How My Baby Dropped Acid and Ended up in the Emergency Room

I’ll try to make this short, while also hitting all of the important details. We’ll see how brief I can be.

Ever since Creegan was born, he seems to have spit up a lot more than is typical. We assumed, as did Creegan’s doctor, that he had acid reflux, which is not wholly uncommon in newborns. Melanie and I both have acid reflux, so I figured that increased the odds of our children having it, and thus I never really questioned that that’s what Creegan was dealing with.

At about four weeks of age, the spitting up seemed to increase. Creegan had a doctor’s appointment at about 4½ weeks old, and the doctor prescribed Zantac. The spitting up only seemed to get worse. In fact, “spitting up” no longer seemed an appropriate description. He was projectile vomiting. It looked quite literally like someone turned on a garden hose hidden inside Creegan’s mouth. It didn’t come out in one quick spew either; it would sometimes keep going for a second or two, which was really crazy looking given that the stream was so big and arching.

Mama called the doctor and the doctor said that the Zantac could possibly be making things worse. And so, quite counterintuitively, she instructed us to increase the Zantac dosage and instructed us to make sure Creegan had some breast milk immediately after taking any Zantac. We hadn’t been instructed to do that before, so we tried it. If anything, matters only got worse. By this point, Creegan had gone a day without pooping and his urinating was quickly disappearing too. Clearly, nothing was getting through his system. Consulting again with the doctor, we were told to cease with the Zantac altogether and put Creegan on Pedialyte and nothing else. If things didn’t improve by that evening, we were told, we should take Creegan to the ER.

Things didn’t improve. Wednesday night, Melanie took Creegan to the emergency room. As I’ve learned all too well by this point, emergency room visits generally take 6 – 8 hours before anything is figured out. Finally, they were able to deduce that Creegan has pyloric stenosis. The condition affects about .3% of babies, mostly males, and typically first-born males. It usually manifests itself at about 4 weeks of age. It’s an overgrowth of the muscle between the stomach and small intestine, and because the muscle is too large, food is unable to pass from the stomach into the intestines. Having nowhere else to go, that food eventually comes back up. The only treatment is surgery. The surgeon goes in and stretches out and spreads the pyloric muscle open, eliminating the obstruction. (For an excellent summary of pyloric stenosis, including its symptoms and treatment, see this article from kidshealth.org. It’s spot on from what we can tell.)

Creegan had surgery on Friday morning at approximately 10 a.m. We were told this surgery is incredibly routine and simple, a guaranteed fix if performed correctly. The actual surgical procedure takes as little as 8 minutes. Dr. Crooms performed the surgery, and by 10:45 or so, he told us everything had gone well. The surgery was over.

Now for the recovery. Creegan had to wait until 4 p.m. to eat any food by mouth. He hadn’t eaten since 5:30 a.m. the previous day, almost 35 hours earlier. An IV kept him hydrated and nourished, but he wasn’t happy not to be eating. Melanie had to do her best to keep him calm, all the while feeling heartbroken to deny him what he was asking for. At the 4 p.m. feeding, Creegan was allowed only half-an-ounce of Pedialyte. Fortunately, he ate well and did not fuss and fight for more. He was a bit doped up on morphine, so that helped. In fact, he slept almost all day yesterday, into the night. At 7 p.m., he had a full ounce of Pedialyte, again doing well with it. His next feeding was scheduled for 10 p.m., at which point he was going to receive an ounce of fluid, half Pedialyte, half pumped breast milk. He was too doped up to eat at 10 p.m., and kept sleeping. He didn’t eat until 1 a.m. He spit up after this feeding, but the nurse said it was nothing to be concerned about. The spit up was kind of snotty, and they expect there might be some spitting up as Creegan gets used to eating again. Since then, Creegan has had two more feedings—still the half Pedialyte, half breast milk mixture—and is up to two ounces. He has not spit up again. He is doing well. The next feeding will be two ounces of pure breast milk. If all goes well with that, then he can begin breastfeeding (at the breast) like normal at the next feeding. As long as the doctor makes his rounds at a decent hour, Creegan will supposedly be able to come home today.

It’s still possible that Creegan has acid reflux. The pyloric stenosis wouldn’t explain the spitting up that occurred during Creegan’s first few weeks of life. Even though acid reflux was dropped as a possible cause of his most recent ailments (and yes, that’s the lame and convoluted way that I got the title of this post), it may be something we’ll all have to deal with. That’s something we happily accept.