Anyone Have a Child Go Through a Swallow Study with Barrium?

Updated on March 03, 2009
L.S. asks from Carrollton, TX
25 answers

Son is 6 months and does nothing but projectile vomit all day! It hasn't hurt his weight at all, thank God, 20 pounds already! He was making what I thought were cute growly noises when he 'talked' that his doc said was not normal. Called it a huge long name and said it's referred to as lazy larynx. Something about one side of larynx does not fully close, usually they grow out of it. Was noticed at his 4 mo. check up and said was not a concern. Now that he makes the 'noise' all the time, they are concerned that his throat is irritated and he is trying to clear the irritation by talking.

We are calling for appt at ENT on Monday morning- not supposed to allow him to lay flat, taking Zantac (not happy about med that masks a symptom, but we have to get him some relief, asap.) Doc also wants me to pump and thicken milk with rice cereal so it is less likely to be aspirated, but he been spitting less over the last two days since stopping cereal last Sunday (on rec. of another mamasource answer about reflux being about alkaline vs. acidic foods- thanks!).

What would you do? Thicken with formula which he does tolerate but will add to constipation (only poos every 5 days anyway)?

Any insight to a barium swallow with an infant would be great. Hate that he has to have such aweful chemicals for a test, but we have to have answers. Alternatives? None were offered at the doc.

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So What Happened?

Wow- thanks for all the great advice! I have decided to go the natural route. We are still going to have the swallow study done, waiting on the doc offices to call back. In the mean time, I am still going to nurse. I do pump in the mornings, but I lose so much volume with pumping that I am not willing to try to pump exclusively at this time. Several things he does are even pointing me away from agreeing with docs diagnosis of laryngomalacia. I'm sure he would love to be proven wrong as he loves my kids.

We are also looking at chiropractic care for him. Looking for the right person in the Carrollton/Plano area if you have suggestions for one that specializes in pediatric care.

Modifying my diet seems very reasonable, too. He's only 6 months, so he does not need to be on solids yet, either. Since he is doing so much better without the cereals, we are considering allergy testing for him, too. Nothing points to a need to push solids right now - so we'll wait!

Life is not perfect, still looking for answers, had a scare over the weekend with a painful cry (learned about supository tylenol!). Yet, God is good, life is sacred and blessed. No need to give up hope - He still cares about all of us through even the most difficult of circumstances.

Thanks again for every piece of advice and well wishes. It was fun to go to your pages and see what else you've commented on, too! What a great place for all of us to benefit from the experience of others! Anyone interested in my area of 'expertise' of surviving and preventing cancer in my kids, please check out my other writings before this Saturday.

Blessings,
L.

Featured Answers

S.J.

answers from Dallas on

My son had the same problem, and we had a hard time finding a day care provider due to all the barfing. The Dr's. were also not concerned due to him gaining weight. They said the same thing about a "flap" not bieng fully closed/grown yet.
He outgrew it, at about 6 1/2 months. If I recall (this was about 15 years ago) adding cereal to the milk did help a bit. I think my kids were eating babyfood so I had added prunes or other food and there was no constipation. Matter of fact both my kids had this problem, and both by about 6 months outgrew it...hopefully that is the case for you to - hang in there.

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R.R.

answers from Dallas on

My grandson had a barium swallow study done when he was in NICU. I can't tell you much about it, but it was for reflux also. He uses formula with rice in it too all the time. I do know that the barium itself didn't affect his poo or his disposition, he just drank it in a regular bottle.

Can you give him some apple juice or something similar to try to help with his constipation?

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R.V.

answers from Dallas on

I am sorry to hear your son is having so much trouble.

First, I would have him on Formula 100% of the time. Every thing you eat transfers into the breast milk and you don't know at this point what is causing the issues.
My daughter was doing this and when I quit breast feeding she improved soooo much.
Second, using cereal to thicken the formula is the correct thing because it helps it stay down and out of the lungs.
Third, do the test. You want to get your son help as early as possible. Remember, esophagus cancer is caused by these kinds of issues.

Good Luck,
R.

