Preemies, hiccups, and Mary Poppins

Victor is plagued with hiccups. I get them a lot, but his are so violent it looks as though his chest is collapsing (like CPR!). It looks so uncomfortable. They are always triggered by eating, and I have long suspected that his prematurity as well as his dystonic CP are factors (probably on top of some kind of weird genetic predisposition).

Interestingly, there are no studies that I can find indicating preemies are at higher risk for hiccups (independent of CP). Babies hiccup in the uterus, starting about 9 or 10 weeks – basically prepping the diaphragm for breathing. In the NICU, premature babies hiccup as a sign of stress or over stimulation (it’s one of the cues that tells you to help get their nervous system re-organized).

So, to me it makes sense that hiccuping could be an issue for more preemies in the long run given this normal in utero process has been interrupted and replaced by this abnormal stress hiccuping. There is a lot of imprinting that happens in the NICU and then throw in nerves that are still myelinating, muscle coordination issues, and exposure to medications and you probably have a perfect hiccup storm. Then again it could just be Victor.

Nothing has worked for his hiccups. Not drinking water or holding his breath (bot of which are supposed to increase carbon dioxide in the blood and stimulate chemical receptors to quiet down the phrenic nerve, the one that supplies the diaphragm and the electrical source of the hiccups).

Recently, while researching this plague (after a particularly natsy evening round) I found an article in the New England Journal of Medicine touting a teaspoon of sugar. I admit, all I could think of was Julie Andrews dancing around her carpet bag in the nursery singing,  ”A spoonful of sugar.”  

I figured, what the hell? The dentist might frown, but the science seemed solid (involving simulating chemical receptors in the back of the throat and a few other things that seemed reasonable). The success rate was great: it worked for 19 out of 20 patients. Pretty damn good.

So last night when Victor was once again wracked with hiccups mid meal, I told him I had a magic cure. He was scared at first, not knowing if I really had sugar or if this was some new nasty medicine (it has happened before. Sigh). He let me pop a teaspoon full on his tongue and I had him close his mouth while it dissolved.

HE STOPPED HICCUPPING! I could not believe it. He also grabbed at the sugar bag, because basically he was main lining the stuff so all his brain could say was more!

Could it have been placebo? Possibly, but I have tried so many other hair-brain hiccup schemes that have not worked I think it was probably science (got to love chemoreceptors!).  And the treatment was natural, unlikely to harm as long as he brushed his teeth, cheap, and tasted good.

I am all for natural therapies, but they really need to stand up to science. And when they can be evidenced-based and come wrapped in a paisley carpet bag? How great is that!?

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