9 week old with possible GERD?

My daughter is scheduled for an upper GI next week. She has no problem with weight gain. We keep her upright after feedings, she is on a hypoallergenic formula that is thickened, she takes Prevacid, and she gets burped often. She will take no less than 4 oz at feedings.

She really doesn't spit up much, but out of nowhere she will start to gag and choke, and sometimes turn a bit red or bluish. It's really scary. The doctors up til this point have said it is reflux, but have done nothing for the gagging because she is a healthy weight. I can't be with her every second of the day and it really scares me that she will choke when I'm not with her. Any idea on what this could be if it is not GER or GERD?

If it is GERD then it is what it is. I am just looking for other explanations since my MD's seem to not take it seriously since she gains weight well.

Thickened feeds not only do not work to treat reflux, they increase the risks of aspiration. Like too many treatments they implemented it *then* started studying it. Thickened feeds make it appear the baby spits up less because the spit up doesn't make it all the way out of the mouth, but it still ends up in the esophagus causing pain, damage, and in some cases aspiration (food in the lungs) which can cause other problems.

Also thickened feeds stay in the stomach longer which gives them more chance to come back up. One of the primary rules of treating reflux in older children and adults is small meals of foods that leave the stomach quickly -the same is true of babies except the logic seems to have escaped the medical profession

The fact that that she is still gagging suggests that the GER is not being adequately treated OR something else is causing a problem.

They should have done some tests long before giving you prevacid. Specifically the Barium Swallow x-ray (fluoroscopy) to rule out other physical problems. Also scintography can help detect whether the food is staying in the stomach too long, in which case you may want to consider medications to treat that as well. A pH probe, while invasive, would be able to definitively tell you whether the gagging is related to periods of increased reflux.

http://askdrsears.com/html/10/t106004.as...
Are there any medical tests to see if my infant/child has GER?

The following are clues and tests that your baby has GER and how aggressively it should be treated:



http://www.llli.org/llleaderweb/LV/LVFeb...
Thickened feedings are suggested by many doctors. However, thickened feedings do not always work (Bailey et al 1987), can interfere with breastfeeding, and may increase the risk of food allergies. Some studies have shown that thickened feeds can have an adverse effect on growth in some babies and increase the risk of respiratory involvement (Orenstein et al 1992). Because thickened feeds remain in the stomach longer, they may actually cause more reflux. For these reasons, mothers should consider their options very carefully before deciding to use thickened feeds. If a mother does want to try this, she can use her expressed milk thickened with cereal and offer it with a spoon before regular feedings at the breast. Surgery on the LES is a rarely used treatment except in the most extreme and unresponsive cases.

Studies have shown that formula-fed babies are more likely to exhibit symptoms of GERD than are breastfed infants. Weaning from the breast should not be regarded as a good solution for GERD. Non-thriving babies should be evaluated for underlying illness. In most cases, GERD can be handled through proper breastfeeding management, positioning, mother鈥檚 diet, and education. When these steps do not bring about relief, more extensive testing and other treatment options may need to be explored.

http://www.medscape.com/viewarticle/4706...
Thickened Feeds

Thickening feeds with rice cereal (one tablespoon per 2 to 4 ounces of formula) is associated with a decrease in the number of vomiting episodes, but does not improve reflux index scores (Rudolph et al., 2001). Jiang, Ewigman, and Danis (2001) report that thickened formula may reduce the frequency of regurgitation and total volume of emesis. It may also reduce time spent crying and increase time spent sleeping.

Rice cereal used as a thickener increases the caloric density of formula and may cause constipation. Thickened formulas also require enlarged nipple holes to feed, potentially resulting in greater ingestion of air or formula, which can favor regurgitation. Because rice cereal- thickened feedings have 150% of the caloric density of un-thickened feedings, only 65% of the volume needs to be fed per meal; thereby decreasing gastric volume (Orenstein, 2001). In an infant who is solely breast-fed, it is not possible to thicken the feeds unless the mother uses a breast-pump and then feeds the infant, which can be tedious and less desirable.

sorry but that sounds like gerd to me RN and mom

Why are you feeding her hypoallergenic formula and Prevacid? Was this recommended by your doctor or midwife? Stop fussing, get your breasts out and feed the child naturally.
Why do americans have to look for problems in their children? Just get on with life and loving your children without sticking tags on them.