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Is it ok for my child to constantly vomit? Born premature. Formula milk ok?

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My child is premature born in 31 weeks. I got him home at 36 weeks at the weight of 1.95 kg 3 wks ago (his birth weight was 1.8 kg). now his weight is 2.4 kg approx. 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 and not able to sleep on bed. 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.

Our doc has also prescribed Nestle Pre Nan. Is it ok to give my child this formula milk 3-4 times a day? He is almost 39 weeks now.
Is is ok to use soothers if he cries a lot.
Doc has also prescribed Ostocalcium+Vitamin D and B12 syrup twice daily.
Posted Tue, 17 Apr 2012 in Child Health
Answered by Dr. Santosh Kondekar 3 hours later

Thanks for posting your query.

Let me first tell you some normal things that happen with premature babies. They are low in weight and they are at risk of low temperature and low sugar apart from feeding issues. Your baby has been gaining weight adequately as per records, this means whatever vomits the baby is having has not caused any problems yet. Earliest finding will be not gaining weight, which on an average should be at least 20 gm gain per day.
Infants do pass motion with each feed, that is called normal gastrocolic reflex.
Also, premature babies have low hemoglobin, often related to low erythropoetin hormone than iron. So apart form iron tonics, your baby may need evaluation for erythropoetin levels in blood. Iron should be withheld if loose motions are present.

Some form of vomiting called possetting, is normal in infants in early months. Such vomits usually won't cause weight loss and won't be more than 5 times a day, Also only occasionally they may be in large quantity to cause malnutrition. Such vomits are usually curdish and follow 30 minutes after feeds.
The other type of vomits that may not be normal are;
1. Reflux disease: Though reflux is normal to great extent in infants, vomiting related to reflux will be 4-5 times or more per day and may cause low weight gain over a month. It may have acidity associated. Acidity alone may cause vomit and can at times be related to some specific formula feeds, changing form one to other may help at times.
2. Gut obstructions: Commoner being so called pyloric stenosis, easily diagnosed by sonography, there are many other types, though not that common.
3. Throat problems: Throat infections, fungal infections, infections caused by bottle, and at times cough may cause repeated vomits.
4. Many others including common conditions like over feeding, infections of gut, malabsorption syndromes, etc .
You may need a stool malabsorption study and stool culture, as vomiting here is also associated with pasty stools.
Given above information, I may conclude to call it most probably related to reflux and accordingly further management has been started by your doctor. If no response, doctors may plan investigations according to causes mentioned above.
Its surely not ok to have vomiting that is not normal or causing low weight gain.

You may withheld calcium and vitamin supplements till vomiting issue is resolved.
you may use formula feeds if it is advised by a doctor, but remember mothers milk is best for baby till 6 months of age.
Soothers are ok with crying, provided you don't get them contaminated, which itself may introduce infection. Infants commonly cry for hunger, pain, constipation, colic and nose block.
I hope this answers your query to fullest, if so, Please accept the answer.

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