Will reflux cause pneumonia?

Hi Carol.

Yes, it’s true that reflux can cause pneumonia. It can happen if they aspirate the contents of the reflux into lungs. But that’s not terribly common, especially if you don’t put them down right after a feeding. Hailey always sounded like she had a head cold and was gurgly, but she still didn’t aspirate from what we know (thankfully). You’re right, PPIs won’t control the reflux itself. I’m not sure why your ped made you worry about aspiration if your son doesn’t have any symptoms. But if you are concerned, you can elevate his mattress at night, and hold him upright after feeds. We started thickening Hailey’s feeds when she was 4 months old, but I don’t know if it helped or not.

Sorry I don’t know much of Matthew’s history, but other than the crying, what symptoms does he have related to his reflux? If your son does have reflux and seems uncomfortable, I would ask for a referral to a ped GI, especially given your ped’s attitude about reflux. For a baby who’s in pain, it’s really not acceptable for a doctor to take a “let’s wait for them to outgrow it” position. I won’t bore you with our long story, but every doc we saw told us to wait until Hailey outgrew it…. and we’re STILL waiting. She wasn’t properly medicated, and even though she did remain along her curve, she was suffering… she cried all the time, and ultimately she developed a very serious feeding aversion that we are still dealing with. If she had been treated properly from the beginning, even though she was gaining weight, I truly believe that we might not be in this situation today.

Whereabouts are you in Canada? We’re in TO.

As I said, I would ask for a referral to a ped GI, and in the meantime, I would ask your doc to humor you and try a DECENT dose of PPI for Matthew. You might want to check out http://www.marci-kids.com. They actually have TONS of info on PPIs and reflux in general, and have illustrations depicting your initial question, how reflux can cause pneumonia (I believe). If your doc does try a PPI, then you’ll want to make sure that the dose is adequate.

As for the crying unless he’s held upright, you might want to look into babywearing. It really saved my arms in those early days. Laura (hellbennt) is a big advocate of babywearing, and can probably help you out if you’re interested in finding out more.

Best of luck to you.

its very sad that so many doctors dont prescribe medications just because the child is gaining weight. if they are in pain-they obviously need medication. maybe you can see a pediatric GI?

I’m not the best person to answer babywearing questions. Laura definietly is. I’ll try to pull up a link from a post a while back when I was looking for a carrier. I started off with a baby bjorn, and then i got a heart to heart sling which was too bulky, but I used it anyway just becaause I had bought it. I know that some people have used hotslings. Which kind of carrier were you looking into?

hi there, it’s me

from the Introduce Yourself Forum, there’s a stickie (top post) called Groupie Intro–

click there & scroll down to a link called Babywearing

from there, the top link is called ‘Babywearing Condensed’ – this should give you a good overview

for Toronto: http://groups.yahoo.com/group/KoalaMamas/

Carol, how old is Matthew again?

Hailey always choked and coughed during her feeds. They told us that it could be due to many things- an uncontolled suck-swallow-breathe pattern, the flow being too fast, or refluxing while she’s eating which causes the coughing and choking.

When Matthew chokes, does his face change colour? Our doctor always told us that if she turns red then she’s clearing it and protecting her airway, but if she turns blue then it’s a clear sign of aspiration. But I don’t know if it’s true or not.

Also, does he make any sounds associated with the choking? Sometimes there is a high pitched wheeze sound, which we were told was called “stridor”.

The thing with coughing and choking is that it can lead to aspiration. If it is happening repeatedly, then I would certainly tell your doctor about it. He might want to do a swallowing study to make sure that there isn’t a problem with aspiration that’s going on. Be warned though that the only place that does this on babies in Toronto is sick kids, and they have a wait list that’s 4 months or longer. They can get in faster for the general assessment, which is done by an OT, but the video fluoroscopy (modified barium swallow) takes much longer. So if you think there’s a problem, best to tell your doc right away.

We had Hailey’s choking investigated. She would cough and choke and turn blue. During this time, she made a high pitched wheezing sound, and she got what we called the “deer in the headlights look”… her eyes would bulge open and she just looked shocked. Then she’d scream afterwards and often puke. When she was checked at sick kids, the OT felt that she wasn’t aspirating and that she was fine (she didn’t choke during the assessment) and she wouldn’t order the modified barium swallow. I’ve always felt that she was aspirating though.

We thickened Hailey’s formula a bit and played around with various nipples and bottles, and after a very frustrating time of trial and error, we eventually found the right combination of nipple and thickening for her. We also made sure that she was sitting quite upright while feeding, and that I was holding the nipple at an angle so that there wasn’t air inside, but that it wasn’t tilted so much that it was pouring into her mouth too quickly.

What kind of bottle and nipple are you using? Some people have had success with the dr. Brown’s kind. We started off with playtex and then moved on to dr. Brown’s. They have a soft nipple that makes it easy to suck and latch (even though they didn’t solve the issue for us).

Good luck.

(BTW, whereabouts in TO are you?)