human
Is it PPA or is there something wrong with my 9 week old son?I want to mention that Im not a FTM. This is my second baby. My first didnt sleep consistently through the night until 2.5. But I really feel like this isnt normal and no one is taking me seriously.Around 2 weeks he started refusing to sleep on his back. Weve had to resort to bedsharing(not what I want to be doing) and he still will only sleep in 30-60 min max increments. He breathes through his mouth a lot. And sounds like a pug when he breathes sometimes. He will stop breathing for a few seconds and then wake himself up with coughing/gagging noises. He frequently gags/chokes when breastfeeding as well. My pediatrician thinks the breathing is normal and that hes working us by crying when we put him to sleep on his own (told us to keep putting him on his back in his crib and hell figure it out. But he screams immediately).Hes had his tongue and lip tie removed a month ago. Chiropractor appointments. Hes on reflux meds. And Ive been dairy and soy free (was having green mucousy diapers) for 2 months. All of this has greatly improved his colic/fussiness- hes usually happy now. But not his sleep.My last resort is maybe an pediatric ENT. But idk what they would even do. Everyone keeps telling me his breathing is normal but I just have a feeling its not. I dont want to waste anyones time.Ill link a video of him breathing and screenshot of his owlet sock showing oxygen lvl and how frequently hes waking (orange is awake). I really really appreciate any advice.
gpt
See the pediatric ENT.The breathing sounds to me like he may have a "floppy" airway and could have a condition called laryngomalacia or tracheomalacia. It's fairly common, often does not require medical intervention, and typically improves with age, but you should have him evaluated particularly given the nighttime coughing and awakenings, which are likely because of the condition causing temporary drops in oxygen (as you saw on the owlet) resulting in the body's response of cough/awakening to bring oxygen back up. The pediatric ENT can use different techniques to determine whether this (or another) condition is present and responsible for the symptoms.Interestingly, children with this condition are sometimes recommended to sleep on their stomachs as it helps relieve the upper airway obstruction caused by the floppy larynx and/or trachea, so by refusing to sleep on his back, your son might just be telling you what his airway needs right now. The ENT will provide guidance on how your child should best sleep as well as any other recommended modifications to help with the condition.If bedsharing, practice safer co-sleeping techniques as much as possible as described here. Most important is firm mattress, no pillow/blankets present that could possibly obstruct the face during sleep, no smoking, drinking, or siblings.
Pediatric question: For an 8mo baby with hypotonia and delayed gross motor milestones, how much could diagnosing the cause impact the PT/OT she is already receiving?We are talking about an IUGR baby who was born 0.03rd percentile at 38 weeks and is now 13th percentile weight, still has low BMI and diagnosed at 6mo with overall hypotonia. Currently working with PT in person weekly and OT via video-chat weekly.Skills being worked on in PT/OT include:rolling front to back (emerging, working on efficiency)rolling back to front (she never does this unassisted)weight-bearing on elbows in tummy time (often lifts arms and arches back)weight-bearing on hands in tripod sitting positionshifting weight and reaching while in prone/various seated posesbuilding lower abdominal strength with targeted exercisessensory brushing and joint compressionsimproving one and two hand grabsreconditioning oral aversion (from extensive craniosacral mouth work and tongue tie revision w/ post-surgical exercises around 4-5 months old)eating solid foods (baby will touch foods, but never bring to mouth, accepts spoon feeding enthusiastically)neck and shoulder stretches for mild torticollisIm probably leaving something out, but this is an idea of our therapy focus. We live in an area with only one pediatric neurology practice, so we cannot begin to diagnose or rule out anything until our scheduled visit in 2 months.My questions are: Is the therapy we are doing appropriate regardless of diagnosis? How could delaying diagnosis until 10 months (or later) affect her long term outcomes? Would there be any reason for us to travel out of state to a larger facility if we could be seen sooner (on our own dime, eight hours away)?TLDR: Is diagnosis of the cause of mild to moderate infant hypotonia urgent when PT/OT is already underway?
A proper pediatric neurological evaluation will better guide PT/OT, as well as if any other necessary treatments if the underlying cause is treatable.