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Preborn child is vomiting continuously and not gaining weight. Underlying cause?

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Practicing since : 2005
Answered : 262 Questions
My little girl is still in hospital she was born October 2012 at 26 weeks..due date was 28th January..she's still on oxygen which she'll be coming home with,she has a major problem with vomiting..berum meals and xrays in Wishaw general and Yorkhill in Glasgow have revealed everything is fine...she's having between 4 - 7 moderate to large vomits a day...its not reflux and we really want her home..her milk is Similac and she's getting everything from gaviscon,domperidon,carabel...her milk is really thick...she's back on tube feeds which is still making her sick every 2 hourly...she was being suck fed.her milk was cow & gate nutriprem 2..but got changed to similac for her to gain weight...her weight is going up but now as much as doctor would like..right now she weighs just under 8 pounds when she was born she weighed 1 pounds 8 ozs
Posted Sun, 28 Apr 2013 in Child Health
Answered by Dr. Balaji Chinnasami 2 hours later
Thanks for your query to healthcare magic.
It concerns me that your baby girl is vomiting continuously & not gaining weight satisfactorily.

The most important cause for persistent vomiting is Gastro oesophageal reflux, I’m happy that your doctor has ruled that out by doing barium meals & X-ray. The treatment your baby has been receiving so far is appropriate. I just need few more information.

1. Have they ruled out infection (esp. fungal infection) recently? Because preterm on prolong hospitalization are prone to catch fungal infection & can result in failure to thrive (i.e. not gaining weight properly).

2. Has any screening (blood tests) for inborn errors of metabolism being done? Because this is considered another important cause for persistent vomiting.

3. Is your baby’s head circumference being monitored regularly? Because abnormal increase in head size also results in vomiting.
There are also multiple other causes of persistent vomiting, which I do feel your neonatologist will take care of.

Don’t worry, keep in regular follow-up with your neonatologist, Your baby will definitely improve. I’m happy to answer any further queries in this regard.

Take care,
Dr. Balaji Chinnasami, MD
Assistant Professor-Pediatrics.
Above answer was peer-reviewed by
Follow-up: Preborn child is vomiting continuously and not gaining weight. Underlying cause? 46 hours later
She has no infection,blood tests all good and head circumference is being monitored and is fine..from 1am til 7:30pm she wasn't sick..just little possits...had a small sick at7:30pm,if she was still being sick and her oxygen was at 0.5 which is what she'll be home on..can we take her home?...we're 3 mins away from hospital and I have a car and we can fill out her nappy changes,sickness and feeds and I can bring her to hospital everyday..can our doctor say no?can we take her without any problems?she is very bored in hospital and she would have us around all the time at home..which I think would be good for her..I would like your opinion as I'm going to say this to doctor myself and her mum aren't happy with her being longer in hospital when she could be with us at the house..she's in a small room in a big cot with 3 incubators in the room and no space to move as other parents visitors and nurses are always there.
Answered by Dr. Balaji Chinnasami 11 hours later
Hi dear,

Thanks for giving me more details about your baby. As long as your baby is not on any iv fluids or iv antibiotics you can request your neonatologist about taking her home. May be your doctor is waiting to change her from tube feeds to oral feeds. It needs expertise to give tube feeds. If tube feeds not given properly could result in aspiration into lungs due to tube misplacement. But there is no harm in discussing about time of discharge. If he needs few days more then may be you can wait. Till then you should be confident about providing complete baby care including tube feeds if needed. I am sure you are well trained by this time about taking care of your baby independently.

You are not wrong in discussing about getting your baby getting discharged and taking her home, but at the same time also consider his view point regarding the same.

If you have any other query I am happy to help you or else kindly close the query and rate it.

Take care.
Dr. Balaji Chinnasami MD
Assistant professor, Pediatrics
Above answer was peer-reviewed by
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