There are so many scary things out there for most Moms, especially as a first time Mom. She can’t help but worry about her baby’s healthy development from the beginning to the end of her pregnancy. Often times the worrying is for nothing, though completely normal for any Mom to feel. Of course, there are times that complications do arise in pregnancy, whether it is her first or fourth pregnancy.
During these times, it is important she stay calm, gather as much information as she can from her doctor and her medical team so that she can do the best and safest possible thing for herself and her baby. She may have some difficult and painful decision to make ahead of her, but at the heart of it, is her love for her future child will help her make the right decision.
Standard ultrasound screenings are where most anomalies in utero will be detected. The sooner this happens, the better for everyone. The woman will have more options available for her baby if she gets all her facts right up front. Sometimes there is risk of a genetic abnormality or anomaly. Here she will have to make many difficult decisions if she decides to continue with the pregnancy. She may also be given the option to terminate her pregnancy if it is considered early and safe for her to do so. There are no easy answers here. It is a very personal decision and one for which no woman should be judged either way.
There are also things like problems with the baby’s heart, developing organs, or other forms of distress. Often, surgery will need to be performed immediately when baby is born, and there are risks there as well, though often, things do work out and baby is fine. Finally, there is one condition which a lot of women don’t know a lot about, but sometimes is detected in utero. It is called Double Bubble. What is this condition and how could she make the best decision for herself and her baby? Here are 15 Need to Knows about Double Bubble:
15 It Happens Between Stomach and Intestine
Double Bubble is really medically called “duodenal atresia”. It is when there is a blockage that forms between the stomach and the intestine. This is known as a common obstruction in the intestine area. The incidence of it occurring is between 1 in 10,000 live births. In about 50% of cases there are known to be congenital anomalies that occur alongside the Double Bubble and in 30% of cases, babies are found to also have Trisomy 21, also known as Down Syndrome.
There are many cases where there seems to be a familial cases of duodenal atresia. There is more evidence now available that there is a genetic origin that cannot be discounted. The most important thing, however, is that the woman and her family are given all the information possible about this condition so they can be aware of all the help that is available to them and to their baby.
14 A Third Will Be Born With Down Syndrom
Another thing that a woman and her partner must be aware of is that many babies, 1/3 to be exact, who have duodenal atresia also may be born with Down Syndrome. What they also must know that though babies born with Down Syndrome have some health risks, it does not mean that they will not be healthy in many ways as well as grow and flourish into beautiful children and adults. Yes, there will be challenges for sure, intellectual and motor mainly, but many children with Down Syndrome thrive and do well as does any child with the right kind of support, love, and belief in their abilities.
Now every doctor will give a woman an option of termination of pregnancy based on results of an abnormality in her ultrasound. It is their job to provide her with a choice should she not want to continue a pregnancy with a baby that has genetic anomalies. However, this is a very personal choice for every woman, and she should not be pressured either way whatever her decision is. The important thing is that she is given the option and told best and worst case scenarios. After that, it is up to her to take the next step.
13 Work With A Special Team
Another thing that will happen is that Mom will most likely end up working with a high-risk pregnancy specialist who will order an amnio and further blood tests to determine what else is or could be going on. This would give the specialist and her doctor more information on the baby’s health and help them make better recommendations for baby’s well-being and for the future mother’s. Many options would be discussed, but as always, the woman will have the final say in what she would like to do and how she would like to proceed with the rest of the pregnancy.
She would be given facts about the chances of the baby carrying any genetic anomalies or abnormalities and what this could mean for her baby. This way she and her partner could prepare for parenting a child with challenges should they decide to go that route and should the challenges be to a more severe degree. It varies and often one can only tell after birth.
12 Baby Will Have Surgery
It is often common in babies with duodenal atresia that they will need to have surgery a few days after birth. It is often heart surgery that is required, and this is often common with babies who have trisomy 21 (Down Syndrome). This can be detected antenatally so families can learn a little more about help available for their little one. Of course as has been said, the severity of the heart issues vary from case to case.
Babies who are born with duodenal atresia often vomit soon after birth. The vomit is usually bile-stained green. If this happens, doctors will tell Mom that if she has started milk feeding, it will have to be stopped. After that a tube will need to be passed down through the nose into the stomach. This will drain any fluid that has collected in the stomach. Baby will begin to receive fluids through a vein drip for the time being.
