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Gavaging the infant lung
Avraham Avital1, Simon Godfrey, Raphael Bortz
1Institute of Pulmonology, Hadassah University Hospital and Hebrew University-Hadassah Medical School, Jerusalem, Israel. avitl@hadassah.org.il
Insights
A baby girl
Area of Science:
- Pediatrics
- Pulmonology
- Gastroenterology
Background:
- Infantile failure to thrive and respiratory distress can stem from various causes.
- Diagnostic challenges arise in identifying the etiology of persistent pulmonary infiltrates in infants.
Observation:
- An infant presented with failure to thrive, tachypnea, and bilateral infiltrates.
- Bronchoalveolar lavage fluid showed positive oil-red O staining, suggesting lipid aspiration.
Findings:
- The infant's symptoms were attributed to chronic aspiration pneumonitis.
- Forcible feeding by an anxious mother was identified as the cause of aspiration.
Implications:
- Psychological support for caregivers is crucial in managing pediatric feeding disorders.
- Early identification of feeding dynamics can prevent severe respiratory complications in infants.
Abstract:
An 8-month-old female infant was hospitalized for persistent bilateral infiltrates, failure to thrive, and tachypnea. An extensive diagnostic workup was negative, except for strong oil-red O staining of the white-turbid bronchoalveolar lavage fluid and borderline esophageal pH monitoring. Conservative treatment failed, and she was scheduled for gastrostomy and Nissen-fundoplication until the family physician found that the anxious mother was feeding the child forcibly, which caused chronic aspiration pneumonitis. The mother was given psychological support and was supervised, and the child recovered completely.