We came home from the hospital last night but not without a little drama first…
Tuesday night Ethan was a bit of a pain throughout the night… He kept vomiting up his meal and immediately acting like he was starving. I spent a good portion of the night nursing, burping, and cleaning up spit up. He’s always been quite a spitter, but it had progressed to projectile vomiting. I had to change clothes several times, but he pretty much stayed clean because it was spewing away from his body onto me. He was spitting up so much that he wasn’t making very wet diapers. He was still peeing, but not very much. And they were concerned that he wasn’t pooping very much or very often. On Wednesday morning, after watching him projectile all over me, the nurse practitioner decided that it was pretty serious, and ordered an upper GI study to be performed on Ethan. There was a possibility that his vomiting was due to pyloric stenosis, which is a thickening of the muscle that empties the stomach into the duodenum.
His doctor really doubted that pyloric stenosis was his issue, but they wanted to check to be sure because pyloric stenosis requires a surgery. The doctor said that he thought all the drainage, phelgm being coughed up from the lungs, and the breathing treatments were irritating Ethan’s stomach causing him to vomit so much. He also thought that Ethan was developing severe reflux and the upper GI might reveal that as well. He was already being given Zantac in the hospital because they thought he had reflux.
I doubted the reflux because his pneumograms performed in the NICU showed that he did not have reflux. And the Zantac didn’t seem to be helping him as he was still spitting up a lot with or without it. The doctor said that reflux can come and go, and that he was probably developing it. He said that we may have to switch Ethan to a formula for reflux and add rice cereal to help thicken it. Not what I wanted to hear… I don’t want him to be on formula.
anyway…. The Upper GI was really interesting. They told me not to feed him anymore that day and wait till he was starving to perform the test. He had to drink the barium drink, so they wanted to make sure he was hungry enough to take it even if it tasted bad. Well, he must have really liked it because he drank a LOT of it and didn’t complain at all. I watched the screen while they did the test. It was really interesting to see the mechanics of him sucking on the bottle and gulping down the liquid. It filled up his belly, then it started to empty into his intestines. That meant that he does not have pyloric stenosis. Amazingly, he DID NOT spit up a single drop of the barium drink. His test showed no signs of reflux either, although it is not a definitive test for reflux.
I waited around in his room for a while waiting to see if the doctor or anyone would come check on us and let us go home. Eventually I went to the nurses station to inquire. She said that the doctor didn’t write orders for us to go home, so we needed to stay the night. I asked her if we could go home even if he didn’t write the orders, and she said that yes we could, but insurance companies don’t like that and may not pay the bill. She offered to call the doctor and see if he would release us because she knew we were so ready to be out of the hospital. The doctor called back quickly and released us. He didn’t seem to be worried about the spit up and vomiting and sent Ethan home on his regular diet. No restrictions – just to continue his breathing treatments, follow up with his regular doc on Friday, and follow up with him in his office on Tuesday.
I did consult with the lactation department before we left to make sure that there wasn’t anything that I could be doing to make my milk acidic or disagreeable with Ethan. She reassured me that wasn’t the case, and gave me some pointers to help if he has reflux. She told me to nurse him as upright as possible, and every time he moved to take him off and burp him. Nurse him as long as he wants and as often as he wants, and burp him continuously throughout the meal. She also suggested that instead of bottle feeding him with rice cereal added, we could try feeding him a teaspoon of rice cereal by spoon before nursing him if we needed to thicken his meal. She said that if he does has reflux he should certainly continue to eat breastmilk because it is much less caustic than any of the formulas and would be the least irritating to Ethan’s stomach.
Soooo… after all that, we are back at home. Very tired today… Ethan is a bit confused about day time and night time again. He ate continuously from about 2 in the morning until about 4:30, same as he did the night before. Before getting sick, he would cluster feed in the late evening, and sleep well at night, waking only once to eat. I’m not sure how to get him back on that schedule, but I figure he will get it straightened out soon enough. The good thing about last night is that while he was spitting up last night, it was not nearly as much as the night before. Neither of us had to change clothes a single time, woo hooo.