barium swallow

[Anonymous]

Hi everyone….

I’m still relatively new to the board….followed up on all the terrific advice from all of you wonderful parents on this board and I now have an appt with a good pediatric specialist in Philadelphia (Jefferson University) that deals with a lot of young infants with reflux. My husband and I take her next Friday, but have to get a barium swallow done on her in the meantime. Can anyone tell me…is this painful or going to make her any more uncomfortable than she already is? My Hannah already at this point refuses the bottle frequently, sometimes after only an ounce or so, even if she’s hungry (she does the back arching/grimacing/pain cry we all know so well)….how much will she have to take and what will this be like? Will I be able to be with her during it? I’m nervous about testing for this…I’ve heard that often the barium test isn’t even a good diagnostic tool for GERD anyway, that it doesn’t always provide info and further testing may be needed. I’m scared to put her through a lot…feel like she’s already going through enough each day 🙁

Thanks for any input you might have!! Kath

[Anonymous]

Actually, I think the barium swallow is one of the most painless procedures Quinn has ever endured. She’s had two. It’s very painless and can provide some very good information. What they will do is take her to an xray room. First, they will take a few films of her anatomy to be sure that if there is something wrong with her swallowing, it’s not due to a structural abnormality.

Next, they will either lay her flat on the table, or have her sitting up in a special chair and take moving xray pictures of her as she is drinking the barium. The barium is a white liquid. I think it’s chalk like. But Q didn’t seem to mind it. As far as I know, you can bring some chocolate or a flavor to make it easier for her to take… but ask the therapist first. There will be a speech pathologist and an xray person there evaluate her as she is drinking the barium. If she eats anything else like finger foods or something like that, they will ask for one or two and cover it with barium as well to see how she swallows that too.

What they are looking for is difficulty in swallowing… how often the food comes back up the esophagus, reflux into the nasal cavity. If there is excessive or little jaw movement. On some occasions, they will be able to tell if the tongue is not doing a good job. They will basically see how she eats from the inside. It’s kind of neat to watch your baby’s bones and stuff move around on the xray.

Sometimes, right away they will tell you if they saw something abnormal. I know that with Q, they told me right away that she needed therapy. I do wish you luck with the testing. IF she does not like to drink, she may be a little uncomfortable… so be sure she is hungry. Many times, they only need to see a little bit and so 1-2 ounces is fine. That’s all it took for Q.

Good luck! Let us know how it goes, please!

-Sarah

[Anonymous]

In case they forget to tell you, the barium can be consitpating, so try to give her some water after the test and throughout the day when you get home. If she won’t drink water (I’m not sure how old she is), feeding her some formula or breast milk right away will probably help too. Ask the docs and technicians about this. No one told me when Myles had his Upper GI.

Good luck.

[Anonymous]

Just wanted to clarify…

Is she having a MODIFIED barium swallow, or an upper GI. Sometimes the upper GI is mistakenly reffered to as a barium swallow, but the tests are not the same. The modified barium swallow is looking for difficulty swallowing or aspiration like Sarah said. The upper GI is looking for structural malformations through the GI tract.

[Anonymous]

Oh and also, be prepared for some weird poop. Sometimes it can be gray or even a little white. This can last for 4 days.

-Sarah

[Anonymous]

OOOhh…you weren’t kidding about the poop thing. My baby girl (seven weeks old) has always been a pooper, but this stuff was pretty terrible, if I do say so!

They did what I believe to be a modified barium swallow….they had me hold a bottle to Hannah and while she drank (head turned to the side) they took pictures and looked through a camera at her insides. You could see the barium go down and stay down, then I took her and held her, trying to burp her (she hardly ever burps) and held her upright. They had me lay her down again, this time completely to the side, to see if the barium came back up. They also had her lay flat and waited till she cried to see if that made it come up. Nothing happened, so the report they are sending my pediatrician is that she does not have reflux.

I tried to explain to the dr that she doesn’t act, for lack of a better term, “refluxy”, with every feeding. It gradually gets worse throughout the day (this was at 10 this morning, a good feeding time for her). By night-time she is arching her back and screaming when given the bottle, usually after an ounce or so. I asked if reflux could be a condition that isn’t always evident on a barium swallow and was told that this wasn’t likely. I was also told she is probably “fussy or colicky”. I find this frustrating….I know my daughter. She is quite a fussy thing, but her fussy cries and painful feeding cried are totally different.

I am still taking her to the pediatric specialist next Friday. I have been documenting each feeding, along with how she reacts to being fed and how much she takes in. I want to be taken seriously, because regardless of whether or not it’s reflux, I firmly believe that even a fussy infant should not be screaming in pain when being fed a bottle, each and every day. I feel bad saying this but I almost wished they saw something on the swallow test, something to validate what we see every night, something to make it seem like we aren’t going crazy here!

[Anonymous]

Actually I’ve read here many times that the Upper GI is not a definitive test for reflux, because the baby may not reflux at that particular time. I think she had just an Upper GI from what you described. That’s the same thing they did with my little guy, and they called it an Upper GI.

I hope the specialist is more helpful. You are right…she should not have to be in pain while eating. Good luck and please keep us posted.

[Anonymous]

This has happened to us once when she was younger. She did, however reflux during the study, but it was so minimal that they didn’t prescribe her anything. Don’t feel bad. Every time I take Q to do a test, I always say… okay Quinn, don’t make a liar out of mommy. Because she does. Last time we were in the ER because she had a high fever of 105 for days. I finally took her in and it was down to 100.4. They sent us back home and said to continue with what we were doing. I came back in that same day hours later because Quinn was purple and her fever was over 105. They decided to admit her then.

Don’t feel bad. This happens a lot. Continue pushing for some answers… trust me, eventually they will come. Quinn’s reflux started out as very very mild. But it became apparent that her reflux was not mild at all.

I would say that because she didn’t reflux during the study… keep your mind open to her maybe having a milk or soy intolerance… this could be upsetting her tummy. I would try switching her formula and see if that helps a little. To something like Alimentum or Soy.. and if that doesn’t help still, try some hypoallergenic like Nutramigen or even Neocate. Keep in mind that it does take about a week for a new formula to make a difference. Discuss this with your doctor first if you do not feel comfortable, though.

Don’t forget, you are her mommy and her voice. If you do not feel like you are getting answers, get a second opinion. Quinn has had many many second opinions. And we even avoided having to insert a n/g tube with second opinions. It isn’t right for a kid to have to feel pain from eating. That is a good way to start an oral aversion which can lead to many other complications. So keep pushing to get the answers you need. you’re doing a great job!!!

-Sarah

[Anonymous]

That makes me feel alot better…..to top the results of the barium test off, Hannah was SO well behaved and not at all fussy or unhappy during the whole thing. (We call her our fuss-face at home). She smiled and cooed at everyone, not even balking at the bottle and not chugging and choking at it as usual.

We’ve had her on: breastmilk (projectile vomitted that)

Thickened breastmilk (with rice cereal) – constipated her horribly

Similac advanced with iron – no change in reflux, but it was slowly getting worse

Nestle Good Start (we loved this formula…but the dr had us switch to soy. We didn’t want to…digestively this was the best one, but we thought we should try it to make sure an allergy wasn’t causing the reflux. So we went to –

Isomil (she was having such gas pains and was barely going to the bathroom. When she did, she was in obvious pain.)

Nutramagin – we all disliked the smell, but she disliked the whole thing from the getgo. We were on it for almost two weeks and each day she took in less and less, with more of a fight. Since then we’ve switched back to Good Start, and she started eating more again.

At least we can tell the next doctor that we’ve certainly tried changing up her formula!

[Anonymous]

Yeah, it does sound like you’ve gone through a lot of formula. When you go to see the GI specialist… you have an appointment, right? Well, when you go, mention this stuff to him and about her barium swallow. Most docs will do the ph probe. That’s the best way to see if there is reflux going on. It is a 24 hour test and so there’s no getting around the fussiness with that.

I can totally agree, though. Quinn is incredibly fussy at home with me, but when she is with other people, she can be much calmer. And then I find that I defend myself by telling people how she normally is or what kind of problems we encounter at home etc, etc, etc…

Hang in there! I do hope that you can find a doctor who will help get to the bottom of this.

-Sarah

[hellbennt]

please please read & bookmark

Groupie Intro: my intro: https://www.infantreflux.org/forum/forum_posts.asp?TID=853&am p;PN=1&TPN=1

[Anonymous]

It makes me really mad when docs use the UGI to diagnose reflux (it actually sounds like that was the test that your daughter had to me, but I could be wrong). That test is only supposed to be used to diagnose structural abnormalities. Sometimes they can see reflux. They also told me that Hailey didn’t have reflux based on this test. I told the GI that my carpets begged to differ!

Don’t give up, and if your doc refuses to take you seriously because of this, let us know where you are and we can try to recommend a good doc.

[Anonymous]

Noah had his GI appointment on last Thursday. He was doing better, but
she did up his dose to 22.5 mg/day of Prevacid. That seems to be
working better now. He actually gained weight since on Prevacid. She
also wants him to do a Barium swallow test on Wednesday 3/7/07. I am
freaking out. My son will not want to drink that stuff. I know. Is
it even flavored? How much of it is he going to need to drink?
Then,
I read if he doesn’t drink it on his own, then they insert this tube
through his nose or throat. It sound horrible. Does anyone have any
experience with this? Any recommendation? Please

[Anonymous]

How old is Noah?

I would try not to worry- young babies generally don’t have too hard of a time with it. Especially if he’s bottle fed, as they feed it through a bottle.

Hailey had a feeding aversion, and wouldn’t even BF, but she sucked back that barium no problem. She was 9 weeks old.

They mix it with a bit of something (I don’t know what), but it’s not “flavoured”. And they don’t need to drink very much.

If he won’t take it from the bottle, then ask them to try other feeding devices before the ng. They used some kind of syringe thing with Hailey. And you always have the right to refuse anything that you don’t agree with.

What are his symptoms? Is it silent reflux, or flat out vomitting?

As I said, this was a pretty easy test for Hailey… worse for me, I think. I worried a lot about it beforehand. I was also afraid that she wouldn’t take the barium, but she surprised me.

[Anonymous]

Myles had the test at 5 months of age. He was refusing all but sleep feeds at the time so I had the same fears as you are having. Sure enough he wouldn’t suck on the bottle so I suggested using a syringe and pacifier and they said that would be fine….to just be careful so he didn’t choke. So the nurse held the paci and I held the syringe and I’d squirt a little into his mouth and the nurse would put the paci in. This worked just fine. He probably only swallowed 2 ounces and they said that was enough to see what the needed to see.

Maybe bring on of his own bottles because it’s probably more likely that he’ll drink from the bottle and nipple he is used to.

Glad to hear the 22.5 mgs is helping. Hopefully that will be the answer for him. Myles did fine once his Prevacid dose was high enough.

[Author]

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