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Thoughts on spitting up


 
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thadlo
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PostPosted: May 12 2010, 8:41 PM    Post subject:
Thoughts on spitting up
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Sienna was not much of a spitter when she was little. However the last few months it seems to be getting out of hand. She spits up a bit right after a bottle, or an hr. later. She will spit up food colored stuff too even an hr or so after eating. She is fed oatmeal mixed with either a fruit or veggie twice a day plus her bottles which are breastmilk and formula. She is also on nutrivene, DHA, and probiotics. She takes prilosec for reflux. She is NOT on the nutrivene enzyme cause I've read it can make some babies spit up more.
Now she doesn't show signs of serious reflux - she sleeps ok most nights - once in a while she'll cough or fuss. She doesn't arch or cry when eating, she isn't terribly fussy. I thought maybe it was a dairy thing so I cut out dairy in my diet and she is on the similac formula for lactose intolerant babies.
I don't know if her spitting up like this is normal - I've never had a spitter. She'll spit up nutrivene colored stuff hrs after consuming it. It doesn't matter if she's sitting or laying down or how much time has passed between meals.
Any suggestions? Is this normal?

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Momtoseven
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PostPosted: May 12 2010, 9:45 PM    Post subject:
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Is she spitting up a lot or just a little? I was thinking maybe she is just burping more with a variety of different foods being introduced. Mark is definitely spitting up more now that we have introduced foods. Sometimes it is a little(with a burp) and sometimes a lot - more like vomiting than spitting up or burping. Also as Mark has gotten older he has needed more reflux meds. Sorry I don't have more to offer. After two years of vomiting at least once every day I have been unable to figure out why and am now hoping that he will eventually outgrow it. Rolling Eyes

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AliMama
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PostPosted: May 12 2010, 11:19 PM    Post subject:
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We had a LOT of spitting for quite a while. It seems to have improved since we switched reflux meds--from Zantac to Prevacid. She still spits up after bottles, especially if she hasn't burped well. She occasionally has small amounts of vomit after eating a lot, too.

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TheBradyBunch
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PostPosted: May 13 2010, 12:22 AM    Post subject:
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The only real symptom Noah had of reflux was spitting up, when the ENT looked down his throat though he said that he had a very irritated throat from reflux...

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Tigger
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PostPosted: May 13 2010, 4:00 AM    Post subject:
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Talitha has reflux and even now she is 4 goes through stages of spitting up. I haven't identified anything specific that causes her to spit up. She is also lactose intolerant and I give her lacteeze (a lactase enzyme supplement) if she has anything with dairy in it.

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earlyam
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PostPosted: May 13 2010, 5:00 AM    Post subject:
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Just before Ethan turned one he used to spit up loads after feeds. For Ethan though it was related to his constant congestion. After every bf and sometimes after solids he would spit up almost immediately or within half an hour! He's quite congested at the moment so we're seeing some episodes of Ethan being sick after his meals again.......I'd forgotten how fustrating (and messy!) it can be.......he always seems to spit up 10 minutes after I've got him dressed or when he's out in the stroller.......I'll have to remember to take more changes of clothes and lots of baby wipes out with me again Rolling Eyes

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grantsmom1
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PostPosted: May 13 2010, 3:58 PM    Post subject:
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Grant is 3 and still has reflux, although it has improved over time. We did try to keep him upright, and tilt his bed or use a pillow, but I'm not sure that helped. Sounds like it doesn't work for Sienna. No diet adjustments helped us (or were recommended by his dr). The only thing we do now which probably won't help you out yet, is that we try to give him food with his drinks. He is more likely to spit up if he has a glass of water, than if he has a drink with food. We also used to thicken his bottles/drinks. Some people use rice cereal, but we used Simply Thick. I've heard it helps with reflux, but we had to use it because he aspirated. We're still frustrated with it, but very glad it has improved. We do like earlyam said, and pack extra clothes/ burp clothes. I think it is pretty common w/ DS, even in my local area... something to do with low muscle tone and the muscle devoloping? I know I didn't help much, but you're not alone!

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lespring
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PostPosted: May 13 2010, 4:25 PM    Post subject:
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Well, "spitting up" and "reflux" are the same thing. So, if she's spitting up, she's refluxing.

Most kids who have visible reflux (in other words, you're seeing them spitting up) are usually also having episodes of silent reflux. That means it's either only coming part way up the esophagus (which tells you what grade their reflux is) or they're swallowing it back down.

Silent reflux is more damaging the visible reflux, because the esophagus gets a double exposure of acid, once going up and then going back down.

