Sleep Advice

Sunday, 17 June 2012

REFLUX? or Pyloric Stenosis?

Pyloro what the ?!?!?!

In Mitchell's third week he finally gained significant weight - 320g  I was so pleased that finally all the milk I have was fattening up my wee boy nicely.  After that week it felt like everything went wrong...

His spills became massive vomits.  Both of us would need a change, and his cot too if it happened in there.  He would become very stressed if it came up his nose, then stressed from constant clothes changes, then stressed because he was hungry again.  But I kept telling myself, as I read it everywhere, not to worry it won't be his whole feed even though it seems a lot.  WQell, at the end of his fourth week he had lost 140g and had not pood for nearly 4 days.  My midwife saw him throw up and became immediately concerned at the amount coming out of him.

We tried Weleda Colic poweder which made very little difference, went to the doctor for Gaviscon which again made very little difference especially because I couldn't get him off my breast to get the bottle with Gaviscon in it fast enough before we were both covered in puke again.  Giving it to him first was not much good either because it came up again.

So we looked further into Reflux, and over supply and forceful milk ejection and so began a week of lying on my back to feed him when my breasts were full, sitting him upright to feed, feeding for only a minute and pulling him off to allow my milk to flow out onto a towel (more like squirt everywhere!), burp him and return him to feed for a further minute, while also carefully keeping him upright.  These things had the greatest effect and we got down to only 2-3 spews per day.  But still he wouldn't poo with the help of Coloxyl drops, and I was too scared to make the cycle movements with his legs.  His weight gain was very minimal, in fact he actually lost a further 50g after 2 days.

Mitchell did not show all the signs of reflux.  He was never in pain from stomach acid, was happy to feed and got very upset when I'd pull him off.  I was at my wits end.  One night after 2 hours of feeding, and cleaning up spew, changing clothes for both of us etc etc, I looked at him and thought I am so over this and exhausted I just want to put you in your cot and leave you there.  Then I cried and cried, it took us nearly two years of heart ache to conceive this little guy and here I was wanting to abandon him - I was very very low.

I just didn't feel in my heart that he had reflux.  I took him a wonderful Osteopath Marsha at the Osteopathic Clinic here in Hamilton.  She was wonderful, and Mitchell had a fantastic day, feeding well, very few spews and sleeping well.  I thought we were onto a winner.

That night he spewed a huge BROWN spew in his bed, we rung healthline who said to take him to hospital.  After seeing the registrar and then a consultant, the consultant got him to poo with a rectal examination (not nice to see your 6 week old react to that) and then said he wanted to do an ultra sound to check that the valve or tube of muscles that empties the stomach into the intestines (the Pylorus) was not overgrown with thickened muscles.  As soon as he described this my gut reaction was, oh yes that is what is wrong with my baby.  So I asked what happens next if they find the muscles have thickened?  A surgical procedure.  OK brace yourself I thought.

In order to get a clear ultrasound image the stomach needs to be empty, so our six week old baby had too fast for just over 4 hours.  The ultra sound confirmed that his Pylorus muscles were thickened, and therefore the tube narrowed (stenosis).  Normally the Pylorus is 4mm thick and 14mm long, Mitchell's was 6mm thick and 19mm long.

The major problem with Pyloric Stenosis (other than the vomiting, no pooing, weight loss etc) is that the excessive vomiting of the hydrochloric acid in the stomach puts the body and bloods into alkalosis which does all sorts of bad things I don't really understand.  The electrolytes in the blood must first be corrected with IV fluids and fasting before the baby can be operated on.

Mitchell's last feed was at 2:30pm on Tuesday, and he started an IV drip around 4pm that evening, with surgery likely on Wednesday morning.  Wednesday came and went, with surgery booked for Thursday morning, still no feeding. 

Mitchell went into theatre at 8:30am Thursday morning.  My heart was broken. I felt I had made him wrong/faulty, I couldn't do the one thing that made him happy, and is instinctual for me and that is to feed him, I felt I was betraying him by sending him off into something he had no idea was coming, I was a sworried as hell that he would react to the anesthesia, or worse that he would come back with a major complication, a different baby.  I sobbed and sobbed with my whole body.  It was a double edged sword, I knew it was for the best, but it just seemed such a horrible thing to give consent for strangers to operate on my tiny baby.  All of that on top of about 7 hours sleep in 4 days.

10:45am and Mitchell was awake and in recovery.  I still wasn't allowed to feed him so Craig had to cuddle him so he wouldn't smell me.  He had a husky cry no doubt from the tubes put down his throat, and three holes, two for the instruments above his belly button, and a bigger one in his tummy button where the camera was put in. 

Four hours after surgery he was finally allowed to feed.  He did that but pretty much slept the rest of the day. 24 hours after surgery my happy little boy emerged out of his sleepy state.  He was attached to machines to monitor his vitals with about 5 different tubes or cords.  Feeding was tricky in the entanglement.  He was all smiles and grins.  We were given the ok to go home on Friday morning, but not officially discharged til the afternoon.

Mitchell has been a completely different baby since the operation in so many great ways.  I can finally breastfeed him like I did with our first son, and he has only vomited 3 times in 3 days, mostly because he has gorged himself, or if he has been laid down too soon after a huge feed.  He is much more relaxed in his whole body, he barely cries because he is finally full. Best of all no more loads and loads of washing.

I'll post some photos and more details about Pyloromyotomy in the next post.


  1. I'm so glad to read that your little man is finally the relaxed and happy baby you knew he would be.
    My husband had PS (he has an impressive scar!), and when our son started projectile vomits etc, the midwife and doctor were on high alert because of the hereditary risk in first-born males. We were lucky, and our son was fine, but those moments of wondering were awful.
    I am sorry you had to go through this, but so glad that someone listened to your concerns and took them seriously :)

  2. Thank you so much for your honest, heartfelt and positive story about Mitchell's PS. I am grateful that he has responded so well to his surgery.
    The same condition left me scarred not only physically but also emotionally - via my parents' trauma with it in darker days. This has prompted me to research and blog about this whole subject, and I've been amazed by how many parents feel distressed over the medical world's coldness and slowness in recognizing and dealing with their baby's obvious symptoms.
    Your writing about your experience is something that was never done in my day, and I'm sure that Mitchell's scars will remain minimal and that you will do a great job helping him to own his survival story.
    Best wishes!