings are persistent like this, child needs medication to control the vomiting immediately.

Prokinetic and anti emetic drug like domperidone drops has to be given orally every 8th hourly in prescribed dose to stop the vomitings.

Continue to give sips of ORS like Pedialyte to maintain hydration and monitor his hydration status by activity, urine output, and moisture of oral cavity.

I advise you not to give cow's milk as it aggravates the problem and is associated with infections, allergy, and indigestion with colic.

If you don't have enough breast milk, continue to give Nan1. But you should take precautions in hygienic preparation, handling, and feeding of formula milk to baby.
Give formula milk feeds using a cup and spoon.

Avoid bottle feeding.

At present I advise you to consult the doctor as early as possible for the control of vomitings and to investigate for any other pathological causes for it.

Hope I have answered your query, if you have any clarification please let me know.

Wish your child a speedy recovery.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Infant vomiting continuously, has lot of gas and takes out milk when burps. Advised to give periset injection 6 hours later
Thanks doctor I also need to know how many times and how much feed should I give to my baby..
Also, one thing that I had noticed is now from today morning his vomiting is sticky in texture and looks like mucous but it has no smell..but he does not seem to have cough-cold..

Also, should v give the proper full and prescribed feed of Nan 1 or can v make a little thinner milk and give it to him so that it digests easily and he does not vomit..please give ur advice.

Thanks
 
 
Answered by Dr. E Venkata Ramana 32 minutes later
Hi,

Thank you for getting back.

Demand feeding is the best method of feeding an infant.

Demand feeding means whenever the child is hungry and cries for feeds, you should offer feeds.

This type of feeding encourages child involvement in feeds and gives a secured attachment.

On an average you can give 5 feeds per day and each feed consisting of 150ml.

But it ultimately depends on child hungry and satiety.

The sticky mucous content in his vomitus is due to the presence of secretions from the lining of mucosa.

Don't give diluted formula feeds as that will aggravate the reflux.

Reconstitute the formula feeds as per the instructions on the pack.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Infant vomiting continuously, has lot of gas and takes out milk when burps. Advised to give periset injection 10 minutes later
The sticky mucous content in his vomitus is due to the presence of secretions from the lining of mucosa.

Dear doc did not understand the above line..please explain what is it and do we need to do anything for it..I mean any medicine.

Also, as u have advised v are giving him neopeptine..please let me know the doses and for hw long can v give him neopeptine.

Thanks
 
 
Answered by Dr. E Venkata Ramana 18 minutes later
Hi,

Thank you for getting back.

The sticky content of vomiting is due to the swallowed mucus secretions from the inner lining layer of his food pipe and mouth.

No medicine is required for this.

Neopeptine drops will help the gas problem of the child.

It can be given 6 drops twice daily orally for 1 week to 10 days. If there is no excessive gas you can stop the drops.

Hope I have answered your query, if you have any clarification please let me know.

Wish your child good health.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Infant vomiting continuously, has lot of gas and takes out milk when burps. Advised to give periset injection 15 minutes later
Thank you doctor..one more thing..I have sharp pain in beast when I start feeding and it subsides after a minute or two..is it normal or there is some problem.

Thanks
 
 
Answered by Dr. E Venkata Ramana 8 minutes later
Hi,

Thank you for getting back.

Just pain in your breast at the start of feeding without any other problems like some discharge, ulcer, or any swelling are of little concern.

But look for any ulcer, crack in the skin, or any swelling.

Proper attachment of the child lips on the breast will prevent the pain from improper latching, so check for proper attachment.

If the pain is worsening consult your Gynecologist for examination and advise.

Hope I have answered your query and feel free to get back if you have any concerns.

Regards.
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Follow-up: Infant vomiting continuously, has lot of gas and takes out milk when burps. Advised to give periset injection 1 hour later
Hi doc, one more query..yesterday when I visited doc he gave vaccinations to my kid but someone said that if a kid has vomiting or loose motions then vaccinations are not given be given..is it true..and does his condition detoriated because of the vaccinations..waiting for your reply
 
 
Answered by Dr. E Venkata Ramana 50 minutes later
Hi XXXXXXX

Thank you for giving me opportunity to answer your queries.

