Gastroschisis/fussiness suggestions?

Specialties NICU

Published

Can anyone offer any magic tricks to calm chronic abdominal kids that cry all the time? I know that fussiness tends to come with the territory for a lot of these guys, but we currently have a ~65 day old gastroschisis kid that is about to drive the whole unit to drink. For the most part it's a frequent cry that ranges from mildly colicky to utterly frantic.

We've tried a few different things. Here are some of the things that seemed to work at least for a little bit, but there has been no lasting success with any of these:

** Lots of holding, rocking, burping, singing, the basics...

** Holding in the prone position across the nurse's lap

** Placing her in her vibrating bouncer seat

** Using our foot to rock the bouncer with a little bit of force

** Placing her in her car seat/stroller and letting her watch Dr. Seuss

** Tight swaddling with an extra blanket roll that encircles her head

** We're on Mylicon and Reglan

I know that there are more things that we've tried, but those are the ones that come to mind. Any additional suggestions?

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Specializes in ER, NICU, NSY and some other stuff.

Unfortunately that is the nature of those gut babies.

Does your unit have a swing. sometimes they like the swing better than the bouncy seat. You can also try a warm pack on her tummy.

Also make sure the parents understand these are high need babies before they go home. I suggest at least 2-3 nights of rooming in. I also tell them to utilize a good support system if they have one. I always feel these kiddos can be at increased risk for abuse.

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Specializes in Neonatal ICU (Cardiothoracic).

Wear her out with a head-to-toe bath as soon as you can each shift. Set up the illegal french fry lights, grab some J&J baby bath, and start scrubbing.

-Sometimes swaddling makes them more crazy...usually because they're sweaty and miserable.. it does depend on the baby.

-oral sucrose in moderation

Good luck! Sometimes these kids just can't be made comfortable.

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Specializes in NICU, PICU, educator.

Oh man, right now we have two of those little darlings! They were in the same room and we had to separate them as we all truly thought we were going insane!!!

All the above suggestions! We have child life come play with them also during the day, but during the evening and night...yikes! and they don't sleep long stretchs....that makes it twice as bad! I think they are just so dang crabby because their insides were jammed back in helter skelter....they can't be in there right,KWIM?

If someone could come up with a sure fire quieting cure you'd be a rich person!!!!!

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I really appreciate the suggestions so far. Near the end of the shift we thought about heat (er, our unit secretary thought of heat) but the baby had finally conked out and stayed out for the last two hours of the shift.

We thought of sucrose (also late in the shift) but it just seemed a little odd, I think just because we've connected it in our heads more with procedural pain. I'll definitely try to ask about that though.

Another idea was maybe dipping the pacifier in those little Enfamil bottles of 5% glucose that just sit on the shelves anyway, but I don't think that's sweet enough to do anything at all.

It's bath night tonight, so we'll see if we can make that work to our advantage.

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Specializes in NICU.

Great suggestions already, I can't think of anything else. Those are sometimes the most frustrating babies because you can't do ANYTHING to make them feel better :(

Someone needs to invent a "butt patter". Usually those babies would be quiet and content if you pat their butt all night .... and we all know we don't have time to do that for 12 hours!

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We get all the gastro kids in a 20 county region because our facility is the only one who does neo surgery.

We have a gastroschisis baby who is a month or so older than yours. We can't send her home because she isn't gaining weight (I think she cries and thrashes all her calories off) and she isn't taking all of her feeds PO. Her mom brought in a Baby Bjorn carrier, and someone on staff tries to carry her around in that and it works wonders. She is our reigning unit Princess, we bought her a crown and took photos. We had to put her in an isolation room because she was causing all kinds of rukus with the kids around her. Sometimes, when nothing else works we just let her cry it out, she takes a good nap after that.

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Specializes in Maternal - Child Health.

Does your unit have a volunteer cuddler/rocker program? If not, can you establish one by your next shift?

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Specializes in NICU.
Does your unit have a volunteer cuddler/rocker program? If not, can you establish one by your next shift?

We have volunteers / cuddlers on our unit - but they're only there during the day! Doesn't help us much on the night shift! We pretty much do everything that has already been suggested... warm packs on the tummy do seem to help - as do swings. So does "selective hearing" :D.

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Specializes in NICU, Infection Control.

Music: http://www.amazon.com/Stops-Crying-Heartbeat-Musical-Therapy/dp/B00003TFYP/ref=rsl_mainw_dpl?ie=UTF8&m=ATVPDKIKX0DER

A CD player (any small one would do, and pillow speakers help, too): http://www.amazon.com/First-Years-Crib-CD-Player/dp/B000056J6T/ref=pd_sim_ba?ie=UTF8&qid=1198988702&sr=1-79

Add the swing, possibly some Mylicon drops and/or Tylenol, and maybe a small hot pack for his/her tummy.

Cross your fingers!! Gut babies are just plain the most miserable customers in the kingdom. Drug kiddies come darn close, tho.

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Specializes in ER, NICU, NSY and some other stuff.

Exactly prmnenrs. One of the girls I used to work with used to threaten to let them just "lick the inside of the lids of the chloral bottle."

I think the only thing worse is a methadone baby.

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Specializes in NICU, Infection Control.

"...I think the only thing worse is a methadone baby."

They're really neck and neck. We've had one of these lately. It takes for--ever to w/draw from. Bleech.

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