Like someone else mentioned, it might be time to have her reflux meds adjusted or changed.

Some kids with reflux have lots of problems with sinus infections because the stomach contents get splashed up into the sinus cavity (Angela has this problem) and the same with ear infections. The eustachian tube drains into the throat, and refluxed stomach contents can get pushed up into the eustachian tube. When Angela got her first set of ear tubes she had refluxed material coming out of her ears! YUCK!

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Grady's Mommy
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PostPosted: May 13 2010, 6:11 PM    Post subject:
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Grady will be 6 in a couple weeks and still spits up occassionally. I finally took him to a GI doc about 2 years ago and they ordered an upper GI. Came back normal. Still happening, so I took him back again to a different Dr.

Nothing stood out to this Dr. as concerning. He's not in pain, it's not often, he's not constipated, it doesn't happen with certain foods, etc. etc. He ordered another Celiac Test (had one at 2yo) and it came back normal.

Now we're on to a full abdominal u/s to make sure there's nothing wrong with his organs that could be causing it.

Next step, if we choose, is an endscopy or a stomach emptying study.

**The few times Grady has actually thrown up, when sick, he has thrown up very UNdigested food. Like entire bites of hot dog. HOURS (like 5 hours) after lunch. I mentioned this to the Dr. and he said no big deal, not uncommon.

**My uneducated, mothers' instinct opinion is that his sphincter muscle from his stomach to his esophogus is weak (low muscle tone) and this is just going to happen. Dr. says I could be right. If we can't find anything wrong during testing, we may just let it go and accept it. It only happens every few weeks or even months.

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grantsmom1
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PostPosted: May 13 2010, 8:15 PM    Post subject:
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Kathy - I am not an expert by any means, but Grant never seemed to be in any pain. His first GI said that was a reason that it wasn't acidic. When he was closer to 2, we took him to a 2nd GI dr and did an endoscopy. It showed the acid was actually irritating his esophogus, and recommended Prevacid. It doesn't reduce the amount of spit up, but would reduce the damage from the acid. I don't know if Grant had a higher pain tolerance, or if he was just used to it, but it was surprising to his drs. Sounds like Grady's is very infrequent, so my guess is it would not be causing damage or irritation unless he was refluxing where he didn't spit it out, like Leah described. Our Grant is like Angela... Reflux, sinus infections, always feeding off each other!

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thadlo
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PostPosted: May 13 2010, 8:16 PM    Post subject:
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Thanks everyone for your thoughts. Sienna's bottles are already thickened with Simply Thick. It wouldn't be so bothersome except that she spits up so much longer after she ate. I would expect it when she's finished and burps but this happens an hr. or 2 later. I guess I'll call the Dr. and see if we can try another medication.

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maggiebeth25
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PostPosted: May 13 2010, 8:28 PM    Post subject:
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how long has she been on the similac? when rachel started the similac sensitive RS she spit up (her prevacid dose was also taken down-we brought it up again) and she would spit up over an hour and a half after she had last ate. it was the weirdest thing. since we upped her meds again, it really hasn't happened.

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lespring
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PostPosted: May 13 2010, 9:19 PM    Post subject:
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Kathy, I don't understand why they haven't already done a scintiscan on Grady. An upper GI series only RARELY Shows reflux. It's such a short test, they have to just happen to reflux during the time the test is done.

The scintiscan takes an hour or more, and takes a picture every 3 seconds for the duration of the test. You can also see reflux on it. When Angela had her first scintiscan done, she only visibly refluxed 2 or 3 times, but the test showed 75 episodes of GRADE 3 reflux! That means she refluxed every time her stomach contracted. And yes, she emptied very slow! Your stomach should be empty within 20-30 minutes after finishing a meal. Angela's was still completely full one hour after finishing.

So, when she had her nissen done, she also had a partial pylorotomy (separating the plyoris, which is the muscle that controls how fast the stomach empties.) She has emptied at a slightly slower rate than typical, but it's at least tollerable, unlike before.

