Preemies

Swallowing issues? Late Term preemie (long)

Title for mobile users: swallowing issues? Late term preemie (long) 

My girls were born via c/s at 36w. Elizabeth had some breathing issues and lower APGARS at birth,needed oxygen,and a bit of help w/ transitional breathing. She avoided NICU admission though. They also had some minor temp regulation and feeding issues.

Both girls came home taking 30ccs by bottle w/ preemie nipples.they are up to ~ 3oz every 3-4 hours now on a slow flow nipple.

Elizabeth has been having a very difficult time with feeds,particularly with swallowing. She does not follow an acceptable suck:swallow ratio. The majority of her feeds end up dribbling out and soaking burp cloths. We've noticed she has gotten very hoarsey sounding, will exhibit rapid breathing,often chokes and turns blue,makes gurgling sounds,takes 30+ mins for a feed,and sometimes will refuse a bottle.

She has MSPI and is on Neocate. She also has reflux and is being treated with Zantac. We go back to her pedi GI tomorrow for the swallow issues. I'm guessing they will be doing a study to see what's going on.

Just curious if anyone has experienced similar issues and what the outcome was. 

Re: Swallowing issues? Late Term preemie (long)

  • My son was born at 36 weeks via c/s with the same issues (though not as extreme as turning blue, etc).. He was in the NICU for 8.5 days...Sounds like your Elizabeth should be there...
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  • I'm sure you could have other issues going on with the turning blue, that sounds very concerning, but do you think her reflux is really being controlled by the Zantac? My son had a lot of those same issues, horse gurgly noises, slow to feed, refusing bottles, all related to his reflux. Is she vomiting, arching her back, grimicing at the bottle? My son (35 wks) responded well to Zantac but my friends kids (36 wks) both had better luck with Prevacid. Just a thought, though like I said, I might really be oversimplifying. Good luck!
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  • imagemrsbnlmel:
    I'm sure you could have other issues going on with the turning blue, that sounds very concerning, but do you think her reflux is really being controlled by the Zantac? My son had a lot of those same issues, horse gurgly noises, slow to feed, refusing bottles, all related to his reflux. Is she vomiting, arching her back, grimicing at the bottle? My son (35 wks) responded well to Zantac but my friends kids (36 wks) both had better luck with Prevacid. Just a thought, though like I said, I might really be oversimplifying. Good luck!

    DD1 had severe reflux (projectiled) and was hospitalized with some complications from it including FTT. She just outgrew the most of it around 12 months. She was on Prevacid and so unfortunately we have a good deal of experience with it and our GI. The twins are on Prevacid,not Zantac (my mistake up there). I really don't feel like most of these symptoms are the reflux unfortunately. The arching of the back has quit,as has the screaming with feeds when refluxing. Wish it was so simple though :/

    I definitely feel like there is a true swallowing problem. However the turning blue happens after a feed when she attempts to bring up a liquid and struggles,so that part could be reflux related. Hopefully we get some answers today as feeds have become very stressful for her and us and growth has been less than ideal.

    Thanks for the help ladies. 

  • Sounds like your daughter is aspirating.  My DD had tons of feeding issues, horrible reflux and had a delayed swallow.  Definitely request a swallow study.  The symptoms you are describing don't sound safe.  Also thickening my daughter's formula helped immensely. 
  • Our DS (35 weeker) had swallowing/feeding issues but he was kept in the NICU because of it. He also was on a ventilator for a bit, too, so that could have had something to do with it. He had a feeding tube for a little while because he couldn't get the sucking/swallowing down. 

    I'd call your pediatrician...it makes me a little nervous that she's turning blue.

    (ETA: Just saw you have an appt tomorrow. Hopefully you'll get some answers then!) 

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  • Late term preemies are known for having eating/feeding issues. Hope the GI can shed some light on what is going on, but you will probably be sent for a swallow study. They may also put in an NG tube as a precaution if she is aspirating as well.
  • As others have said, I would be concerned about the turning blue. When we first brought Adalyn home we had the same issues, but we had oxygen, a pulse ox, and apnea monitor. When she turns blue does it look like she is passing out? She could be bradying from the reflux. Definitely talk to the GI. I hope that your LO does better soon.
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