Just having loose motions or vomitings is not a contraindication for vaccination.

Vaccination can be given in such mild illnesses.

Vaccination can be postponed if the child is having significant acute fever illness, because it is difficult to know the cause of fever in this instance.

Vaccination doesn't cause any deterioration in child health.

I don't think the vaccination is the cause of your child problem of vomitings.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Infant vomiting continuously, has lot of gas and takes out milk when burps. Advised to give periset injection 32 minutes later
Doc, I want to knw one thing..for last one month and a week..there was no problem and suddenly one day he started vomiting and now he is not taking even water..there must be some reason as to why this hppened..also I would like to know for how long this will continue as he is not taking even 1/4th of food what he used to take before..this will have a very bad effect on his health..when can v start with his usual routine..and wether he will be able to get back his earlier apetite or not..also as a parent it is very distressing to see my child vomiting continuosly..so what should I do to prevent such problem again..and what should I do as he is not full with my feed and wants more..because just now I gave him just 1 ounce of Nan 1 and he vomitted all of that and was crying as he was hungry..plz reply..and thanks for clearing so many of my doubts..waiting for your reply..
 
 
Answered by Dr. E Venkata Ramana 2 hours later
Hi XXXXXXX

Thank you for getting back.

I do agree with your concern of his persistent vomitings leading to health effects on child like poor weight gain and other problems.

This type of persistent vomitings requires investigations to rule out any underlying pathological causes like intestinal obstruction and metabolic disorders apart from gastro esophageal reflux.

Idiopathic hypertrophic pyloric stenosis is a condition in which child will be healthy for first month of life, around the age of 4 to 6 weeks child develops persistent vomitings after each feed. After vomitings child becomes hungry and cries for feeds.

So I suggest you to rule out this condition after consulting and discussing with your pediatrician.

Ultrasound of the abdomen which is a simple and noninvasive investigation which will detect this problem.

Other causes of vomitings are metabolic disorders like inborn errors of metabolism, congenital adrenal hyperplasia which are rare causes.

That is the reason for my advise to consult the pediatrician for the examination of the child feeding pattern, and vomitings pattern, and to investigate with ultrasound abdomen followed by other blood investigations to rule out the metabolic causes.

And as he is having continuous vomitings at present, he needs some antiemetic drugs like domperidone to control them.

So my advise at present is to consult the pediatrician as early as possible for the assessment of the child hydration, to investigate for the pathological causes, and for the medication prescription for the vomitings.

Hope I have answered your query, if you have any clarification please let me know.

If you don't have any doubts you can close the discussion and I request you to kindly rate my answer to improve myself.

And I wish your child a speedy recovery and good health.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Infant vomiting continuously, has lot of gas and takes out milk when burps. Advised to give periset injection 26 hours later
Dear doc..have admitted my kid in hospital..all his blood and urine reports are normal but he is still vomiting..docs are saying that they will do ultrasound tomoro morning..what is the process after ultrasound..and if everything is ok in ultrasound then what is reason that he is vomiting so much..is there a possibility of stomach infection and shouls we give medication for stomach infection..should I ask my doc to gv antibiotics..plz suggest..
 
 
Answered by Dr. E Venkata Ramana 8 hours later
Hi XXXXXX

Thank you for getting back.

If metabolic problems ruled out by relevant blood and urine tests, and ultrasound abdomen is normal, the other problems looked for are gastroesophageal reflux, gastritis, and milk allergy.

You can discuss about your concerns of stomach infection with your pediatrician.

At present, the mainstay of treatment is to control the vomitings with medication, to maintain hydration and nutrition with intravenous fluids, and to investigate for the causes for persistent vomitinga and the definitive treatment.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
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