not keeping food down- advice needed (long)

[sleepysox]

DS2 is 1 and has a brain condition (Acc and Ventriculomegally). Some of the kids who have it can't tolerate solid food, only purees. DS didn't have any problems in this area until he started nursery. He was unable to digest the solid food as it wasn't pureed enough, and would throw it up at the following meal- the food had just sat in his stomach until more food went down at the following meal, and then he would lose the contents of his stomach and it would come out as it went in. This is under control now, as he only has purees, but now he wakes through the night as he's not getting enough calories (we think) and so we're being refered to a dietician.

However, he also vomits when he has a cold, and can't keep anything down at all, even formula. He has had a constant cold since he started nursery and the only time he hasn't thrown up constantly was last week when he was given antibiotics for an ear infection.
The doc and paed say it's normal for a child to vomit when they have a runny nose/ catarrh, but the NHS direct doc today said it wasn't normal for it to be so often for such a long period of time and we need DS to be investigated, but doesn't know what to suggest!

So, has anyone experienced this/ got any info/ advice? DH and I are so sleep deprived and are functioning on between 2 and 5 hours sleep a night, plus we both work and are at the end of our tethers. SS are looking into giving us respite using funding from direct payments, but apparently that takes 2 months to get arranged.

Any input would be fab.

Thanks ladies. :)

Hi. I don't have any knowledge of your sons condition, but my two younger sons suffer from asthma and both suffer baddly from vomiting if they have a cold. If it lasts 5 days our gp is seeing them daily to check if they are dehydrated etc and to check if they need to be admitted to hospital. He also has some medicines that he reserves for in his words 'very poorly children' not the general run of the mill antibiotics which ds2 ended up on when he was a bit older than your ds. So from my experience your gp could be doing at least something regarding Sustained vomiting due to colds.

In terms of what you can do, (apologies if this doesn't work with your sons general care) to try and ensure he doesn't become dehydrated every ten mins or so give a teaspoon of water (or by syringe) preferably with dehydration salts in -can get from chemist. Even if he looks like he has thrown it up my pharmacist friend assures me some will remain inhis stomach. If/when he can tolerate keeping water down basic foods like rice and pasta are best, but I am not sure how well they purée. Having said that mine all seem to like to eat either jelly or cucumber (both high water content) when they have been ill...
Hoe at least some of that is useful.

I've no knowledge of your DS's condition, but my DS2 vommits regularly when he has a cold, and his paed said it was to do with nasal dripping. It is usually when he is in bed asleep. The doctor suggested saline drops in his nose before bed, but they didn't make much of a difference. Maybe worth a try for your DS though.

Sounds really hard, I hope you get some respite soon.

Thanks for the info.
I've just got back from the out of hours docs who said that DS still has an ear infection, so has prescribed more antibiotics. Why the paed didn't pick this up on our appt on Thursday is a mystery, as he did look in DS's ears. Apparently DS isn't dehydrated yet, but I will buy the rehydration salts next time I'm out, as I think they'll come in handy. DS can't manage lumpy food, but I'll try ma knowing our track record. I'll try mashed potoato when he's perked up after the antibiotics have worked. Pasta and rice tend puree down to glue!

IT's good to know that there are stronger antibiotics for poorly children. If, after the second round of antibiotics, he gets worse again, I will go to the docs and be more forceful and really lay it on the line about how difficult things are.

I'll have a look into saline drops too.

Thanks for replying and for all the useful ideas.
YOu're the best.

NHs direct should have a link to this forum!

Hi, not on here much so only just seen this.

Has your Ds had a videofluoroscopy to assess his swallowing or a PH probe to check for reflux?

Continual vomiting can be due to a weak fundus (valve at top of stomach) or poor swallow leading to choking then vomiting. Our DD2 had these investigations repeated at various times, they showed poor swallowing, some reflux, etc. After various mediations we now have one that works, and a gastro button.

You say he wakes because he's hungry - is he thin?

I guess the dietician will tell you to add calories using fats, but it might be worth asking for another eating assessment?

Thanks for your reply mmbs- very informative thank you.

DS hasn't had any of the tests you mention, the paed said he didn't want to investigate, as it was simpler for us to just give him purees, and he said that it would be unneccessary for 'horrible investigations'. However, that was about 3 weeks ago, and since then he has been much worse.

DS hasn't been sick for a whole day now. The out of hours doc gave us some more antibiotics as she said his ear infection hadn't cleared up, and today he's kept down about 200mls of formula in total throughout the day. So I wondered if the ear infection may have caused this bought of sickness?

IF DS starts to be sick again, then I will ring his paed and push for further tests. I will probably push for further tests, if once we reintroduce solid foods, he starts to be sick again.

Sorry for my apalling lack of knowledge, but what's a gastro button?

I will print out your post, so that I can gen up ready for any future conversations I might need to have with the paed in the near future!

Thanks for replying. Your post was so useful.

Gastro button here.

DS3 has swallowing problems and is on puree too. He doesn't have any other medical issues so i do not know the impact that also involves. I do know that at 3.4, he is now not growing as to his previous centile and is hungry all the time. Gastroenetrology were the first to do checks as to why - and apart from dairy intolerance, found nothing. We are now waiting on ENT paediatrician to see if the problems are further up - which if colds , ear infections etc are causing vomiting, could be a good referral too.
dietician only suggested a few puree items to get more protein in - baked beans, houmous and egg yolk. But i know what it's like when they are hungry all the time.
i'm a bit of a wuss and still give DS bottles of milk through the night. Seems too keep him full enough 'til first breakfast!

Auntevil - doesn't that make him less hungry so less appetite to eat solids in the day?

Btw Sleepysox - have you had a SALT do an eating assessment?

No - he troughs his way through the day. It just gives him some more calories through the night to stop his tummy aching. He's sitting on my lap right now having a 2nd pudding after lunch as he's still hungry. He will also have another snack before dinner and possibly something after dinner. He had 2 breakfasts as well. The amount of food i puree up in a week beggars belief !