7 week old FF baby dropping centiles - help please!

[Elednor]

First off let me say that I've spoken to a GP, HV and pharmacist about this and they all have differing advice. I'm sorry for the epically long post, but I want to get all the information out there so hopefully someone can help.

7 week old DD has been suffering with what I believed was colic from 4 weeks old. She began to drink less, eventually only having 1.5oz - 2.5oz per feed, screaming and fussing afterwards and not sleeping. She also had a couple of nappies where she was screaming whilst trying to poo, it was awful. We started using Dentinox colic drops alongside Dr Brown's bottles, and the difference was instantaneous! We got her weighed at 5 weeks and her weight had gone from the 50th centile to between the 25th and 50th, but as she'd had a bad week, we'd expected that! She'd started having 3-4oz per feed so I was confident things were picking up.

We took her back to be weighed yesterday and she's now dropped to between the 9th and 25th centile. HV was concerned and referred me onto the GP for a review. HV thinks it could be silent reflux, as DD sometimes has a bit of milk leak out of her mouth, she fusses after about 2oz of her feed and it can be a battle to get her to take anymore. Since 4 weeks she's gradually gone from having a couple of dirty nappies a day, to now having them once every 3 days. The poo is still green, but not pellet like but rather a large lump that's not dry but seems like it could almost be constipation IYKWIM?

The thing is DD sleeps like a dream at night, no problems laying flat swaddled in her cot. She wakes up, has her feed and goes back to sleep without any fussing or crying! In the day she's hard to settle to sleep - refuses to nap in her crib, pram, cot or bouncer but over the last few weeks she isn't exactly happy on our chests or in our arms either. It's really draining listening to her cry because she's so overtired, then she finally drops off and three minutes later she's awake again, drops off five minutes later then after ten minutes wakes up. She seems to sleep quite uneasily in the day.

I'm not sure it is reflux as DD is happy to sleep in her cot at night, and also has no problem laying on the changing mat etc to be changed. I wonder if she is a bit constipated, could that cause her to feed less and be able to get comfortable to sleep?

GP has given us Gaviscon on the basis that he thinks it might be reflux, and it doesn't hurt to try. When I pointed out that lots of people's babies had suffered constipation with Gavison, and I believe DD is already constipated, he agreed with me but said it wouldn't make her constipation any worse and that the reflux was important to sort out first. I asked about changing formulas but he didn't know about formula and was really aghast when I told him HV couldn't advise on formula and told me to ask the pharmacist.

Pharmacist says Gaviscon can't cause constipation. I asked if switching formulas could help and he said yes, and if he had to choose between using something like comfort milk or gaviscon, he'd go with the former first to see if it helped with the constipation or reflux.

HV has told me to give DD a feed every 3 hours now and keep a journal of her feeding schedule. I've always fed DD when she's asked for it, and as DD won't dreamfeed, I'm having to wake her up to feed her - which is fine if she's had a good stretch of sleep, but if she hasn't and has struggled to sleep, then she only has 1.5oz or 2oz, then fusses and screams because she's overtired. She takes ages to resettle, then we have to repeat it over again. Looking at the feeding schedule yesterday, I think she actually had a couple of oz's less than normal. Today has picked up a bit (so far) but as she's now feeding every 3 hours, she's taking less each feed so it evens itself out.

I would say that feeding on demand, or on a 3 hour schedule, she's only managing around 21oz a day whereas she needs to be having more like 24oz at least. I have to go back to have DD weighed next week, and they said they definitely want to see an improvement, but I don't know how?! At the moment I've decided to switch to comfort milk and see if it helps her constipation, which may help her drink more? She had one bottle of it last night - she only had 2oz, but this morning she had a more paste-like poo although it smelt absolutely foul

I'm so worried about this. HV and GP both said how concerned they were, and HV says DD's weight mustn't drop anymore and I somehow feel like it's my fault. I gave up breastfeeding DD at 14 days old as I had mastitus at 10 days which was agonising, then DD and I both got thrush as well as a bacterical infection all over my breasts which were big infected spots everywhere. Some of them still haven't gone, and I'm on my fourth week of antibiotics now plus medication for something else which GP said would be present in my milk for at least 2 weeks. Whilst she was BF we had none of these problems, so I can't help but feel that this IS my fault, if I had just carried on pumping and dumping for a few weeks and then tried to go back to breastfeeding, this wouldn't have happened

[tiktok]

So sorry to hear of all this :( It's not acceptable for your Hv to say she cannot advise on formula. Can you ask for a referral to a paediatric dietitian in the face of such poor help?

Going back to bf is not impossible. You have only been 5 weeks away. Google relactation and see if you think it might be for you. Not easy, but possible.

Keep posting!

[josephine1986]

So sorry you are.going thriugh this

It may be worth looking up symptoms of cows.milk allergy or intolerance? Yiur baby sound.s much like my daughter who has multiple food allergies.

She was extremeley unsettled, inconsolable, crying in pain while pooing, fed a little then refused crying, slept plorly in day, persostent nappy and facial rashes, spinachgreen mucous filled poo.

If it is this, the good news is yoj can ease her symptoms wuite easily by switching to a hypoallergenic formula. But your gps and hvs sound completelh clueless. I would seek the opinion of a paedeatrician, even if you have to take the baby into a and e. Sadlly there is.very poor knowledge about this from gps despite it being not so uncommon.

Sorry for typos - feeding. Good luck

[josephine1986]

Oh and agree with tiktok above, you need a referral to a paediatric dietitian. Waiting lists are long, I'm sure you would get a speedy-ish one due to the weight loss but they are still much too long.
If you are stumped you can speak to a paed dietitian privately - you can search online for registered dietitians.

[Elednor]

Thanks so much for your replies. I do have an electric double pump and did consider relactation when this all started, but the GP says I have impetigo on my breasts which I'm still trying to get rid of so no skin-to-skin contact on my chest and when I pumped during having mastitis, I struggling to pump as DD won't be put down, even when asleep and I couldn't manage to do it whilst holding her as I did try. Add to that that I got waves of nausea and anxiety whenever I used the pump I did enjoy the closeness of breastfeeding but when I got mastitis I was screaming and sobbing before every feed, and then emotionally I just checked out from everything. My mental health definitely suffered and as much as I miss aspects of BF, I just can't cope mentally and emotionally if it goes wrong again, especially as I have an older DD to look after too.

I could ask for a referral, but would I go through HV or GP? And wouldn't they want me to try gaviscon, ranitidine, etc first? I am just not totally convinced it's reflux with the fact that she sleeps fine at night lying flat.

Is it really bad that she's dropped so far down on the chart? I am making myself nauseous with anxiety with her feeding now

[SunnyL]

My DD had terrible reflux and dropped lots of centiles - from 75th to 9th. She was bf so I don't know how much she was taking with feeds but it was a similar thing to you in that she'd be fussy during the day but it didn't affect her at all at night.

Once we started on thw gaviscon tho she started putting weight on. She's now a little porker at 10 months. We're still giving her gaviscon as when we stop she gets really pukey again.

I know how worrying poor weight gain is. Keep talking to health care folks though. The challenge with babies is they can't talk so diagnosing them can be experimental.

[josephine1986]

I agree that the fact she sleeps well at night would suggest the main issue is.not reflux

You need to see the gp for a referral.

[josephine1986]

Oh sorry just read previous post. Does reflux cause green poo?

[Elednor]

Last night wasn't so good. We woke every three hours to feed DD, but she's still only managing 2-3oz a feed. I was so excited as when she had her first bottle of comfort milk at 6pm, she had the whole 4oz! Then she had an oz or two at every feed but it was a battle to get her to take more I don't know how long we should give the comfort milk to see if it works and she drinks more, does anyone know? I'm going to take her down to the baby clinic and ask the HV how long we should give the new milk before trying gaviscon but it will probably come under 'promoting formula' and they won't be able to help me

DD is having a feed now, but I have to get her to take another 4oz before 10 if I want to hit the 24oz mark.

SunnyL that's interesting that your DD lay flat at night with no problems and has reflux! Doesn't rule reflux out then!

[Doodle1983]

Sounds like your LO has some problems we are facing too. I went to the dr convinced of reflux and was told it was wind. Baby being sick a lot and showing signs of discomfort when laying down. Started comfort milk on advice of HV (smelly trumps a go go). Then my DS started refusing feeds. Like yours would take initial bit of formula then scream and refuse the rest and spend ages having to settle him back down. Went back to see a different gp who gave is gaviscon. Worked a treat for sickness but still squee eking at feeding - really getting me down. Feel like I'm stuck at home at feeding times and feel so sorry for baby!