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D.C.

answers from Dallas on

Hi there. My little guy, starting at about 9 months, has had 3 swallow studies. Ours were called a Modified Barium Swallow Study. He had to drink and then he ate some for them as well. I was completely weirded out and nervous and then when we got there it was no big deal. The barium didn't taste bad at all and he had only a little bit and he didn't seem to mind it at all. Then they gave him some pudding with barium in it, and then a cheeto with barium on it and I think a bite of a cookie. His was done at Medical City and the girls there were only for little kids. They were very caring and reassuring and he did great. We found out that he had reflux when he was 8 months, sure would have been better if we had known before. He did the projectile thing too. We started using Simply Thick to thicken his formula and we started him on Prevacid. Prevacid doesn't mask any symptoms, just calms the acid down, so to speak, so it doesn't hurt their throat. Once we started him on the Simply Thick and the prevacid there was a world of difference. Things will be just fine. If you would like to email me, please feel free. One more thing, the barium can stain so have him wear a large bib or take something you don't mind being stained a little. Also, it might help if you bring one of the bottles he likes to drink out of. That way he has something to drink out of he is comfortable with, if they allow that at your study.

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C.C.

answers from Dallas on

My dd had her swallow study done at 4mo. I had been trying to tell her NICU nurses (and after leaving the hospital) ped that something was wrong for all that time. At first they said it was normal, than it was colic, than reflux meds. Fianlly they sent us to children's med center in dallas for a swallow study and told us it was the lazy larinex. I don't remember how thick they said to make her bottles...but they told me to put food thickner in it. Turns out she was allergic to that. So the dr suggested AR formula. She took that until 15 or 18 mo, she was a little delayed on eating solids and underweight (born premature). Dr and Nurse Pract. don't always know what is right. You are around your child more and sometimes they are distracted (to busy) to notice. I had one give an adult dose of a prescription for my almost 3 yr old last year. I knew it seemed like more than usually and I called the pharmacy - they can do it my wheight and call the dr.
Good luck.

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M.M.

answers from Dallas on

Has anyone suggested a dairy allergy or intolerance?? When my baby suffered from reflux, my ped said to eliminate any and all dairy (i was a nursing mom, so that ment from my diet). i followed my nursing coach to the letter...which included "caisen" which is a dairy product used in prepackaged foods (lunch meats especially). With in 2 days we saw a major difference...with in a week the problem was solved. With the mention of constipation (can be a dairy issue), it may be worth looking into if you have not yet done so.

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W.H.

answers from Dallas on

they have flavored barium also. my daughter had an open . esophagus stayed shut and she would have major projectiles all the time. we also mixed rice cereal with all liquids. if you go to a formula, try Enfamil A.R. it has added rice starch and is thick and when it hits the tummy it thickens up more. that worked wonders for our daughter. she also was put on zantac. NEVER HELPED her at all. aswk her doctor if it could be an open esphagus . i hope you find the cause of it. good luck to you and your baby.

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B.D.

answers from Dallas on

We did the barium swallow test for my son when he was 6 months old. It as pretty easy once we got my son to drink a bit as he never wanted a bottle when I was around! Basically, they put the powder in a bottle and it took images as he swallowed to confirm if it was going into his airways or not. It was a pretty amazing test to watch. It was very quick and once they see where the food goes when he swallows, they are done.

We did not go through anything as extreme as you are going through and my son's test showed he was swallowing properly. However, one of my friends has gone through what you have. She thickened her daughter's food and had much improvement. They also went through some type of treatment to correct her swallowing. If you get to that point and want more info, send me a message and I can ask more about what treatment they did for her.

I also have to throw out there to think about what your son is eating. There could be something in his formula that he doesn't tolerate well. I would ask questions around what type of food allergy and intolerance testing is available as an alternative for you.

Good luck and remember that your gut feeling is usually right, so make sure to listen to it.

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M.B.

answers from Dallas on

My daughter started doing that at 5 months and we went down that same rat race of meds and what they call "nectar" thick formula. As time went by she got worse. Ask the doctors to take his blood pressure and check his kidneys. My daughter at 8 months (3 months after all the projectile throwing up started) was finally diagnosed with a kidney that had a tumor and needed to be removed. All they need to do is a sonogram of the kidneys and take his blood pressure numerous times to make sure of an accurate reading. My Pediatric Dr. to this day is still amazed at what all happened to my daughter because it was overlooked as the reflex/ esophogus flap not closing. I would insist on those two things being done.

