Doctors Lounge - Pediatrics Answers
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Forum Name: Pediatric Topics
Question: neocate not working
|Nicks mum - Fri Sep 16, 2005 1:56 am||
My son Nick is 6 months old. He was born with a cleft palate and at 6 weeks old a naso-gastric feeding tube was put in as bottle feeding was SO hard, he HATED it, it was making him too tired and he was loosing colour. He is now fully tube fed. He is on losec. Two months ago an upper GI endoscopy was done (this was due to him throwing up considerable amounts at about 3 of his 6 feeds a day and him wriggling a lot duing tube feeds) the endoscope revealed a large number of intra-epithelial eosinophilis in the oesophagus consistent with eosinophilic oesophagitis. In addition there was mild to moderate gastritis. The gastroenterologist thought it consistent with eosinophilic gut disease and put Nick on Neocate, which he has been on for at least one month.
This is where the problems have got way worse. He is now throwing up at 5 of his 6 feeds, still considerable amounts (about 50 mls of the 150mls given each feed). I try re-feeding but with mimimal success. I wonder why there are more allergic cells in his eosophagus than his stomach, considering he has been fully tube fed since he was 6 weeks old. I don't know what to do next- I've tried every different feeding position, doing the feed slowly, not moving him (the feed he keeps down is done when he is in a very deep sleep in the middle of the night, I don't wake him). Weight gain is very slow- but minimally there. He is starting to wriggle again and arch his back half way through the feeds. I feel I should put him back on the "normal" formula. Is it common for babies to react poorly to the neocate? Nick hates swallowing, and I feel is never going to take food/ drinks orally- I need help!!!! Thank you for your time.
|Dr. Heba Ismail - Fri Sep 23, 2005 6:37 am||
Yes, it is common for babies with eosinophilic oesphagitis to respond poorly to neocat and in that case steroids are prescribed. Even then relapses are common, necessitating long-term therapy with low-dose steroids or even immunosppresive therapy.
Hidden parasitic infection remains an elusive and unrecognized cause of an unknown number of cases, suggesting that empiric antihelminthic therapy should also be tried in some patients.
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