Mystery Baby

[xfitrn]

Hello All!

I am writing to see if anyone has any idea or has seen a baby like the one we have now. She is 48 days IDM born 32 weeks gestation aga. She was all the norm initially and transferred to level 2 relatively quickly for feeding where she has stalled. She cannot finish a bottle and sounds very congested while feeding. While we say congested - think sounds like she needs to be deep suctioned A LOT! We suction from every angle and get nothing. This has been for since she was about 2 weeks old. We have done CT, MRI, Barium Swallow and nothing. They all show normal. This child cannot finish a bottle though! Our PT works with her daily. You can see defeat in her eyes when she is unable to finish. I also find it odd that when she feeds, she leaves both her arms limp. She does not flex her arms. She is a mystery but at this point it seems the docs are just waiting for mom and dad to give up and let a g-tube be placed. I am still bothered. It seems to me that she has something wrong but no one knows. Has anyone seen anything like this? Does anyone have any ideas? Thanks in advance.

[xfitrn]

Oh and she had an NG. Our facility doesn't do OG's past the first few days if they can help it. She was still a very loud gurgle baby even on discharge but at least she could eat. I guess now we will probably never know. Probably the PICU RN's will be the ones to know down the road. Again...thanks to you all!

[Jory, MSN, APRN, CNM]

I will keep working on it! She is seen daily by our PT. She has been doing baby feeding babies and doing what most speech do for preemies in our area for 25 years. She is angry as all get out and swears something else is wrong beyond normal IDM. She has been working with this baby since second week of life. I haven't tried side lying. I don't think anyone else has either. I am hoping to have her when I go back Saturday or Mon-Wed this week. I will keep the thread updated and let you know as it progresses. It's so dang bizarre! We get IDM babies all the time! (We are on the Mexico US border and have some of the highest rates of diabetes in the nation) but this one.....so strange. She's not even LGA. She's a little cute package of mystery.....

Here is the kicker...speech therapists are not physical therapists and physical therapists are not speech therapists.

Before anyone puts this baby though a very painful (and probably very needless surgery) she needs to be evaluated by the APPROPRIATE specialist...and that would be speech.

To do anything less, is doing that baby a grave disservice.

PS: I posted this before I saw your last post..but I'll leave it. The "side lying" option that worked? A speech therapist would have done that FIRST, before anything else. That is why your facility needs to get speech, not PT, to work with the babies...especially if it's Level III. I'm sitting her amazed that nobody tried that sooner.

[NicuGal, MSN, RN]

We are level 3 and don't use speech, we use OT and PT for stuff like this. Speech is usually not used in NICU's, unless you have an old chronic. Our PT and OT specialize in NICU kids. So there is no injustice here per say.

[prmenrs, RN]

No disrespect, but some areas of the country use Speech Therapists for oral-motor issues, and some use OTs. And, imho, an experienced neonatal RN can teach a newbie OT/whatever a LOT! We are colleagues, here, not competitors.