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S.D.

answers from Dallas on

Hi, L.! I read your post on my request for info and thought I'd respond to you here - it'll be easier for you to find. :)

My daughter was diagnosed at three days with laryngomalacia ("lazy larynx"). She made loud, squeaking noises (stridor) when she breathed due to the obstruction in her larynx. She also projectile vomitted and spit up when she ate. It is typical in children with laryngomalacia and they are often put on meds for this (ENT put her on Zantac now due to her young age and said that, when she is older - 6 months, I believe - she can be switched to Prevacid). We've also learned through several doctors that children with laryngomalacia tend to collect/pool their formula in the back of their throats instead of swallowing it which makes a gurgling sound. Thickening the formula with rice cereal (1 tsp cereal/2 oz formula) has helped my daughter with this immensely as well as helped her keep from spitting up.

The danger of spitting up in laryngomalacia and the reason (at least in our case) for putting the baby on meds to prevent that is that the stomach acid that comes up with the food irritates the airway (as you said) and can cause the airway to swell. This is dangerous in a child who already has an obstructed airway and can cause it to narrow even further making breathing quite difficult. This is what happened with my daughter when she was two weeks old and had to be admitted into the NICU and intubated.

My daughter is 4 months now and has had no other severe problems. When she is congested, we have to take special care in suctioning out her nose and throat as she has difficulty clearing the secretions out on her own (that whole "pooling in the back of the throat" issue again). We never had to have a swallow study. I assume that's because she doesn't have an issue with keeping her food down really (maybe spits up a couple of times a day and only vomits if she is coughing too hard). She just had her 4-month check and we've been given the green light on starting her on solids whenever we want (which I haven't yet so don't know how that will go). The doc said that it SHOULD decrease her incidence of reflux as putting kids on solids typically does and that we should remove it from the bottle. After reading your post, I'll keep my reservations in place that this will be the case.

Keep me updated on how everything is going and please feel free to email me. I'd love to see how someone else is handling this issue with their own child who is of a similar age. Good luck!

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A.G.

answers from Dallas on

I think you have recieved very good input. I don't want to freak you out but one of my friends had a daughter that had this condition and died at 4 months from aspiration. I believe in holistic medicine and I would use that in conjunction with my pedi. Canial Sacral has done wonders for one of my chidren. But this can be very serious and I am sure you are doing everything in your power to make sure your baby is safe. Sorry if I scared you, just don't want anyone to go through what my friend has endured.

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K.M.

answers from Dallas on

My oldest daughter, who is now 9 years old, had pyloric stanois. She was diagnosed when she was 2 weeks old and had surgery 2 days later. During the week that they were trying to figure out why she was vomiting and losing weight, we were changing her formula, adding rice cereal and running test. It did help hold the formula and breast milk down longer when we added the rice cereal, but it did not solve her problem. They did a barium swallow when she was less than 2 weeks old. It was very difficult for me to watch. We gave it to her through a baby bottle. Unfortunately, it did not discover her problem. I would recommend you talking to your doctor before you stop what was recommended. Also, let them know that when you did not give the cereal, that the child did not throw up as much. Good Luck.

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A.M.

answers from Dallas on

L., my littler guy did a Upper GI at 6 months and did great. No problems getting him to drink the barium cocktail. They prepared us for it by having him not be "full" before the procedure and boy did he gobble it down!

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V.P.

answers from Dallas on

My son, now 21 months, has gone through 3 swallow studies: one in the NICU (failed and was on thick-it and Zantac as well) the 2nd one 3 months later--he passed--and the third at 18 months old for a complete upper and lower GI. None of the 3 bothered him and he actually had "fun" during the test due to the attention being given to him. Nothing was noxious and the barium is as safe as anything else in this world!

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A.J.

answers from Dallas on

OMG!!! WE NEED TO TALK...

