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Child with aspiration pneumonia with regurgitation

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Dear Sir,

My son master Arham born on 09/09/2013 is 54 days of age as on 02/11/2013. He was born by caesarian operation, and was hale and hearty on birth. After first feed, he showed problem of supposedly aspirational pneumonia. Following the same he was kept on C-PAP for 2 days in NICU unit of child care hospital. He was given 7 days course of antibiotics (Ambikacin and Meropenem). When discharged he when he showed significant sign of improvement.

Now for the past 1 month, he spills off milk whatever he has drank from his mother. He is been exclusively breast-feeding from his mother. Quantity of spill off is huge few time in the day (frequency of which is 2~3 times in a day) and small quantity spill of 20~30 times in the day following being fed.

His weight statistics is as follows:
On birth: 3.300 kg; 20/09/2013: 3.12 Kg, 29/09/2013: 3.500kg; 02/10/2013: 3.700kg, 17/10/2013: 4.300kg; 24/10/2013: 4.550kg and 01/11/2013: 4.640 kg. His length and head circumference as measured in the hospital also shows significant increment. I.e. 20/09/2013: length: 49 cm and head circumference: 34 cm and on 24/10/2013: length: 54 cm and head circumference: 37cm.
He does motion regularly and urinate properly and frequently. He plays and has normal growth status.

He has been vaccinated on time for: BCG, OPV, HB, DPT-1, OPV-1, HB (2), Hib (1), Rotarix (1), and pneumococcal (1).Child care specialist suggested Neocarmin drops (0.5 ml) when required for his colic. He says since his weight, activity, motion are normal, nothing needs to be done for his vomiting problem.

My questions are:
1. Is it normal to vomit so frequently and in such quantity?
2. If it is normal, please tell us point of panic?
3. If not what needs to done?

Arun Sipani
Father of Arham Sipani

Category: Pediatrician

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Category: ICU/ Critical Care Specialist
Dr. Saptharishi L G is online now

Expert:  Dr. Saptharishi L G replied 4 Days.

Dear Parent,

Thank your for your query at DoctorSpring.com.

It must be quite distressing to witness your baby regurgitating multiple times in a day. Based on the provided description, which were indeed very useful, it appears that your child has PATHOLOGICAL REGURGITATION.

We routinely advise parents to burp their babies after feeding them. This practice helps remove the air that the infant accidentally swallows while trying to gulp down the milk.

In the case of your child, the fact that your baby is gaining weight adequately and growing well is definitely reassuring. Yet, a baby regurgitation feeds 20-30 times a day sounds abnormal. The fact that your baby has had an episode of 'aspiration pneumonia' is definitely worrisome (if that was the actual diagnosis). So whenever GER (gastro-esophageal reflux disease) leads to aspiration, it is known as GERD ( Gastro-esophageal Reflux Disease) and has to be evaluated and treated.

Firstly, I would request you to burp your baby routinely after every feed; for at least 10 minutes each time. If the problem persists, request your paediatrician for GER Technitium scan or equivalent test available near you. It is necessary to evaluate any child who is having such prominent regurgitation.

I hope that I have addressed your queries.

Saptharishi L G

Dr. Saptharishi L G
Category: ICU/ Critical Care Specialist
Senior Residency: DM,  Pediatric Critical Care, PGIMER

Residency: MD, Pediatrics, Postgraduate Medical Education & Research (PGIMER), Chandigarh, 2013

Internship: JIPMER, 2009

Medical School: MBBS, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, 2008
Dr. Saptharishi L G and 4 other Medical Specialists are ready to help you

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