Baby cant Burp, any ideas why?

  1. My sister had a baby girl on tuesday and she has been having some breathing troubles. She became cyanotic on Tuesday night and went to the nicu for evaluation, apparently everything went ok and she is now at home with baby,however my sister states the baby seems to be "choking" for lack of a better word. She is gurgling after eating and she is having a difficult time burping and spitting up and seems to be gasping for air at times. Ive not actually seen the infant so this is just her description. When she called the Dr. he told her the baby probably has an underdeveloped sucking reflex and didnt seem alarmed or want to even see the baby. Has anyone had experience with this sort of problem?
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  2. 11 Comments

  3. by   mattsmom81
    I'm not a pedi nurse so I can't speak to medical aspects, only as a mother....and I would be concerned too from what you describe. Tell your sister she needs to bring the baby to the office, perhaps demonstrate what she is seeing, and have her concerns directly addressed by somebody...if there is nothing seriously wrong she needs reassurance, support and education from the nurse or doctor. This diagnoses and how to manage it should have been explained at the hospital prior to discharge... perhaps it was but she is not understanding. Suggest she write her questions down and hand them to the doctor or nurse if they have a tendency to leave the room too quickly.....I've used this for patients in the hospital too.

    When my kiddos were small, my pediatrician' s nurse was a godsend ...she helped me immensely in this dept...was actually more help to me than the doc as she could relate easier. Encourage your sis to get this addressed...be calmly persistent so she understands and can cope.

    Perhaps someone here from pedi/NICU background will address this here, but it is difficult on a forum like this.

    Best wishes.
  4. by   purplemania
    good advice. What if she aspirates? What if she has does choke? Generally, I have told mom's (of babies with GERD or pyloric stenosis) to keep baby upright about 20 min after feeding. But they have to be watched carefully, because the head is heavy and it is easy to lose the airway. I would INSIST that the baby be checked at a time when she is due to feed. Hold the feeding if necessary in order to have the MD observe her. And I would review basic CPR with the parents, or put the instructions on her fridge. Poor mom, I bet she is quite anxious.
  5. by   leslie :-D
    was this baby a premie? as others have stated and i reiterate, this baby needs to be seen. if the baby does not want to feed, then do not force it because that will increase the chances of aspirating. please have the mother insist for her infant to be seen. good luck.

    leslie
  6. by   SmilingBluEyes
    I agree w/the others. Tell her to get the baby to a pediatrician asap. This IS NOT NORMAL and aspiration is a real possibility. Let us know how she does?
  7. by   BittyBabyGrower
    First, that baby needs to be seen in person and not diagnosed over the phone...she could be refluxing terribly or have something else more serious. If she can't get in the office, she needs to tell them she is going to the ER and then find another doc.
  8. by   Auds
    Thank you all for the advice. I agree with you all and wanted to validate my own opinion (still being in Nursing school). I will let you know the outcome as soon as I hear back from her. (We live in separate states).
  9. by   Angela Mac
    Colic, SIDS, real concerns......you can always get a second opinion
  10. by   VickyRN
    Sounds like CLASSIC acyanotic heart defect (VSD, ASD, PDA, COA) symptoms to me. Symptoms are always respiratory and having difficulty while feeding (becoming cyanotic, spitting, choking, gasping, etc) is a CLASSIC symptom. Needs to be evaluated ASAP! Insist on being seen NOW and an echocardiogram done.
  11. by   SCRN1
    I would insist on being seen and would probably go to another pediatrician because I'm sure I would've lost confidence in this one because of making me feel like they were brushing my concern off.

    It could be nothing more than the baby already having an air bubble in the tummy or esophagus and the vomiting is caused because of the formula sitting on top of that when it pops. But, unless baby is examined, we won't know for sure.

    Has your friend tried burping the baby before feeding and about every 1/2-1 ounce? The easiest way I could get my preemie baby (and many others since) was to hold baby in an upright position on my shoulder while patting upward on their bottom. If that didn't work, I'd place them on the tummy across my lap and pat their bottoms.
  12. by   kids
    This sounds more like a bad case of reflux to me rather than a heart defect (isolated cyanotic episode rather than recurrent & worsening occuring both during and independant of feedings).

    Baby needs to be seen ASAP and it is best to try and schedule so the Doc can see the baby feed and what happens afterward. Tell mom to be pushy, I have never encountered a Peds office that would blow you off if you demand to have your child seen...is a huge liability issue.

    In the mean time...
    How much is she spitting up, small amounts or what appears to be nearly the entire feed?
    Is the spitting happening only in the hour or so after eating or does it happen "all the time" regardless of the last time she ate?
    How many wet diapers is she having per day?
    Is she stooling at least daily?
    Does baby appear distressed or unfomfortable when at rest?
    How is she sleeping?
    Is baby breast fed or bottle? (If she is bottle fed make sure mom is using a newborn nipple. Now days many manufacturers make nipples for different ages, if she is not usng a newborn nipple the baby is getting too much too fast.)

    Keep baby semi-upright during feedings and for 15-20 minutes after, a bouncy (turned off) or car seat are a good angle, be sure to supported her head & body to keep her from scrunching down.
    After that try putting baby on her tummy on a firm surface with her head turned to the side for 10-15 minutes, someone has to be with and watching her at all times on her tummy (a lot of the reflux babies I have worked with will burp on their own when on their tummy, also helps prevent aspiration). If she still hasn't burped hold her upright against your chest and pat firmly (but not hard) and rhythmically in the space just below the shoulder blades. Be sure the baby's head is in a neutral position or with her chin slightly up so the airway & esophagus are well open.

    She should probably be propped on her side to sleep.
    "Back to sleep" is statisticly safest in relation to SIDS but can increase the risk of aspiration in some babies. Side sleeping is an acceptable alternitive for airway protecton.
  13. by   hock1
    My nephew, now age 14, can't burb either. If I remember correctly, it has something to do with his cardiac sphyncter. All this has ment for him is that the gass has to come out the other end.

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