Your dr may not know this but you cant thicken Breast milk with rice cereal... the enzymes in the breast milk breaks down the rice cereal and thins it out... so you would have to add tons of cereal to even make a difference to breast milk. You have to thicken breast milk with a product called simply thick. its a tasteless oderless gel like thickener that is easy to use. I used this with breast milk for my son who had severe reflux and a cleft palate so he choked on everything and I was pumping so I used the simply thick.

you can get it at www.simplythick.com (I think) speciality pharmacies also carry it but the cheapest place to get it is direct from the website...

any way, My son who was born with a cleft lip and palate has had several swallow studies its no big deal at all. It is safe and never caused any problems for us at all.

I will also tell you that Zantac does not work for severe reflux you need to use Prevacid solutabs (1/2 in am and 1/2 in pm) and we also had to use Bethanochol(sp) with it. combined , those worked perfectly for my son.

you should go to a gastro Specialist not an ENT for reflux issues and stop going to your peditrician for all this. the pedi's just dont know the latest treatments that the specialists do.

also go to an OT for feeding issues. they should have known that you can't thicken breast milk with rice cereal.

you can thicken formula with rice cereal or a product called "Thick it".

any way, you can go to my website www.texascleftconnections.org to learn more about cleft conditions, my sons story or to get a hold of me.

Thanks- A. J

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L.I.

answers from Dallas on

My daughter had to have a couple of swallow studies following her heart transplant. One of her vocal chords was severed during the process and she was aspirating liquids.
She was given Simply Thick to thicken all of her liquids - I do think you need a prescription for it, so ask your doc about it. It worked well. You probably need to get it at a specialty pharmacy like Dougherty's - though we were in houston at the time and I beieve Walgreens had it too - depends on location. My daughter also had an occupational therapist working with her to teach her how to swallow propely again without aspiration. She wasn't an infant though - she was 2 years old. The swallow study really wasn't traumatic at all - if you are at a children's hospital they are pros at dealing with childen during the process. You definately want to have it done if there is a possibility of aspiration. I learned that it is possible for them to have aspiration without showing any physical signs of it - and the swallow test is the only way to be sure. Good luck and I'm sorry to hear your little one is having so many problems. ;(

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C.M.

answers from Dallas on

My little guy, who will be 4 in two weeks... wow he isnt little anymore!, has about about 20 swallow studies done. He had a whole host of problems from being born 1lb.

It is a simple procedure, otherwise I wouldnt have let my son endure it every few months. The barrium itself is not a bad chemical because hardly any of it gets absorbed into the bloodstream.

Having been in these shoes, you need to see a GI doctor. A pediatrician can not deal with reflux this severe. I say this simply because of what steps you are taking now. I ENT should not be doing a swallow study and with reflux this severe Zantac is not going to do anything, no wonder he is still throwing up! Prevecid is a much more effective drug on babies with reflux.

A GI will also be able to tackle these questions of a possible allergy of somekind to wheat (hence less throwing up with cereal). There is a thickner out there that is colorless, tastless and does not have any calories. It will not change his stool like cereal, again a GI doctor would be more helpful in this because it is expensive and requires a script so insurance will cover it. Its called Simply Thick (you can google it and find it online).

Good luck! I would do the study and see what it says. Feel free to email me, my son had to be on thickened liquids for 3 years to do aspiration, so we have been around all the blocks.. I feel your pain and will be praying for good news!!

C.

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K.L.

answers from Dallas on

When my daughter was almost a year old, she had an upper GI x-ray. When we introduced solid foods at six months, she ate rice cereal or applesauce for a couple of days without incident, but on the third day, she would projectile vomit the contents of her stomach.

Used to only breast milk, she would not swallow a bottle full of barium, so I had to ask them to administer the barium through a tube. Therefore, the test was incomplete, as the technician could not x-ray her esophagus. The x-ray was difficult because she hated being restrained. However, when it was finally over, and I was able to offer her breast milk, she calmed quickly.

Ultimately I discovered that my daughter was suffering from reflux, and once I asked that she be prescribed acid suppressers, she was able to eat solids. I praise God that shortly after my daughter’s second birthday, she no longer needed medication and now only very rarely experiences reflux symptoms.

I would recommend that you meet the technician before the procedure so you can ask questions. Also, do not hesitate to get a second opinion before proceeding with any tests. I pray that God grant you wisdom and provide compassionate doctors as you care for your son.