11 An Issue Of Too Much Fluid
The excess fluid is caused by swelling of areas in the baby’s abdomen, the stomach and the duodenum. This as well as an antenatal scan can indicate that baby has the double bubble. If it has not been suspected for sure, after birth if baby vomits it will be determined through testing at that point. The other things that excess fluid can do is cause an increase in the amniotic fluid around the baby. This is known as polyhydramnios. This could lead to an early delivery.
The woman will be monitored for this. There are usually no long term effects of duodenal atresia. There is, however, a small risk of future obstruction happening. If Mom notices baby’s vomit is a strange color and he/she has a distended abdomen, she needs to consult her baby’s doctor. After the surgery is performed, baby’s stay in hospital is usually about two weeks for full recovery. It varies for each baby. Success is considered to be when baby is able to have a proper milk feed.
10 Baby Is At Higher Risk Of Infection
Risk of infection is important to consider. The mother should be watching out for a few signs. She need not worry initially after baby has healed from surgery. After surgery and the healing period which will vary from one baby to another, baby will be seen by members of a surgical team. They will be able to answer any questions Mom will have about baby’s continues care.
If Mom notices any of the following things there is something wrong, and there most likely is an infection. Things she should look like is no stooling, no urinating, poor feeding or not being able to eat at all, vomiting that is green or yellow in color, poor weight gain, a distended abdomen or GERD (Gastro-essphageal reflux disease). Immediate medical attention is needed. Of course, if she ever has any questions or is concerned, she need only check with the baby’s medical team.
9 Baby's Future Path
Many times babies who are born with this condition end up being fine, though whether they have other birth defects or not, heart disease, or other issues are often common as they grow up. They may require further surgeries. Their medical team will be monitoring them from time to time, and of course parents will know signs to look for that indicate that baby is not thriving or may have developed problems due to heart health or other health issues.
It would be wise for doctors to connect new parents whose children have this condition to other parents whose children were just born and diagnosed. Parents who have children with this condition and have some experience with the ups and downs would be great sources of support to other parents just coming to terms with the diagnosis. The support would be helpful for new parents. Doctors and medical professionals could be there as well to answer other questions.
8 Baby's Movements May Not Be Regular
Constipation is another common side effect of the condition, and often after surgery there are bowel issues which are understandable. However, many times difficulty with bowel movements due to the closures and swelling in the stomach area, make constipation and bowel movements extremely challenging for babies affected by this condition. There are also minor abnormalities of the anus or rectum. This occurs in about 1 of every 500 births. There are sometimes major abnormalities in about 1 in 5,000. It is important doctors check for this and take this into consideration.
There are also associated abnormalities of the small intestine in babies who have duodenal atresia as well as the oesophagues, genitourinary system. If the baby fails to pass meconium in the first 24 hours, he/she needs to have their rectum examined to rule out any constipation issues. The important thing is that parents are told of all the risks that are associated with their child’s condition so that they know what to look for and how to work with their child’s team.
7 Baby Might Measure Small
It is normal that babies born with this condition also measure small, due to many being born prematurely. Even those that are full term are often small, however, due to poor digestion of nutrients and growth not occurring typically. This is due to the irregularity of the fluid retention and other possible birth defects or anomalies that cause problems. Doctors and the rest of the medical team will be aware of this and will monitor the baby accordingly.
Parents will also be told about this and know signs to watch out for if baby is failing to thrive, and told how to help them thrive, grow and feel better at their own pace. This can be a difficult time for families, but with the support of the hospital and perhaps joining a support group made up of parents who can help them understand what their baby will need, and the ups and downs of the journey, things will get easier over time.
6 It Can Be Misdiagnosed
Very rarely this condition is misdiagnosed and is really a cyst that forms in the spleen during the early stages of pregnancy. This is also treatable, and after an operation that is done to remove the cyst and the required healing time, baby will usually fare quite well. A lot of times the cyst mimics duodenal atresia as it also will interfere with the same areas of functioning in the baby’s stomach and intestine.
