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the eric update - day 89: a little nissen clarity. goodbye gassy barley, hello rice.

tonight we finally received some clarity from a nurse as to why the neonatologists and surgeons are so seriously considering eric to be a candidate for g-tube and nissen surgery, despite the fact that he seems to have stabilized and isn't showing any obvious signs of abnormal discomfort during feedings. his upper GI series showed that he he begins to reflux at around 10-15 cc's ( which isn't a lot when you consider that his entire feeding is 45 cc's ) and babies that begin to reflux at such low volumes get immediately put on the short list for being candidates for the surgery, since it's often their experience that babies who begin to reflux at such low volumes eventually need the surgery and procrastinating just leads to esophageal damage.

so, it looks like we may need to balance the doctor's recommendations against the growing number of negative opinions we've received from parents who have had children that have had the surgery. indeed, our nurse tonight who clarified why he was a candidate told us that she had three (!) children who had the surgery done and she wouldn't recommend it unless it was absolutely, positively necessary and all other options had been exhausted.

speaking of exhausing all options, while the barley we've been adding to eric's feedings has been working well to control his reflux by thickening the food and helping to keep it in his stomach, it seems to be giving his "gas". and when he grunts trying to relieve himself of the gassy feeling, he pushes the milk out of his stomach and through his nose, which is pretty much defeating the purpose. so we decided to replace the barley with pulverized rice on the hopes that it would be a little more gentle on his digestive system. apparently there was some debate amongst the nurses as to whether or not the pulverized rice would simply dissolve in the milk; some of the nurses thought that barley should only be used for breastmilk and rice for formula, but others thought that was nonsense. it's funny to see how much debate there can be over relatively simple things, little less the much bigger issues. in the end, the rice seemed to stay suspended in the breastmilk just as easily as the barley.

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10/01/2004 11:17:00 PM 2 comments


I was a bit surprised they started him with barley, as rice is supposed to be easier to digest (it's what I started my two children on, but they were late and huge, as opposed to early and small). The rice does seem to dissolve in the breastmilk, so you end up having to add more to acheive thickness.

By Anonymous Anonymous, at 8:45 AM  

I'm really surprised with the barley, too.

Even with breastmilk, the docs always recommended rice.

As for the GT/Nissen - they may put in the GT so that it's easier for him to relieve any pressure associated with gas....and possibly supplemental feeds. (Usually done if he ends up with any respiratory infections.)

While I can appreciate your concerns (you're such good parents! Yay!), the surgery isn't as bad as many would have you believe. Would I jump right in and say "do it! Just have it done!" withough urging you to consider other options? No. But neither would I discourage you if that's what the doctors feel is best.

Thinking good thoughts and sending prayers!

By Blogger Da Goddess, at 5:09 PM  

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