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mom to Rob 26, Noah 25, Tyler 23, Bryon 23, Angela 16 (DS), Axel 12 (DS, adopted from Serbia 12/2012, AAI w/fusion) Asher 7 (DS adopted from Serbia 12/2011, AAI non-fusion)
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MommyAngela
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PostPosted: May 14 2010, 10:15 AM    Post subject:
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How soon after introducing solids did the spitup begin?
Benjamin never really spit up very much (just normal newborn/infant amount) the first several months of his life when he was only fed breastmilk.
After he recovered from OHS and turned six months old, we started him on solids. A little at a time.
It seemed that as we increased his solids, his spitup became worse.
The thing that concerned me the most was what you described--that he would spit up 1-2 hours after eating. It just wasn't consistent with reflux. Plus it was strange that he would suddenly develop reflux at 6-7 months after never having it.
Another thing he did was that it was painful for him to bend at the waist. He would always want to be stiff as a board.
Anyway, we described it all to his doctor (who is wonderful) and she sent us to get an upper GI with a small bowel follow-through.
It showed that he had a duodenal webbing in his intestines. It had gotten worse over time, and though breastmilk was mostly able to get through the pinhole opening, the solids just weren't.
He had surgery the next week to repair it.

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Mom to three wonderful sons:
Andrew James--3/24/06
Benjamin Matthew--4/24/08 DS--VSD & ASD repaired 10/3/08, intestinal obstruction repaired 1/13/09, hypospadias & ventral hernia repaired 8/21/09
Thomas Alexander--3/25/10

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thadlo
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PostPosted: May 14 2010, 8:54 PM    Post subject:
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Maggie, she has been on the similac sensitive RS for maybe a month? Not real long.
Angela, the way it started for Benjamin sounds like it does for Sienna. Except that she never appears to be in pain.
It just seems like there are 2 ways of going - one way is meds may or may not help and eventually they'll outgrow it although its a mess of laundry and carpet. The other is to be more aggressive and investigate more, try different meds, find a better result. How do you know which is appropriate for your case?

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MommyAngela
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PostPosted: May 15 2010, 12:19 AM    Post subject:
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For us, we never would have known it was anything beyond spitting up if we hadn't pushed for an upper GI w/a small bowel followthrough. Our guys tend to have more intestinal issues than the average babies, so our pediatrician wasn't hesitant to do so.

I just wanted to point out that Benjamin was never in pain when he spit up. Those two things were not happening at the same time. His pain was from the location (I assume) of his obstruction. I do not think there has to be pain like that if there is an obstruction; I think his was just situated right there where it was painful for him when he tried to sit up straight.

I hope you figure things out--it is one thing when our kids have medical/physical issues that we can manage b/c we have the tools we need. It's a far other frustration/difficulty when they're having troubles and we can't figure out what is causing them or how to help them.

Just keep looking for solutions and I'm sure you'll find something soon that works!

Your pictures are just precious, by the way!!

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Mom to three wonderful sons:
Andrew James--3/24/06
Benjamin Matthew--4/24/08 DS--VSD & ASD repaired 10/3/08, intestinal obstruction repaired 1/13/09, hypospadias & ventral hernia repaired 8/21/09
Thomas Alexander--3/25/10

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lespring
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PostPosted: May 15 2010, 8:55 AM    Post subject:
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I agree, Angela was never in pain either. In fact, she achalasia, which is supposed to be excruciatingly painful and she never complains about it. I think it's conditioning. Both with reflux and achalasia, she was always like this so to her the pain is normal. Most typical kids do show pain from reflux, because the acid burns! Our kids just tend to have a really high pain threshold (Angela's neurosurgeon at Mayo says it's because they're missing pain receptors) and very often don't show pain.

Because Angela's reflux was often projectile, she was also tested for duodenal webbing like Angela's Benjamin. Renee's Kennedy had duodenal webbing as well. Fortunately for Angela she didn't have that problem, she just had a host of other stuff!

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My mom's blog
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And don't forget to visit MINE!
http://itsmylifemom.blogspot.com/

mom to Rob 26, Noah 25, Tyler 23, Bryon 23, Angela 16 (DS), Axel 12 (DS, adopted from Serbia 12/2012, AAI w/fusion) Asher 7 (DS adopted from Serbia 12/2011, AAI non-fusion)
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maggiebeth25
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PostPosted: May 15 2010, 10:00 AM    Post subject:
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thadlo wrote:
Maggie, she has been on the similac sensitive RS for maybe a month? Not real long.
Angela, the way it started for Benjamin sounds like it does for Sienna. Except that she never appears to be in pain.
It just seems like there are 2 ways of going - one way is meds may or may not help and eventually they'll outgrow it although its a mess of laundry and carpet. The other is to be more aggressive and investigate more, try different meds, find a better result. How do you know which is appropriate for your case?


did she really start spitting up when you switched to that formula?

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and Charlie (8/12/11) MSPI
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thadlo
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PostPosted: May 15 2010, 8:24 PM    Post subject:
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No, I can't say that her spitting up has been worse since being on this formula. Can't say though that it has been better either.

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Lorene in MI
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