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A.M.

answers from Dallas on

Hi my son went through the barium test. What they have you do is have your son miss his last meal. And then at the doctor's they will give him barium which looks like milk through a bottle. He will be placed under what looks like a big x-ray machine but it will allow you and the doctor to see how the fluid flows through his organs and see if his larynx is indeed the cause of his problem. You get to stay by his side the whole time. Or he may be allergic to the cereal you are feeding him but it's better to be safe then sorry. After the barium test my son didn't behave any differently and wet and soiled his diapers like normal. No scary side effects. I rested easier knowing that at least my little guy didn't have the lazy larynx. He eventually just outgrew the spitting up thing. I'm had to drink barium before for another test and it tastes like thick vanilla, have you had milk of magnesia... like that.. not as bad as you think it is.

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K.S.

answers from Dallas on

My youngest, who was a preemie and in PICU for RSV, had to have several swallow studies. They believe that when he was intubated twice, it damaged his esophagus and he also had laryngomalacia. Luckily, he did outgrow it, but it wasn't until about a year.

The studies weren't that bad. He didn't love them, but it gave us a lot of great information. The one thing I would consider is using a pediatric place for the study as opposed to an adult location. Ours specialized in children, so they were very patient and nurturing, both to my son and me =)

We also thickened for about a year due to severe reflux and aspiration. The Simply Thick is what we started on, but it caused him a lot of GI distress, so we switched to the rice. It did constipate him, but a little milk of magnesia in every other bottle fixed that right up.

Zantac didn't touch his reflux, switched to Prevacid, which helped some, but what really helped was when he got older and got on table food and was upright because he was sitting up and moving.

Good luck and hang in there!

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S.R.

answers from Dallas on

My son did a barium swallow test at about 14 months, so a bit different from your situation, but it wasn't that bad. The woman administering the fluid (it will be in a bottle for your little guy) was really sweet; she had toys to distract him with. It was MESSY, so make sure you have a complete change of clothes for him, and maybe for yourself too in the car.

I second the suggestion to see a pediatric GI to take a closer look at this. The ENT and GI should be able to work together, and any doctor who tries to talk you out of getting a second opinion isn't worth seeing again!

I would also recommend taking your son to a chiropractor. It may sound nuts, but a chiropractor offers a gentle, non-invasive option which might improve your son's reflux. There is no magic bullet for anything, so I'm not pretending that your son's issues would disappear after a few adjustments, but if it might reduce the severity or frequency some, then in my book it's worth a shot. My kids and I see Dr. Melissa Shelton (www.drmelissashelton.com) at Preston and Hedgecoxe. She sees lots of babies, takes most insurance plans, and is really wonderful to work with.

I'd also like to put in a plug for continuing to nurse. Breastmilk is the most perfect food for your baby, and even if you have to do elimination diet trials of your own food to look for a food allergy, the other benefits of breastmilk (immune system support, most easily digestible proteins, perfect fluid balance as the weather warms up, etc.) are worth it.

Good luck on this journey. You are obviously doing everything you can to help your son. Trust your own instincts, and don't let the doctors brush you off or force anything on you. You have a right to understand what's going on, and they have a responsibility to explain it to you until you are satisfied.

S.
SAHM of 3

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S.R.

answers from Dallas on

My daughter was 10 months old when she had her swallow study with barium. She tolerated it quite well. My only caution would be the possible recommendation afterwards. The therapist finished and told us that we should put a g-tube in our daughter immediately. When I asked what would happen if we did not, she said our daughter would get pneumonia and die. Of course this was NOT what we were expecting to hear. Our daughter was thriving and was eating fine. I was actually set to deliver our second child two days after hearing this. I was very blessed to have previously worked for a doctor who called other specialists for me about the recommendation. We were told by several pediatric specialists (doctors) that we should NOT do the g-tube since she was thriving just fine. Therefore, we used thicken up to "thicken up" her liquid intake. You can find this at Walgreens, etc. She was on this for about a year and took Prevacid as well. She eventually grew out of the aspirating issue. She is a happy, healthy 6 year old now. Please just be cautious with any drastic recommendations. The person we had was a speech therapist/pathologist from Cooks. This was the only bad experience we have had at Cooks. We love Cooks and all the people there except for this lady. I just did not want to tarnish Cooks' good name, but I wanted to let you know where we had it done. I hope everything goes well for your little one and that you have peace through it all.

