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Infant feeding

Reflux, and other problems in 15 week old, what to do next?

27 replies

TheDetective · 14/03/2013 20:53

Having driven my postnatal quiche bonkers with my ramblings, I'm starting a new thread, both to write down everything that has happened over the last few weeks, and to ask for advice.

My DS is 15 weeks. He was initially breastfed for 3 weeks, then bottlefed on Cow & Gate. He was never the worlds quickest feeder, but no real problems to speak of. He was always a contended baby. Until 10 weeks.

At 10 weeks he started posseting more than just your standard amount, but wasn't distressed by it. He was doing it hours and hours after feeds. What was strange about it was that the only time of day he didn't do this was at night, when he was lay flat in the cot.

A few days later, he got his first cold/snotty nose. The vomiting continued, mixture of fresh feed, partly digested feeds, and watery vomit. You could get him up at 9am after the night and he would vomit having say, not fed since 1am.

At 12 weeks the cold was lingering so I took him to the GP, and he said all was fine, no infection. Bog standard cold. Asked about the vomiting, and he said see how he is when the cold has gone. While there he did see him vomit, my baby does like to oblige in showing off his symptoms!

The following week (13 weeks) he was no better, but the cold had been gone for days. So after discussion with the health visitor, I tried him on SMA staydown. This was great. Did what it said on the tin. Or so we thought.

He had been taking between 3-6oz 3-4 hourly, he would average around 24-30oz a day. Slowly he started taking less with feeds. He started screaming and fussing with the bottles, refusing feeds. He became very clingy, and unsettled (this unsettledness started around 12 weeks) after previously being a very settled baby. He was arching his back, and a few days after starting the staydown, was vomiting at the same rates as previously. So at week 14 he was started on Omeperazole after I asked the GP to prescribe it. At the point he was prescribed it, he had gotten to his worst point. He had not fed for 12 hours at that point. It took us another 4 hours to get him to finally feed.

The next day it was as if a miracle had occurred. My lovely settled, happy baby was back. It was fantastic.

But, 24 hours after that, he then started with the same symptoms, vomiting, arching back, refusing feeds, screaming, you could hear the acid rising in his throat, he was a very unhappy little thing.

I decided we needed to give the Omeperazole time, as they say it takes 5 days to show a difference? Well, 6 days after starting it, he got to his next lowest point, and had once again refused to feed all day. He was going 8 plus hours between feeds (except at night, he would go 4-5 hours once over night) so was taking 12oz a day roughly. (4 x 3oz feeds)

This was this tuesday. I took him to the HV who weighed him. He had put on very little in 2 weeks. Gone from 13lb 14, to 14lb 1. Advised to see GP and ask for ranitidine to be added to meds.

GP refused to give him any meds, or increase the omeperazole. (Long back story will not bore you!)

Took him to childrens A&E where we were given ranitidine, domperidone, and a paeds referral. They witnessed his awful feeding, and were shocked at how bad it was. Literally 2 sucks, scream, vomit, spraying everywhere, arching back etc.

He was starting to show signs of dehyrdration, and had a red throat acid related?.

The additional meds seemed to make no difference.

The feeding was still as bad, and I was so very worried by this point. So last night I tried him with a lactose free milk. Not because I think he is lactose intolerant, but in desperation to see if he would take something.

He did, he took it absolutely fine, apart from vomiting after feed, and in between feeds, but he actually took it, and was settled. None of the previous behaviour. I actually wonder if he is CMPI, but this was all I could get to try yesterday. I've ordered a tub of pepti junior, but I feel reluctant to try him with it because of so many dietary changes. I used the lactose free purely to get him to feed. And he did.

I should add that we have spent hundreds of pounds on different bottles, teats, and tried all kinds of feeding positions, just in case anyone is wondering.

Where do I go from here? What do I do?

I may have missed bits, am being pestered by DP to come off here. Will come back and add anything I've forgotten, but please reply to me and help!!!

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StuntNun · 14/03/2013 21:44

In your position I would start weaning him on to solids. Maybe wait until he is 16 weeks but then go for it. Give the CMP free milk a try but he may not take it as it smells awful, like water you've boiled potatoes in. If you suspect CMP intolerance / allergy then you really need to get this diagnosed as you need a definite answer either way.

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fairimum · 14/03/2013 21:45

I would stick with the lactose free for a couple of weeks first to see if that works before changing again? unless you give it a fair chance for his system to get used to it you will never know what it is that is working, espically if he is taking it and settled?? xx

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fairimum · 14/03/2013 21:46

oh and push for urgent peads consultant appointment!

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TheDetective · 14/03/2013 21:53

I'm very hesitant about weaning him. He just doesn't seem ready in the slightest. No signs at all.

I've got the name for a private consultant, who I will enquire about and cry at finding the money for.

