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What Do Occasional Hiccups And Crying During Diaper Change Indicate?

Posted on Tue, 25 Aug 2015

Question: dear dr. XXXXXXX bhavsar,

thank you for your brief reply.
1. my son did not having any cough, or breathing difficulty. he often hiccup only.
2. he cries only need diaper change, hungry, and sleep.
3. he is 4 months old and weight 7.6kg. i think he gain weight a lot.

hope this will give you clue.
thank you.

Answered by Dr. Pradeep Kumar Jain (34 minutes later)

Brief Answer:
I won't get worried for such mild deformity

Detailed Answer:
Hello

I have gone through the details and images.
The deformity which is most likely due to floating rib does not cause any long term complication.
Occasional hiccup especially after feed is normal in this age.
Weight usually gets double by the age of 6 months.During first three months weight gain of 30 mg/kg/day is normal.So weight of 7.6 kg at this age is normal and you need not to worry for that.
Cry is normal if baby is hungry,when diaper is wet or before sleep.
Get chest X ray done for diagnosis of floating rib.
I won't get worried as baby is accepting feed well and gaining weight adequately.
I hope baby is getting vitamin D supplementation as per the recommendation of XXXXXXX academy of pediatrics.

Please let me know if you have any more doubts.
Wishing good health for your baby.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (26 minutes later)

dr. XXXXXXX XXXXXXX

have you seen those photos yet?

Answered by Dr. Pradeep Kumar Jain (22 minutes later)

Brief Answer:
Yes I have seen the images

Detailed Answer:
Yes sir
I have seen all the images and to me it appears to be due to floating rib.
Please get chest X ray done to confirm or rule out the same.
I won't get worried as baby is gaining weight properly,accepting feeds well without any breathing problem.
Please let me know about the Xray report.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (11 minutes later)

is it xray is harmful? he is 4 months old and i am afraid he is being exposed with radiation. how to cure floating ribs the safest way? thanks

Answered by Dr. Pradeep Kumar Jain (33 minutes later)

Brief Answer:
You can wait and observe

Detailed Answer:
Thanks for writing back

Yes, you are right.Chest Xray will cause radiation exposure.
You can wait as there is no associated problem.
There is no specific management for floating rib unless it causes pain due to some nerve compression.
So don't worry and observe the baby for growth or any other associated problem.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (4 hours later)

thank you for your reply. the things i worried the most is his grow will be effected. i am afraid that "tuck-in" rib cage will compress his lungs. i also afraid when he grows up his standing position not in balance, and his walking ability also effected. this is what i worried the most doctor. thank you.

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Development of lung usually takes place in utero

Detailed Answer:
Thanks for follow up

Maximum development of lung takes place in utero.
So if there is no respiratory problem till now it is unlikely in future also.
As seen in image,the deformity does not appear to be of severe variety.So it should not affect the growth.
Walking,standing usually depends on spine,hip and legs.Rib cage has little role in balancing.

I would suggest you to get him to an orthopedic surgeon for direct clinical examination and I think better you get an X ray done to alleviate your anxiety and to rule out other possible rib deformity.

If you have any doubt I shall be glad to help you out.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (2 hours later)

doctor, is that possible to cure floating rib by bringing out my son out in the morning and sunbathing? please advice any other solution to cure it. thank you.

Answered by Dr. Pradeep Kumar Jain (29 minutes later)

Brief Answer:
No morning sun bath won't help in cure of floating rib

Detailed Answer:
Morning sunbath helps in synthesis of vitamin D.aVitamin D is important for growth of bone but it won't help in cure of floating rib or other congenital abnormality of ribs.
So better consult an orthopedic surgeon.This may not need any treatment at all.Treatment may be needed for cosmetic purpose or if there is associated pain.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (25 hours later)

dear doctor,

my main concerns are
1. afraid his lungs being compressed and not fully develop
2. his walking ability and standing ability not in balance.
3. afraid his body organ effected by this floating rib cage.

when he grows up and only cosmetic procedure needed i do not mind.

thank you.

Answered by Dr. Pradeep Kumar Jain (14 minutes later)

Brief Answer:
I don't this mild deformity would lead to any severe complication

Detailed Answer:
After going through the images the deformity appears to be of mild variety.I don't think such mild deformity would lead to any severe complication like poor development of organs,lung hypoplasia or any abnormality related to posture or walking.
Again I would insist you to consult an orthopedic or plastic surgeon to assess the severity of condition and discuss all the queries to alleviate your anxiety.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar