Nissen

[Anonymous]

Hello I’m new here and I need feedback. My son was born premature at 29 weeks old. He is term now (he was due Feb. 14). He won’t drink from a bottle or breastfeed d/t reflux. He is on zantac, carafate and reglan. The doctor thinks a nissen fundoplication will help. He has had a swallow eval and a barium swallow, which didn’t reveal much. He is still in the NICU and we haven’t been able to take him home. I’m leaning towards the procedure b/c nothing is working and he is getting worse at eating instead of better. We are worried he is developing an aversion to eating b/c he associates it with pain. The procedure would probably involve a g-tube so we could take him home and feed him with a feeding pump until he is able and willing to eat. I have no idea how long it would take for him to develop the ability and desire to eat after the procedure. Other than the reflux and eating issues, he is healthy. He does have slow motility and doesn’t stool often – about every 4 days – but he weighs 8 pounds and is very alert. Does anyone have a similar situation?

[Anonymous]

Hi there. I’m so sorry that you’ve gone through so much. I’m sure that the doctor told you that many preemies have reflux. How have they been feeding him? Many babies in the NICU also develop oral aversions due to so many procedures and tubes involving their nose and mouth.

I hope this doesn’t sound harsh, it’s just because your son is still so young. But I would personally think very hard and get several opinions before agreeing to do a fundo. This was presented to us as an option because my daughter had silent reflux that was becoming impossible, as well as a feeding aversion. It was brought up by a doctor who said that a feeding tube and fundo would be our last option. Thankfully neither the doctor nor myself wanted to go that route. I’d be cautious of a physician who is suggesting that you do this procedure on a young infant. It is not a quick fix. MANY MANY babies who have them done have complications that can be worse than the reflux itself. I know that the feeding aversion is hard, but a fundo will not correct that. Babies with feeding tubes typically need to go down the road of feeding therapy, same as babies with oral aversions who do not have feeding tubes. And you can have a feeding tube without a fundo. Feeding therapy in these cases is often a long process. It’s not a quick fix. There is only one or two people on this site who have experiences with fundos. Kevieb still hangs around here, so you may want to pm her, but the fundo worked out well for her daughter. Most other people I’ve heard of had not had such a great outcome. Do your research beforehand, and talk to others. I’d check out http://www.infantrefluxdisease.com and even better http://www.parent-2-parent.com/forum. These sites have many people who have experience with fundos. Too many times I’ve seen parents turn to this thinking that it will fix things. I would only do it as an absolute last resort after everything else had failed when my baby was older, and even then I’m not sure. I would get another opinion, and get someone who will prescribe your baby a good dose of prevacid or another PPI, such as 30mg, ideally in bufferbabies. Check out http://www.marci-kids.com. If you can control the reflux pain, then gradually the feeding aversion should improve as he gets older, even if he needs feeding therapy in the end, or even if he needs a feeding tube. I would also insist on more tests before going down that road. My dd had a feeding aversion and it was very hard. We often battled a feeding tube. Many people had to get feeding tubes for their babies. Most of them did not need fundos. And as I said, this is fairly common in preemies. I apologize for sounding harsh. I’m definitely biased, as I hate when docs suggest fundos like their the answer, without telling people about what can and often does happen. Hopefully someone more neutral will chime in. Good luck.

[Anonymous]

I would definitely want an endoscopy and trial of a PPI before going the route of any invasive procedure. Just my opinion though.

[hellbennt]

welcome!
good advice here…

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