Fairmum I'm just worried that I'm giving him the wrong thing. I only gave it as I was desperate for him to feed. He looks like shit to be honest. Pale, eyes sunken. He's not himself at all.

I wanted to give him the CMP free milk but I couldn't get it, I've had to order it online.

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TheDetective · 14/03/2013 21:54

Stunt He's 16 weeks tomorrow. I thought if I was to wean him 17 weeks would be better??

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ValiumQueen · 14/03/2013 21:57

Remember he was very overdue so is not really 15 weeks. We had around the same due date and J is 20 weeks as I had a section at 39 weeks. I think stunt has made a good point about early weaning. I would also stick to this formula until the tub is finished at least.

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StuntNun · 14/03/2013 22:09

Double check Detective but I think the advice for weaning is different for reflux-y babies. My only experience was with my DS2 who was weaned at 16 weeks due to lactose overload and it sorted him out right away. Part of O's problem is that his tummy is filled with liquid so when the sphincter opens it's easy for the stomach contents to come up. With some solid food in his stomach there will be less coming back up his oesophagus. But I can only offer my opinion, you really need to see a paediatrician as soon as possible.

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horseylady · 14/03/2013 22:17

I would stick lactose free for two weeks at least then try some with lactose. You will pretty much get a reaction then if there's going to be one.

If he were mine I think I'd want to get to the bottom of the feeding issue if possible or at least give time for the meds to start working before introducing something else.

He is only 15 weeks old in terms of eating etc. and he's been poorly for 1/3 of his time on the outside!

But it's very easy for me to sit here and say that. I'm not in your situation.

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TheDetective · 14/03/2013 22:43

The HV who I saw today didn't make any mention of weaning. I will discuss it when I go on tuesday to see them. Will also have a look in to it fucking dr google!. Apparently I may be able to get an appt with consultant for Tuesday evening. If not this tues, next tues if I can find £150.

Yes, VQ I guess he should be older than he is, but he doesn't seem it, if you know what I mean. These last 5 weeks have really held his development back.

I agree horsey I think I should stick to the lactose free, however he has more symptoms of CMPI.

VQ kellymom.com/health/baby-health/lactose-intolerance/

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blondieminx · 14/03/2013 23:02

Hey, veteran reflux mum here... My top tips would be

  1. Push very hard for a consultant appt and keep nagging till you get one. It may help to know that GP surgeries are apparently now being penalised for a&e visits and given your concerns were taken seriously there, well...Wink you could pop back a few more times?


GP is exactly that, a generalist. You need a doctor who knows what to do about treating this condition. Keep ringing till you get the referral!

  1. You can get lactose free formula on prescription as a "food supplement".


  1. Early weaning not necessarily a good idea. In my experience you just get a different kind of puke for your efforts (soul destroying if you end up wearing lovingly prepped homemade purée). Avoid acidic foods and in particular skins on veg esp tomatoes, sweet corn etc.


Good luck Smile
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Passmethecrisps · 14/03/2013 23:12

Don't worry - lactose free is also CMP free therefore fine if that is the problem.

It took P weeks to get back to even semi-normal eating after her period of food-refusal. Their tummies shrink very quickly and it takes them a long time to trust that it won't hurt.

If you were me I would :
Stick with the lactose free formula - it is almost guaranteed harmless so why not?
Try to feed standing up
Allow him to eat tiny amounts but offer very often. Always have a bottle on the go. Offer when he is relaxed.
Get DH to feed when you are not in the room.
Stop thinking about numbers and worry about the physical. But concentrate on the tangible - nappies, colour and so on.
Keep your HV informed every day (bother her with amounts mind you)
Take to Dr/A&E if no marked improvement in 1 week
Give calpol to ease any sore throat.
Ask for infant gaviscon or carobel ASAP.

And cross my fingers Flowers

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Passmethecrisps · 14/03/2013 23:14

Or if I were you rather!

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TheDetective · 14/03/2013 23:25

I would like to try the gaviscon but unsure because its adding another thing in?

I've stopped the omeperazole and domperidone as these contain lactose. If I'm giving him lactose free formula, then he shouldn't have it in meds?

Must check calpol/gaviscon for lactose.

I will get the lactose free on px, he has the staydown on px ignores the 4 tubs of the bastard stuff in the kitchen but I figured buying a tub first and trying and then asking for the px would be easier than trying to get it px straight off!

