vomiting: reflux, rotavirus, or NGT feed problems

[jess41378]

I have a 6 mo old peds pt with hx of reflux and recent rotavirus. He got the rotavirus while in the hospital to get his NGT for dx of failure to thrive for months prior. He is still vomiting at home per mom. The twin sister of baby got rotavirus too. 2 days out of hospital I do my open case visit. I found out she is giving both babies multivit liquid with same vial and dropper. She has told me she cleans the dropper with boiling water for only a few seconds before using with other child and before putting back in vial. Is this sufficient enough or should she have 2 seperate bottles and boil syringes longer and for how long? Also is it possible she reinfected the pt with rotavirus from the twin by doing this? how long to boil nipples and bottles? In this case of both babies with rotavirus, can they be giving it back and forth to each other or will it eventually reslove on its own? Sorry, not sure if the pts vomiting is from rotavirus or reflux or NGT feeds too much.

[PedsRN1991]

I don't think the vomitting is a rota issue. However, it sounds like she is probably not being overly careful with hygiene between the twins. I know it must be hard with 2 babies....but it will keep going back and forth. The vimitting could be a reflux issue, if she is not keeping the baby upright long enough. Is the ng in the proper placement. If still vomiting, sounds like it shound be advanced to an ND.

Good Luck.

[ECUPirateRN]

Rotavirus is extremely contagious so it is highly likely that the babies caught it from one another. However, I don't think it can be transmitted by use of the dropper as rotavirus is transmitted from fecal-oral contact. While rotavirus can cause vomiting (I had to look it up!) it seems more likely that the cause is reflux, due to history. Does the baby get continuous feeds or bolus feeds? I have taken care of babies who have NG tubes who get continuous feeds about as often as ND continuous feed. Then again, if the baby has rotavirus, who knows what other infection they could have too. That could also cause vomiting.