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Children's Health

Possible Birth Defect Infant



Hi my daughter was born at 34 wks and had a few what i thought was regular problems throwing up a lot several times a day and zantac doesn`t help formulas been changed a lot now on a nonmilk formula but recently went to the doctor and she was worrying about her head size its almost 17 inches spready was 12 when born her three yr old brothers head is 19 his has grown 4-5 inches i took zolof when i was pregnant what it couldat could be wrong with my little girl worried sick just want answers waiting to get an ultrasound the 18 th atlease let me know what this could be


I certainly understand your worry! Zoloft is actually one of the best choices for an antidepressant during pregnancy with a good but not perfect safety profile for the developing baby. Preterm birth is associated with its use as are heart defects and defects of the abdominal wall. Stress is a major contributor to both depression and preterm birth, so it is difficult to know what exactly triggered the preterm delivery.

We do know that preterm babies often have developmental and learning problems. I am not sure how your baby was delivered, but it is possible if forceps were used or it was a traumatic delivery, that bleeding occurred between the skull bones and brain tissue that has compressed the brain tissue triggering vomiting and also blocking circulation of the cushioning fluid in the brain making the baby's head expand rapidly. If this is the case, Zantac and formula changes will not stop the vomiting.

Another possibility is that the baby is suffering from physical abuse possibly from violent shaking or hitting the baby or dropping the baby. In that case, the brain tissue is like bruised tissue anywhere on the body. It swells in response to the trauma of banging against the skull bones and the increased pressure of the swollen tissue on the vomit center in the brain is causing the vomiting and the brain swelling is causing the larger than  normal head size.

It is also possible that the baby was born with excessive fluid in the brain, a condition called hydrocephalus - or water in the head. This falls into the family of defects called neural tube defects that occur very early during pregnancy, many times before a woman knows she is pregnant. Low folic acid and poor maternal nutrition are associated with all of these defects. Sometimes it is just random and we don't know why.

Finally, the best situation would be that the baby has inherited the genetic code for having a large head size and there is absolutely nothing to worry about. The strong vomiting your baby has had could be from pyloric stenosis, which can be fixed with a relatively simple and safe surgery. However, most pediatric doctors would have already checked for signs of this problem before checking the baby's brain for problems.

I know these are mostly very scary health problems to consider. If there is a problem needing treatment, a pediatric neurosurgeon will be able to help your baby. Your daughter's doctor is taking good care of her and I hope you have good news soon that all is well.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University