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Hello. My Son Is 5 And Half Months Old. A

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Posted on Wed, 7 Nov 2018
Question: Hello.

My son is 5 and half months old.

A week ago, he was vomiting a lot and distressed. I took him to the ER and they diagnosed him with an ear infection and gave him drops and antibiotics (and pain relief medication). The symptoms came back 3 days later when we could no longer use the drops (the drops were off-market and expired after 3 days). I went back to the ER and they said the infection was a lot better but provided more drops. This seemed to do the trick for a while.


However, a couple days later he started vomiting a lot (tho this time was not distressed). I took him to the pediatrician who said to throw away the antibiotics (even tho we were only on day 5/10) because the infection had cleared up and the antibiotics could be making him more sick. We did this, but the vomiting continued. We tried pedialyte after the vomiting and used Zofran for the nausea. We are on day 4 and he is still vomiting, so I took him back to the pediatrician.

He said two things I want another opinion on. First, he said he should go BACK on the antiobotic (a stronger version this time) because the infection was back. And he said this way we can tell if he is better that it is working and if it is worse than it’s the antiobotic that made him sick. Second, he asked if he was rolling over. My son has stopped rolling over. He did it at 3 months but stopped around 4 months and change. The pediatrician said it is possible the vomiting and not rolling over could be linked. If this is true, would is the worst case scenario of the link? And is there another opinion on this generally?
doctor
Answered by Dr. Diptanshu Das (4 hours later)
Brief Answer:
No need to start antibiotics again.

Detailed Answer:
Thanks for using the Ask a Doctor service.

I have gone carefully through the entire query. I do not think that you need to go back to the antibiotic. A span of 5 days of antibiotic is enough anyway and if there is no apparent infection left it is no use continuing further if there is a likelihood that it could be making him sick.

I do not find a direct connection between rolling over (in infancy) and vomiting. Your doctor is trying to link gastroesophageal reflux. There is indeed strong likelihood that the vomiting is due to gastroesophageal reflux. It could be due to inadequate burping, overfeeding or due to inability to digest top feeds with formula milk. I do not think that a second opinion is needed but you need to essentially continue the Pedialyte and Zofran as of now.

Keep me updated. Feel free to ask me back in case of further queries.

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
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doctor
Answered by Dr. Diptanshu Das (27 minutes later)
Brief Answer:
Get a second opinion.

Detailed Answer:
Thanks for writing back.

Since he says that he now finds the infection again, it would be worthwhile to get the child evaluated by another pediatrician. I cannot find a direct link between ear infection and vomiting.

The milestones of the child seem proper. So, the cessation of rolling over does not seem to be a concern to me and indeed seems to be moving over to the next milestone. What your doctor is trying to relate is that the muscle tone of babies is low and so the milk may tend to regurgitate back if the child is rolling over and pressing upon the stomach. I doubt if that is the case.

Reflux or vomiting does not seem to make us worry about any chromosomal or genetic abnormality. Your second pediatrician can evaluate and comment. It is hard to comment on this aspect without evaluating the child clinically.

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Diptanshu Das (3 minutes later)
Thanks. In this case, after 5 days the infection had cleared so he told us to throw away the antibiotics (it was supposed to be used for 10 days). But now (which is 4 days later) he said to go back on them because he saw the infection again. I wonder if I should go in person to another pediatrician?

Also, what could roll over regression have to do with reflux — some sort of chromosomal abnormality? My baby holds his head up, can tripod sit unsupported, laughs and grabs so I just thought he had moved on to other milestones.
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Dr. Diptanshu Das

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Practicing since :2005

Answered : 3878 Questions

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Hello. My Son Is 5 And Half Months Old. A

Brief Answer: No need to start antibiotics again. Detailed Answer: Thanks for using the Ask a Doctor service. I have gone carefully through the entire query. I do not think that you need to go back to the antibiotic. A span of 5 days of antibiotic is enough anyway and if there is no apparent infection left it is no use continuing further if there is a likelihood that it could be making him sick. I do not find a direct connection between rolling over (in infancy) and vomiting. Your doctor is trying to link gastroesophageal reflux. There is indeed strong likelihood that the vomiting is due to gastroesophageal reflux. It could be due to inadequate burping, overfeeding or due to inability to digest top feeds with formula milk. I do not think that a second opinion is needed but you need to essentially continue the Pedialyte and Zofran as of now. Keep me updated. Feel free to ask me back in case of further queries. Regards