Choking on his vomit

[Funtimes]

Hi,

DS is now 7mths old and has had reflux from 6wks of age. His reflux has never distressed him with any pain or bothered him as such, so we (nurse, gp etc ..) put him down to being a happy chucker. His weight gain has been more than fine (9.6kgs at 6mths!) and the mess never bothered me.
We began him on thickener in his formula/bottle from 16wks and it improved the amount he threw up imensley and we are still using it, otherwise he would still be vomiting quite a bit.
As I said the mess never bothered me but the reason I needed something to help was that there were starting to become occasions where he would appear to 'choke on his vomit', and it scared the life out of me! His vomit often just comes up his throat and he will just swallow it, but it was like it was going down the wrong way which would cause him to gasp/choke and cough.
When he was a couple of months old and still in his bassinette next to me I would hear him choking at night and would have to whisk him up and pat his back so he would be ok. This would happen all the time but wouldn't be too bad once he was upright, it was more so just catching him off guard in his throat.
Approx 6wks ago he was sitting in his bouncer and he started to gasp and splutter and it looked like he couldn't breathe. He was very red in the face, very distressed, trying to cry, his eyes were watery, clear liquid was coming out of his mouth and nose and his body was stiffening up, pretty much it looked like he was choking on something. It took him a good couple of minutes to get back to normal. This scared the life out of me and I was very close to hanging him upside down, it was horrible. A couple of days later it happened again, this is when I saw a pead.
She said what I described is something called 'Laryngospasm' and there is nothing I can do about it, it is something he will grow out of, but if it is ever bad enough at anytime I may need to call an ambulance! She explained to me it is when his vomit gets caught on his larynx and causes a coughing fit/spasm.
Ok, it happened again last night as my son was sitting upright and it was pretty bad, he didn't cry or anything but again was like he was choking on something and couldn't breathe and was so distressed, it was exactly like the other two times. I thought perhaps being on solids and thickened formula may have helped a bit more but it seems now he is sitting up his reflux is a bit worse and is happening more often.
Im not sure if this 'Laryngospasm' is something you can give me advice on and whether it is associated with his reflux, but was hoping you could shed some light on what is happening to my son and give me a second opinion, it scares the life out of me everytime it happens and im scared that one day he wont catch his breath.
Any advice or a point in the right direction is appreciated. :)

Debbie

[RISA]

Hi Debbie,
What you are describing is certainly scary, and i know from first hand experience just how scary that can be as my son used to choke a lot too. It is awful and you start to wonder when/if they are going to be able to catch that next breath!!

I know that you would desperately want to try anything to stop it happening, but also that you feel so helpless too. My son would sometimes look at me with fear in his eyes, begging me to help him, and i never really knew what to do! Reflux can be such a horrid condition, and it still amazes me that so many people think nothing of it; that to them its just a baby who spits up occasionally!!! sigh

I don't know if it will help, but something you MAY be able to try, is either not thickening his feeds, or thickening it less than what you have been doing. Even though it has been working up til now, I wonder that since he started solids, it;s just that bit too thick for him to handle, and thickened feeds don't work for every refluxer. Sometimes it can make things worse, and any reflux they have can be hard to clear from their oesophagus (which can cause more pain and more coughing/spluttering/choking in some kids).

If you are comfortable with trying that, or experimenting with different thicknesses, you may notice a change. If you aren't comfortable with the idea, then of course don't try it, as I believe a mum's instincts are very important!

Something else that may be worth discussing with the dr is whether medication would be worth trying- either Losec or one of those reflux medications, or a motility medication like Motilium or low dose Erythromycin. Losec will sometimes reduce the amount of refluxing, though not always of course, and the others can help the stomach empty quicker, which gives less opportunity to reflux.

A lot of refluxers are intolerant to cows milk, so that may be another option too- trialling taking him off all cows milk (even traces of it) to see if there is any difference in his refluxing.

Since he started solids, and is on thickened feeds too, is there any possibility of him being constipated, even a little? That can cause more reflux, so if he is a bit constipated, if you work on that, you might find a resolution of the choking, or at least an improvement. Just a thought!

I'm also wondering if his reflux has been influenced by other factors, as reflux can flare with other things too, such as teething, illness, immunisation, a change in routine, being overtired and even crawling or trying to crawl. If any of these things is happening, then that may explain why his reflux seems worse now. If so, perhaps it helps to know that there is a light at the end of the tunnel, and when these factors are removed, things will go back to normal.

I hope I've given you something to think about, and i hope you find something that helps. It IS scary!!! You may not ever need to call the ambulance, but it's also good to know the service is there if you should ever need it. (Do you have an ambulance subscription?)

Glenda