What makes it even more complicated is that a baby can have duodenal atresia AND a cyst or multiple cysts present in utero which complicate things more after baby is born. Again, antenatal examinations will be done as well as an ultrasound. Even if doctors do not see the cysts until after delivery, surgery can still be performed and additional medical measures taken so that baby can start the process of healing and growing as healthy as possible.
5 Breastfeeding Might Be More Challenging
The reason why feeding is not possible at the beginning is due to the blockage in the stomach and intestine which does not let baby take in nourishment the way they are supposed to. They are also not able to break it down the same way and instead get sick. This is why if, within a few hours, baby is vomiting, an intravenous tube will be inserted and baby will be fed formula to make sure they can start on the process of growing and keeping down the nourishment.
Breastmilk may be tried, but it would need to be pumped into a bottle at the beginning until baby is able to keep milk down. This would most likely begin after they have had surgery and their organs have healed. It is a difficult time to be sure, but as long as baby is getting nourishment, gaining weight, and vital signs are strong, Mom and Dad need not worry. They are catching up and will be better very soon.
4 Other Issues Can Snowball
The most common delays or issues with this condition are heart disease or heart defects. More surgeries may be needed. Baby and will continue to be monitored throughout their life to make sure their heart is doing well. Other challenges less common but that do exist, are other birth defects or physical and intellectual challenges that can occur with duodenal atresia, such as other physical issues like constipation and organ issues, possible motor coordination issues, and conditions such as Down Syndrome, which will affect learning and growth of the child.
However, these are not grim predictions. A lot of babies born with birth or other genetic and intellectual challenges are bright, healthy children who, although have their limits, progress to become independent and contribute to society in big and meaningful ways. One of the most incredible ways is by touching their families’ hearts on how hard they work to learn, play, grow and are happy through it all. Often, children with challenging issues have lots to teach the rest of us about health and resilience.
3 It Can Be A Preemie Baby
Prematurity is a big risk if there are complications in utero - any kind of complications. However, many times baby will still be able to be delivered vaginally, with some cases being best delivered by C-Section. Some babies will require being delivered in advance, especially if there are many more complicated issues suspected in the womb. At this point, even being born prematurely by choice is what could help baby fare better and get the optimal care he/she needs.
Mothers-to-be will be told that there are odds they could deliver the baby early, and she will be monitored vigilantly to make sure the best decision is for baby to stay in utero as long as possible. Everything, as in all pregnancies, will take into account baby’s and mother’s help at the top off the list. It can be scary for a woman, particularly if this is her first baby. But she must take heart that under great medical care she and her baby will most likely do very well.
2 It's Genetic
No one is one hundred percent sure, but it looks like the cases of duodenal atresia seen so far are due to genetic causes out of parents’ control. Often Mom and Dad have recessive genes and are carriers of markers that are passed down to baby developing in utero. For duodenal atresia, the incidence of occurrence is 1 in 10,000 live births. It is not always detected in utero, but sometimes a doctor can screen for it.
Usually however, it is only after the so-called “double bubble” is seen that it is detected. The good thing is that medical teams know how to handle the difficulties of this condition, and can present the family with the steps they will need to take for baby’s future well-being. It is not an easy thing to hear, but future parents need to take the information in slowly, ask whatever questions they need, and take it easy on themselves. These things sometimes happen, and there are solutions to help ease the difficulties for babies and their families.
1 Anomalies Found In 50% Of Cases
Other kinds of congenital anomalies that are sometimes found with this condition are, as previously mentioned, Down Syndrome, shorter intestines than normal, lower birth weight, and an imbalance of electrolytes, which are the elements in the blood, tissue and cell fluid needed to help the person balance their energy. Again, all of these risks will be known to the medical team, and they will be monitoring for this and making suggestions to the parents as to how best to support baby through these difficulties.
It will not be easy, but it will be possible to help baby learn to live with these conditions and lead as normal a life as possible. Parents will really learn that they need to take things one day at a time, which is really a good mantra for all new parents to remember. Heart disease is also something that doctors will be constantly on the lookout for, and with this kind of medical attention, babies will most likely continue to do well. Should they need surgery, doctors will let parents know the risks and how best to proceed with safety.