Discussed This Month
|wisdoms from the Preemie-l e-mail group|
|Preston asks, "Hi
folks!! Our son, Chase, has a mild case of BPD
which the doctors expected to clear up w/in a year.
During his recent DR and respigam treatments all have
said that he sounds really clear so I think that his BPD
has pretty much subsided. As far as feeds, here's
what happened w/ us. When we got Chase home from
the NICU in June he was doing well on feeds (approx.
700-750 cc/day) for a 4-5 pounder. About a month
later Chase started retaining fluids and de-sated into
the 70's & 80's. We spent a weekend compliments of
the local children's hospital. Our pulmonary DOC's
started Chase on some diuretics (Diuril & Aldactone)
to combat any potential fluid retention. We also
started to augment his feeds w/ rice cereal or oatmeal
(supposedly oatmeal is easier to digest) to increase the
calories. With the diuretics, we never had another
occurrence of fluid retention. Chase's formula intake has
never really gone above the 800cc level, even as a 12-14
pounder and lets just say that the diuretics have kept
him on the trim side (he's just starting to get a belly
since we discontinued the them!!).
Question for the group (or parents whose BPD kids have been prescribed diuretics)?? I noticed on the net that one of the minor side effects of aldactone is loss of appetite. Has anyone else noticed this as well??"
Michelle also wonders, "I have Twin 26 week girls how are now corrected age 2 months. I would like to know if anybody out there has any suggestions I can bring to our Doctor regarding thier feeding. Right not Megan can have 2 1/2 ozs every 5 hours. She is so hungry. She is such a good eater and we add lots of polycose and corn oil for calories but I know that the volume isn't enough. He only increases her feeds by such small amounts. Kaci can have 60 cc's every 5 hours but she doesn't seem to be so hungry. She is still the smaller of the two also. He won't allow us to go to any solids till they are closer to 10 pounds. Right now Megan is just 7 pounds and Kaci is 5 and 1/4. they have such a restricted volume because of there BPD. I understand his reasoning in there schedule. BUT I would like input from other parents if they have any suggestions that worked for there angels."
Suzanne advises, "John
Henry was on aldactone and diuril when he came home from
the nicu, they
Kathie shares, "My Alex was the restricted fluids queen as she had bad BPD. The pacifier was our lifesaver, but I always hated the thought of "putting a plug in it". When first home, we didn't have too much of problem as her feeds took 1.5 hour every 3 hours, so I literally spent half my day feeding her. When she put on a little weight (like hit 6 pounds-ha!) was when her hunger cries started, but the NICU nurses scared me with horror stories of babies lungs filling with fluid because mom had to give just one more ounce...Some things I might suggest are to use formula instead of polycose. Polycose is nothing but sugar where as formula has the proteins too so it will digest more slowly. So if your adding enough polycose to increase it 5 cals per oz., use formula instead to add the 5 cals. What also helped with Alex was adding 1 teaspoon of cereal per ounce of milk. We added this because of reflux, but it definitely helped her "hunger". And we started the cereal long before she hit 10 pounds. She was probably only 6 pounds at the time. We had to keep up her restricted fluids for her entire first year, but after she hit 10 pounds (at 7 months-or 4 corrected) we started baby food. She was allowed to eat as much as she wanted, and believe you me, she took advantage of that (until she hit 2 yo and stopped eating all together-but that's another story...)"
Michelle adds, "My girls are on long term diuretics for the BPD and were on a fluid restricted diet. To compensate we add 1 teaspoon polycose per ounce of formula and they are using enfamil with iron concentrate with only 9ozs or water to boost the calories. We also add 1/2 cc of corn oil per bottle. All of these things make it a 34 calorie per oz versus the 20 calorie per oz formula straight. Because they are doing so well we were allowed to go to ad-lib feedings yesterday. I would check with your pulmonologist about feedings....not your Ped. "
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