16 month on on PD - advice needed

My 16 month old has ESRD and has been on PD for about 2 months. Since he cannot talk and express how he feels I thought I’d turn to those who can.

I am having a hard time getting his nutrition in him (enterally) since he fills up quickly and then vomits. He only takes in about 60% of his required fluid. Is this delayed gastric emptying? (We have changed his diet about 6 times now).

Also, he wakes several times per night vomiting (dry heaving). Docs have tried to shorten his cycles (7 instead of 9). Should we try to lower his fill volume?

Docs tell me this is normal - infants vomit a lot. REALLY? Do I have to accept this without trying to change it?

Thank you for any advice you can give. Anna

I do agreee that infants on dialysis experience more vomiting than normal.
I am a pediatric dialysis nurse and I know that often our parents tell us that feeding issues with their infants is more stressful than the dialysis treatments. There are several things that you can try. You can try to give some of the formula during the day in small boluses and then give the remaing during an infusion at night. You might also be able to decrease your pass size–you may then need to increase your number of passes. We do know that the dialysate volume can push against the stomach and lead to vomiting. Sometimes you can increase the number of calories in the formula so that you can decrease the volume. However if the concentration is too strong it can also cause vomiting. You will need to work with your dietition closely for this. There could also be some medications that might help–check with your doctor. You may also need to have him checked to make sure that he does not have gastric reflux. Hope this has given you some thoughts to discuss with your medical team.

My son is 3 months old and has been on PD for the past month. He has end-stage renal disease from posterior uretheral valve obstruction. He tends to vomit frequently but seems a little better after having a Nissen fundoplication and G-button placed. He is a very poor feeder and seems uncomfortable with larger bolus feeds. I hope to get him home soon. I hope this helps.
Best wishes,

I’m 70 yrs. old and I’ve been on dialysis over a year. I still have problems with vomiting sometimes. It gets better with the passing days. It’s easy to eat too much because you fill up while you’re still hungry. Remember they are getting a lot of sugar from dialysis and may not want anything sweet. I’ve gag on sweets now.