Feeding Therapy Begins

Now that the stricture in Kiera's esophagus has been opened, we know for sure that she suffers from gastroesophageal reflux. A lot of babies spit up but gastric reflux in babies is so much more complicated than simply spitting up.  Before the dilatation of the stricture, Kiera would cry, gag, and cough.  We were not sure if her stomach contents were coming up the esophagus because the stricture prevented any formula from coming up.  So we thought that Kiera simply had gas pains or needed to burp.  We treated those things to the best of our ability. We also tried to never let Kiera lay flat -- even for diaper changes (very tricky).  She sleeps on an incline and is held in place with a harness at night.

It is really important to treat gastric reflux in individuals that have scarring in the esophagus because the acid from the stomach can make the scare tighten.  So, Kiera has been prescribed a proton-pump inhibitor (omeprazole (Prilosec)), which is supposed to make the stomach acid less acidic which will prevent further scarring in esophagus. As of today, Kiera has had two doses and the medication is supposed to take effect right away.  Kiera's surgeon called this morning and indicated that the mixture of omeprazole that she prescribed was a bad choice because it has a tendency to clog feeding tubes and is no longer effective after 3 days.  So, the prescription was changed to lansoprazole (Prevacid).  Lansoprazole has to dissolve slowly in the mouth.   This will prove to be a challenge as Kiera is not swallowing much.  These medications will not prevent stomach contents from coming up but will stop the heartburn.  We will have to wait and see if it helps Kiera.


In the meantime, we need to train Kiera to trust the bottle.   Fortunately, she allowed us to put the bottle nipple in her mouth yesterday.  Today, for the first time in 8 weeks, Kiera sucked and swallowed.  It was slow going and she only took 10 ml in 10 min, but it's a start.  Here is a picture of her beginning the process.