Is there anything we can do to avoid having the g-tube put back in?
Our 11 month old (premature 28 weeker) is now 13 lbs 5 oz. The doctor has her on Neosure 30 cal and wants her eating 20+ oz/day. She has had a Nissen for GER and had a g-tube until July 1st. She is currently on Prevacid for the GER.
Her surgeon felt that because she was eating really well he could remove the g-tube. Her Gastroenterologist wasn't happy because the surgeon didn't consult her first. Hana gained 5 oz in 3 weeks, but the doctor says it is not enough. Hana eats about 2-3 oz every 2 hours. Doc says she needs the g-tube back in as soon as possible, because if she were to get sick, there is no reserves.
I asked her to wait another month and the doctor agreed. The doc is also checking for an underlying condition with a thyroid panel and a metabolic panel. Is there anything we can do to avoid having the g-tube put back in? Are there sure fire ways that we can do now to try and get her to pack on the pounds?
Hello!
It sure is confusing when the doctors disagree on the treatment plan...there you are right in the middle! With my daughter, it really helped to have one doctor who was the " go to" person and acted as the case manager. For our family, it was our wonderful GI doctor. The case manager can be the primary doctor or one of the specialists. With preemies, it is often the neonatologist or the follow up clinic. See if one person can coordinate the care for your daughter and communicate with all of the specialists.
It is hard to advise you on whether or not to re place the feeding tube. The case manager would be able to look at growth over time, intake and other factors to make a decision. Some doctors add calories to the formula to increase weight. I know of some GI's and feeding specialists who use an appetite increaser such as Periactin for short term use. I am assuming the Nissen Fundoplication has decreased or eliminated the reflux and that is not a significant factor in her slow growth right now.
It puts a lot of pressure on you when everyone is staring at the scale and looking for stready growth. I am sure she is eating as best she can right now given her prematurity, respiratory and reflux issues. It takes a lot of energy to eat and grow. Preemies often burn a lot of calories just by eating. Make sure the doctors are assessing her based on being a preemie.
Let me know how you and your daughter are doing!
Jan
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