Advice re 21 week old baby with bronchiolitis please

[maxmissie]

Hi My dd is 21 weeks and has bronchiolitis.
She is really struggling to feed. Yesterday she had around 2/3 of the milk she would normally have (usually 35-40oz) but today she has had 3oz at 4.15am, followed by 7oz which she vomited and then 2oz about 1pm, so effectively 5oz in 11 hours. I can't get her to have anymore as she just bats the bottle away and gets very distressed. I also can't get her to take Calpol. Last time I checked she had a wet nappy (around 12.30pm) but am now getting worried that she will be dehydrated.

She is sleeping slightly more in the day but we are struggling to settle her at night. She normally sleeps well from 18.30-6.30, only waking once for a feed and rarely waking for anything else, whereas last night she woke four times. She is very upset and miserable when awake and it's taking alot of entertaining to distract her from crying, altough when I distract her she is generally her normal self.

The doctor said this morning that she seemed to be OK still and wasn't showing signs of dehydration but is going to ring me in the next half hour for an update. She will refer my dd to the hospital for a checkup if I ask her to.

I am really concerned about my dd being dehydrated and am not sure whether I should take her to hospital now (once referred by doctor) for my peace of mind or leave her and see how she is this evening. Am just worried that it might be difficult to detect how she is once she goes to bed and don't want to leave it too long if she does need to go to hospital.

Also at night we think it might be easier to settle her if she comes into our bed but as she sleeps really well and has an established bedtime routine I don't want to mess this up for when she is better.

Would be grateful for any advice re going to hospital/dehydration and bringing her into our bed when she's distressed.

Thanks very much.

Ask to be prescibed paracetamol suppositories if she won't keep Calpol down. I had to express and bottle feed dd when she had it but she rarely managed more than 3 oz ata time as it was too much effort. Try feeding her more frequently but with less than you normally expect. Codl hands and feet , especially if blotchy, can also be a sign of dehgydration and also if the skin is slow to spring bakc if you pinch it. If she can cry then her breathing is presumably ok ? (dd just whimpered like a cat).

Don't worry about the waking for now , perfectly normal when they are off colour. It may prove to be a blip in reestablishing your routine but that isn't such a concern right now. Raise her bed head(books under the legs) and humidify the air in her bedroom - wet towels on radiator or humidifier if you have one. Personally I would n't cosleep as she may get too hot.

hth and she feels better soon.

offer her milk very frequently but only tiny amounts at a time. Maybe 50mls every half hour?

Make sure her cot mattress is raised and you could put a couple fo wet towels on the radiator to humidfy the room.

DS2 has had mild bronchioloitis and croup and both times he slept better on my chest. DH and I took turns to do 2 hour night shift stints.

how is ur lo now?

my son has had bronchiltis a fair few times plus the RSV strain at 18 months and 2 1/2 and is really knocked him for 6. he was admitted to hospital both times and needed 02 and nebulisers and steroids

if ur lo is feeding then she may need to go into hosp and be montored i know a fair few babies who have had bronchilitis and needed to be fed through a tube

how long has ur daughter had bronchiltiis for?

hope shes ok xxx

Hi

My ds was about 20 weeks when he got Broncilitis.
Like your dd, he wouldnt feed and because he had reflux too, he vomited most of it up.

My gp said it didnt matter how much milk he was getting and not to worry about oz and things until he was over it. So long as he was getting some fluids thats was all that mattered.
He recommended that we slept him in his rocker and put that in his cot so that he was upright and could breathe better. It worked too and also reduced the amount he was vomiting.

If she is wheezing and sucking in her ribs then she needs to go to hospital as she may need nebulisers/oxygen (my 9mo DS has just been through this).

The paeds told us that they would expect the LO to take about 2/3 the normal amount of fluids and this is OK, but any less and they may need extra hydration, so again this would be something to watch out for. Little and often is better because she may well be sick if she has too much at once.

So if you're concerned at all I would take her to A&E (don't wait for referral from doc if you are worried), they will see her quickly and check her oxygen saturation levels which will decide whether she needs to be kept in or not.

Also I would take her into your bed, routines always go out the window when they are ill and I think it's more important that she gets as much rest as possible, if being in bed with you helps then I'd go with it.

Hope she feels better soon, it's horrid isn't it?

Fluid intake, she needs to take at least 80-90ml/kg or her weight each day. 1oz is approx 30mls. Small amounts and often are fine.

Watch how fast she is breathing and if she is sucking in between her ribs, under her ribs or at the top of her breast bone.
A breathing rate of more than 40 per minute would be worrying for your daughter and I would advise that you seek medical attention.

How long she has been unwell for is important. Bronchiolitis typically gets worse over about 6 days and then gets better more slowly.

Hi
Thanks for all the replies. The GP referred her to the hospital due to my concerns re her feeding. Within the first hour of being there she had 6oz of milk and water! Typical! and was then pretty much all smiles although still wheezy! The doctors checked her and said her oxygen levels and heartbeat are fine and given that she still has wet nappies and has taken some more fluids they thought she was OK and we've brought her home. She's just had 4 more ounces and she now appears to have gone to sleep. Her bed is propped up and we're going to put a bowl of hot water under her bed. Hopefully we can get a bit more sleep tonight and we're over the worst.
Thanks again for all the advice, much appreciated. x

Glad to hear your lo is okay. My DD (age 3) often has bouts of this and is particularly bad ATM so can sympathise.

She is v. wheezy at the moment and still vomits during the night when its bad(although I'm not sure if that's caused by the inhaler she was given).

Hope your night is more restful than the last!!!

hi maxmissie - our 2.5 year old son has had 5 cases of bronchiolitis and was admitted to hospital overnight 3 times (low oxygen levels, wheezing, lethargic, sucking in between ribs and a collarbone). the steroids, neb and supplemental oxygen always helped almost immediately. sounds like you are on the way to recovery - yay!

our doc suggested an effective way to ward off a bad wheezing attacks by giving 6-10 puffs of a salbutamol inhaler a few times a day (provided with a spacer - have your doc show you how to use it) as future colds started coming on. it gives us peace of mind knowing that we can do something at home.

might want to discuss with your gp.

Hi again
We appear to be on the road to recovery, my dd has been eating 3oz every two hours for the last two days and although still abit grumpy and wheezy is slowly getting better. She was much more cheerful today, her bedtime routine is back and we are getting more sleep as she is settling after feeds in the night. Thanks for all the advice again.
x