Baby with severe reflux-consultation

[Rochelle Marsden]

I saw the child and mum yesterday. Mum has stopped all the baby's allopathic medicine after telling her doctor that she intended to. The doctor did not try to stop her!!!

The baby was asleep for a while but when he woke he was a happy little soul for 5 mins. Then his face screwed up and he started to sob in pain. He was wriggling and arching his back. He was > for being on his stomach but amazingly what appeared to stop the pain was me lifting him up in the air and down again continually which was hard on the arm muscles!!! Mum had not discovered this before. He also constantly clawed with his hands and Mum said he will grip on clothes she is wearing. He had no fear being carried by me and also went to the student who was in the clinic observing.

He is a hungry baby and I really wonder if it might help if he was started on food rather than 3 hourly bottles. By food I mean mashed avocado, banana- natural foods.

Mum was on injections of Fragmin(heparin) throughout the pregnancy because blood clots were found when she had pain in the womb and then in the chest when she had an inflammation of the cartilage around her lungs at 20 weeks and she was found to have Factor 5 Leiman. This means the blood is thicker and more susceptible to clotting. She has found that this is inherited.

His birth weight was 8lbs 8ozs and he was full term. Mum had along labour which ended with her having a epidural and the baby was posterior presentation. He was very contented and settled for 3 .5 weeks before this all started. When it started he was put onto Omniomilk - a thick formula which is meant to be easily digestible but it brought him out in a bad eczema on his face and in 3 days he stopped feeding. At the children's hospital he was taken to palpitation revealed something on the left side and a surgeon was called. The surgeon said it was nothing and despite the doctor calling him back for another feel he said the same. Now I could feel a swelling below the ribs on the left side where I (not a doctor) would imagine the spleen was. Anyhow the hospital put him back on the Cow and Gate formula and his face cleared up and he started feeding again. He was sent home after being given antibiotics by drip in case of an infection and testing his blood which revealed nothing.

Mum says that when he is bad he doesn't seem to like being held and seems to scream for when picked up. He has a red face when screaming and although his forehand feels hot his hands feel cold. The intermittent screaming stops after the last bottle whether that is given at 6 or 7 pm. He sleeps well on his tummy but these days one is warned against putting a baby in that position so he is laid propped up to sleep in a sleeping bag. During the course of the night he continually draws his knees up and wriggles to the other end of the cot, round the wrong way . He is moved back about 3 times during the night but sleeps until 7 am and wakes up happy. After 15 mins or so he whinges to tell mum he is hungry and then the cycle begins although it can take an hour or so after that first bottle before the pain begins. Sometimes - and I didn't see this he gulps and his face screws up as if something (acid?) has come up and he screams. He does not choke. He has a little bit of a cough during his sleep every couple of nights. Stool is fine- but more formed since the Gaviscon in the bottle. This has now been stopped. He had a better day according to mum yesterday after the no medication and a few drop doses of Dioscora 30 as soon as the screams started.

Next report will probably be on Wednesday after a paediatrician sees the baby as dad now wants to know if it definitely reflux or if there is an obstruction.

Comments as usual greatly appreciated.

[Dr. Joe Rozencwajg, NMD]

That palpated mass is worrying, could be an intussuception............
Dr. J. Rozencwajg, MD, PhD.
"The greatest enemy of any science is a closed mind"

[Rochelle Marsden]

Thanks Joe but not being a doctor I haven't a clue what this means. When I felt the swelling it didn't seem to bother the child. At least Mum can see the paediatrician armed with more information.

Regards
Rochelle

[Dr. Joe Rozencwajg, NMD]

Intussuception is the bowel rolling itself in, like when you roll a sock. It
can and does roll back on its own sometimes, so that there is no immediate
intestinal obstruction, but it can end in intestinal necrosis.
It should be considered because:
- a mass can be felt
- there is a temporal realtion with feeding: as soon as you feed, the
intestines increase their peristalsis, if there is an intussuception, the
pain starts when a few centimeters of gut have rolled in.

There can be other signs associated like "red jelly" (= blood) in the stool,
but it is not mandatory.

It would be a good precaution to have the parents mention this possibility
to the pediatrician, as it is often overlooked; barium enema is often at the
same time diagnostic and curative.
Dr. J. Rozencwajg, MD, PhD.
"The greatest enemy of any science is a closed mind"

[Rochelle Marsden]

Thank you so much for this and I will tell Mum to mention it. The only way it seems wrong is that after the last bottle at around 6-7pm the child goes to sleep and stays asleep until the next morning. But the other than that it certainly sounds plausible. Maybe the wriggling that the child does during sleep some how unrolls the sock. I have asked mum about his stool and there appears to be no problem with it. At least being off unnecessary medication won't do him any harm

Wow , how can a Barium enema be curative???

All the best
Rochelle

[Dr. Joe Rozencwajg, NMD]

When you do the barium enema, as soon as you recognise the image (pretty
clear indeed) you just continue to "unroll" the intestine by gently and
carefully increasing the pressure of the injected barium, until you are back
to a normal image.

As this pathology and the procedure causes local inflammation, there are
often some adhesions that are created around the area that maintain the gut
in place.
If it starts again, then you resort to surgery, either resecting part of the
gut if it is compromised or fixing it with a few stiches.

If the gut has necrosed and you are in a state of fecal peritonitis, you are
in deep trouble..........
Dr. J. Rozencwajg, MD, PhD.
"The greatest enemy of any science is a closed mind"

[Rochelle Marsden]

Again I really appreciate your clear explanation to a non doctor like me. At college I was ahead of the others at HBP because in my other life I taught Biology but I don't profess to be a doctor!! I shall phone Mum and explain all this. I want to speak to her before Wednesday when she sees the paediatrician because I want to assure myself that nothing is worse coming off the allopathic medication and check she is not giving the child too much Dioscora. I made up a liquid potency and told her to succuss before each dose and that if she has given 3 doses in fairly close succession and nothing has got any better then she is not to give more.

Rochelle

[Dr. Joe Rozencwajg, NMD]

One more thing, afterthought.......
When talking to the mother, please emphasize that if baby is getting worse,
stops pooping, has blood or red jelly from the anus or abdominal swelling,
to RUSH him to hospital without waiting.
Dr. J. Rozencwajg, MD, PhD.
"The greatest enemy of any science is a closed mind"

[Rochelle Marsden]

Thanks and don't worry Mum is not daft. She maybe only 23 but has a University degree in Early Years and is in charge of a baby unit at a local day nursery !! Baby has been not too bad today with no need of any Dioscora. She knows to phone me at anytime.

Rochelle