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DorsetLass · 14/03/2013 23:29

So I had this - exactly - with my second. Quite a surprise after my first never was sick. Exactly the same stage as well. Luckily my husband is a GP with a colleague who has a specialist interest in peads. We tried me cutting dairy, then ranitidine. Like you marginal improvement then back to square one. Then he prescribed pepti junior (lactose free) and it was like a miracle had occoured. Happy baby - still vomit regularly (that is all the time!) but settled and gained weight. Medical theory is that an infection/reflux can cause vomiting. This then damages the villi in the guy that digest the lactose, hence the deterioration in feeding and increased discomfort, more sick and so the cycle continues. We were advised to 'rest' his gut on the prescription formula to allow the villi to regrow for 12-14 weeks. I then weaned him back onto normal formula, and a full dairy diet. Interestingly the dietician said he would have to be lactose free for years - luckily medical insight for us helped more.

I would insist on seeing a paediatrician. There is so much confusion, even among GP's ( I was told I had just forgotten how hard babies are initially!) and health visitors (again mine no help at all apart form advising infacol - useless!). My son really only stopped vomiting at a year - but it didn't distress him, jut everyone he vommed on! If you want any more advise please do pm me. Sorry long ramble - really hope it improves! Oh - weaning did not decrease vomit - it may not be a miracle cure!

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DorsetLass · 14/03/2013 23:30

Typo - meant gut not guy!!

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hobnob57 · 14/03/2013 23:33

I've had 3 refluxers and have had GP referrals for less worrying symptoms. My HV is able to prescribe Nutramigen hydrolysed formula, but I don't know how common this is.
I have been reading a book summarising the latest research on food intolerance and allergy, and it speaks about gut maturity being important re. weaning. The more immature the gut, the more proteins get through, and if you get an allergicky baby, the more likely they will have a reaction to weaning foods. When you consider that many refluxers are also CMPI or CMPA then the early weaning advice requires a balancing of the benefit/cost. Of course for refluxers who are falling through the centiles and who take to solids the benefits are worthwhile. But it is a consideration.

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TheDetective · 14/03/2013 23:35

That is very useful dorset! My first was the perfect feeder too! Pah!!

Do you think adding Gaviscon would help reduce the vomiting?

My main aim is to stop the pain.

And then look at the vomiting again!!

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StuntNun · 14/03/2013 23:43

Is it unusual that this all started at ten weeks or is that typical for reflux?

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DorsetLass · 15/03/2013 00:11

Gaviscon didn't do anything for mine - he had ranitidine. To be honest it didn't stop the vomiting, and he was so much more settled on the pepti junior I didn't worry. There really was no difference when he did/didn't have extra meds.

I honestly had no idea how stressful this could be - after one easy feeder I have to be honest I used to think Mums who complained about reflux type symtoms were being over dramatic. How naive I was!! I think you're wise to aim for getting him comfy, feeding well , then deal with vomiting later. Only other advice I'd give is either buy or befriend someone with a carpet cleaner to get sick out your floors!!!!!

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YellowWellies · 15/03/2013 09:30

I was advised to wean later because of the increased choking risk posed by solids and the likelihood of making intolerances into allergies by putting solids into what is clearly still an immature gut. Sometimes you don't have a choice - my cousins daughter had fallen off the centile scale and they had to wean her or hospitalise her. She put on weight but also now has long term kidney damage. Trust your instincts - if you feel he's too young for solids - he is. I'd go for the private appointment. I wonder if this started with his cold / infection as mentioned up thread?

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fairimum · 15/03/2013 10:31

i wouldn't stop the meds at all, lactose is a 'tolerance' so a tiny bit should be fine (as not getting it in the formula). they reduce the acid which if that is the problem leaving it to build up will damage the esophagus (DS had this and was throwing up blood)

I really think you need to get a peads appointment and follow their advice. It took them meds 3 full weeks to kick in for DS xxx

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fairimum · 15/03/2013 10:31

they do often recommend weaning to help and it does with lots of babies, but it made my DS much worse :(

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Nicolaeus · 15/03/2013 10:41

Refluxy baby here too. Not to bad when newborn but just got worse. Weaning did naff all to stop it, neither did learning to sit up, stand up or walk.

Only thing that worked was finding the right meds which we did when we saw a specialist at 12 months. The sick didnt stop right away but did reduce gradually and by 15 months he stopped being sick unless over excited.

He never seemed that bothered by it except once he threw up loads more than usual so burnt his throat and lost his voice for days.

Definitly push to see a specialist. A normal paed didnt help us.

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marbeth · 15/03/2013 10:51

Lactose intolerance is very rare in babies. Many babies with CMPI have reflux. Have look at NICE guidelines and asked to be referred to a paediatric dietician.

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ValiumQueen · 15/03/2013 11:10

I think you should reinstate the meds as stopping can cause more problems, and the feedback above about solids seems to make sense, so not yet. I think lactose overload is a very different issue, as it did work for stunt it may also work for my Jacob. I read that link and am even more confused!!! So much for breastfeeding being the most natural thing in the world. It is a minefield!

I do not think you should pay privately to see a consultant. I think you should fight loud and hard for help for your baby from the NHS.

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