I said I was going to post about this topic, and the more I read our fellow preemie blogs, the more important I've realized it's become.
So many of our preemie peers suffer with oral aversion, difficulty eating, avoidance of certain textures, and vomiting. It makes weight gain and eating exceptionally stressful for parents. My heart goes out to you all.
Serena and Edwin have no eating difficulties whatsoever. They eat almost everything, and I am not exaggerating here. On Thanksgiving there was almost nothing they didn't eat (broccoli casserole was their favorite Thanksgiving dish...I made it :)
I think about how fun feeding time is for myself, Edwin, and the kids, and I feel so sad that this is a time of stress and sadness for many of our preemie friends.
I can't help but think back to the NICU days. Serena and EJ were almost always nasally intubated. First, the nurses felt the tube had less "play" in the nostril as opposed to the mouth. Secondly, we were told studies showed a decreased occurance of oral aversion with preemies who were nasally intubated than those who were orally intubated, and it makes sense. The only affect is Serena's dialated nostril...a small price to pay for escaping with no feeding issues.
The BIG hospital in the capital of our state removed Edwin's nasal intubation and intubated him orally when he was transported for his PDA ligation...upon return to our NICU it was replaced with a nasal intubation...it is a hospital/nurse's preference and many hospitals simply do not intubate nasally. A major risk can be a deviated septum and perhaps this is the reluctance?
I wonder what other preemies experienced in the NICU? Was your child nasally intubated? How is his/her feeding? I wonder if things could improve for future preemies if more hospitals tried nasal intubation. Or perhaps there is no correlation and we are just lucky in this area of preemie-related issues.
There's a good convo going on on Preemie Mom Blogs about this for anyone interested...
Subscribe to:
Post Comments (Atom)
7 comments:
Margaret had an OG tube. I didn't know any better at the time. She has many eating difficulties and some mild to moderate oral aversion.
With William, I was prepared. I did not allow them to put a tube in his mouth at all. He has no oral aversion and no eating problems (as of now).
Arianna was only orally intubated for 18 hours when she was on the vent... then it was nasal for everything, NG tube also.
She has gaining weight difficulties... she eats rather well, I think (but what do I know), she tries lots of different things, just doesn't eat ALOT of food. Then again, she's doing better than I was at the same age, weight wise.
I'll be interested in hearing what others have to say.
Noah was orally intubated. I'm assuming that's all our hospitals did, since I never heard of the other. He has an oral aversion - one of many issue with his feeding. Our other difficulties include reflux, delayed gastric emptying, dysphagia, and low tone in/around his mouth. He was intubated for about 3 months total - 2 months straight and then on & off for the next 2 months.
Hallie is Noah's twin in the wide world of eating, intubation, and gastric tract issues: she was intubated for around 9 weeks orally; on CPAP (off and on and overlapped with intubation to some degree) for about 2 weeks, and had reflux that presented itself while she was in the NICU but that only received serious treatment once she was home (on Enfamil AR in NICU for last few weeks, and later zantac, and finally prilosec at top dosage, which she still refluxes through). She has mild low tone around her mouth, a very high and vaulted palate from intubation, could never breastfeed and has always had trouble with the bottle (7-8 non nutritive sucks per each productive one when awake), has laryngomalacia that may or may not ever resolve, and a paralyzed left vocal cord that most likely will not ever resolve (she does vocalize, though it's soft). As a result of this, she has problems swallowing: she aspirates thin liquids and has to have everything thickened to a nectar consistency but this still pools up even if it doesn't penetrate (much). Finally, if this is not enough, she has Delayed Gastric Emptying and is now on reflux. Whew.
And, yes, she has eating problems: in addition to constant refluxing and vomiting, she also vomits when liquids penetrate and/or pool. She cannot take anything in her mouth that is much thicker than a stage 2 food without gagging and retching (and often vomiting) and her only 'solids' are tiny pieces of cheese and gerber puffs. She is at about the six month stage, with aggressive feeding, in terms of eating (she is currently 14 months adjusted). We would like to think that there is an end in sight to all of this, but are too busy trying to just get through a meal or at most a day...
Not all of these problems are caused by prolonged oral intubation, but my sense is that some of the issues are and, even if we could just get rid of a few of the issues, that would be a start!
For those of you who had long-term intubated babies, were any of them fitted with a palate plate? Emery had one placed at about 2 weeks of age and roof of mouth is, while not normal, not as hollow or arched as some.
Jordan was intubated orally. He has only been home a month, but he has had no aversions at all. When in the hospital we asked about nasal, but the nurses said that because of the cannula the tube would restrict the airflow a little too much. It took us a couple of weeks to find the right nipple, but we've found one he loves. Things might change by the time he eats solids, but thus far we have been lucky.
Our baby was intubated via the nasal and he simply will not eat. Our OT has made great progress in that he won't gag or throw-up as much, but getting him to take food from a spoon or even his own finger is a real challenge. He is finally eating some graham cracker dust but anything bigger or with more texture is immediately thrown up. I cannot begin to tell you how hard this is every.single.day. I know that we're very lucky so far with his motor development - and I can only hope that this gets resolved sometime soon. The baby is gaining weight but very, very slowly.
Post a Comment