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B.C.

answers from Dallas on

I have a ton of advice for you. :-)
My daughter, E, is a micro-preemie (born at 1#, 5 mos early), so she has had 2 barium swallow studies so far, and we are going for our third here in March. They are NO BIG DEAL. So don't worry over them. It will be okay. The worse thing about them is they want her hungry, so she was, very! So a little fussy. But it shouldn't hurt him, or bother him.
E was aspirating since birth on everything, so we thickend her breastmilk with thickner. Even then, she had the vomiting issue like your son. We have used "Simply Thick" gel thickner in the past and are now using "HydraAid" gel. They are both great, but the packets are easier to empty with HydraAid. E is on Medicaid so we do not pay for it, but your insurance may cover it, if the swallow study deems it Rx. If not, it is about $30 a jar and that will last you almost all month, longer if you are on 'nectar-like' thickness or thinner.
At her 2nd study, done in Oct, when she was 8 mos old, she was STILL aspirating on a 'nectar-like' thickness, so we have been bumped up to 'thin-honey' since then. She has that same "lazy-larynx" issue, also refered to as a "soft larynx" (FYI) and they told us it only gets worse as they get older (which seems counterintuitive) until they are big kids. Aspiration is very serious and can cause fatalities from Pnemonia and other chest infections. So do not take it lightly. The technician at E's Oct study was very upset that she had still been aspirating all that time, and we were very lucky she had never gotten sick.
I know what you mean about the constipation, so I would thicken with a thickner rather than formula if you can afford to, it's almost the same price actually. The thickners will not constipate him. But it will slightly dilute your BMilk, so I would add a little bit of formula to off-set that. We are no longer allowed to give E Bmilk due to a protein allergy, so now we do a ratio of 20oz H2O, 15 scoops of Elecare Rx formula, and 22 pumps of HydrAid for a 'thin-honey' volume that gives E 22 calories per oz. You would do roughly 4 scoops of formula to 20oz BMilk for a 22-24 calorie meal. Depending on your formula's caloric density.
E poops with every feed on that. So it seems that maybe something that you are eating may be constipating him? Be sure you get enough fiber too, a Benefiber supplement may do you both some advantage.
E was on an antacid from birth to December and I agree with you, I hate to give meds if I can avoid it. It did its' duty though, and you want to protect the esophageal lining from being eaten away by his vomit. I know Bulemics have lifeling issues, so there may be permanent damage by stomach acid going the wrong way as much as he is.
Lastly, DO NOT USE "Thick-It". It adds some caloric value, but gets thicker and thicker the longer it sits and is a big pain if you mix batches in advance. It will not work! :-)
E also had an EGD, (camera down the throat all the way to the small intestine) in Oct and despite her vomiting, it was normal thank God. But she did not vomit as much as you say your son does. She also had a PH Probe that came back negative, so again, I asked myself, "Why the Antacid." But I continued it through Dec anyways to be safe.
Hope this helps, write me back if you have any other Qs. And good luck!!

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L.C.

answers from Dallas on

My son had reflux and projectile vomiting too. We took the natural route. Craniosacral Therapy with the right therapist did wonders and so did homeopathy. If I were you I would be very cautious on vaccinating him. At least spread them out . His little body is not digesting well and the vaccines can wreak havoc on his GI tract, NO MATTER WHAT THE DOCTOR TELLS YOU!!! You need to listen to your gut and it sounds like you are not comfortable with the "chemicals" etc. There is a reason us moms have such a strong intuition!!! Its just that we don't listen to it enough. There are other ways besides western medicine to help us heal. Homeopathy heals the source and does not mask the symptoms. If you have any more questions email me. ____@____.com
L.

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T.T.

answers from Dallas on

My son had the same test done when he was an infant. He did better than expected with it. I had it done at Centinneal Hospital in Frisco and the results were informative.
Instead of cereal to thicken the formula (to help keep it down). We used 'simply thick'which worked pretty good.

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