Spoke to the feeding specialist at the hospital as DS had his tongue tie divided 3 weeks ago and I wanted to ask some questions and she suggested cows milk intolerance or allergy. And that I should get my gp to refer me to the paediatric clinic at the hospital as they deal with these things day in day out.
So this morning I'm going to spend an hour on the phone trying to get through to book an appt with my gp, and then go and tell her that her help is rubbish! Ha wish me luck!! X

[Doodle1983]

I should add that DS is 10 weeks but LBW so probably on a par with your lo.

[Karoleann]

How much does your DD weigh?
I'd be wanting a referral to rule out a cow's milk allergy or infection. I'd be worried about the green poo too.

I'm not one for going to A&E unless it's really serious, but I think you should consider taking her back in today, if you go around 9am, it won't be too busy and there will hopefully be a paed consultant or two hanging around.
Will little babies, you should be erring on the side of caution.

[tiktok]

Advising on types of formula to a mother enquiring about a baby already on formula or thinking about it isnot 'promoting formula'. Your HV has misunderstood this, and this misunderstanding is preventing her doing her job properly :(

[josephine1986]

Agree with others, a and e may be your option here. Hypoallergenic fornula, if needed, is just a prescription. I am staggered that the gp and hv have not already consdered she may be reactng to cows milk protein. My daugjter is ebf and its hard to get them to accept she can still react to it but with formula they should have considered this as well as rflux.
Reflux is often a symptom of cows milk allergy or intolerance by the way
Good luck

[Elednor]

DD weighed 7lb6oz at birth, had gained back her birth weight and then some by 5 days! Continued along the 50th centile until 3 weeks ago when she dipped slightly, and now she's hovering close to the 9th centile. As of Wednesday she weighed 4.03kg and has only put on 5oz in the past two weeks.

HV said to continue using the comfort milk until Monday to see if it makes a difference, and if not, then start using Gaviscon with the stage 1 formula. I'm due to see the HV again next Wednesday to see if she's dropped anymore. Today's HV said that DD may just continue along this centile now and be happy - she said as long as she's continuing to produce enough wet nappies, and seems okay otherwise, they won't be too concerned unless she starts to lose more weight.

I had lactose intolerance when I was a baby as did my mother, is that possibly what it is even though DD isn't being sick?

How did it go doodle? Sorry if I haven't answered anything but having to post quickly from my mobile!

[Pobblewhohasnotoes]

Lactose intolerance in babies is very rare. And if you're bf the milk naturally contains lactose so you can't avoid it. It's more likely to be a cows milk protein allergy which is possible with the green stools.

Gaviscon cans does cause constipation. My DS was properly constipated on it and I had to fight to get him on ranitidine. You can get dairy free or hydrolysed formulas from a paediatrician. Not all GPs will prescribe them.

Comfort milk is a bit like gaviscon in that it thickens up the milk to make it stay down.

[Elednor]

I gave her another bottle of comfort milk yesterday and she had half an oz, started squirming and fussing, then had another half an oz and refused to feed anymore, just crying. I gave it half an hour before I gave her a bottle of her old formula with the gaviscon, she had some of that then fell into a deep sleep. She had another couple of feeds with the gaviscon, and she was like a dream baby! Having 4oz in one go without ANY fussing, sitting up for a burp and falling to a deep sleep with only a few minutes of fussiness!

This morning is a different story though She has been finding it hard to settle - seems windier, consequently when she does drop off to sleep, she wakes up and starts crying. We stopped her dentinox yesterday on the advice of the pharmacist, who said that we shouldn't use dentinox for 6 feeds and infacol for the other 1 feed, so we decided to stick with dentinox but now I'm thinking I should go back to the dentinox.

Still thinking it may be a

[Elednor]

Whoops, phone decided to post all on it's own!

Just struggling to cope with this at the moment. I had awful PND with my older DD last time and I really thought this time would be different. I can't stand to see her like this, not knowing what's wrong or what I can do to help, always on edge before a feed thinking it could go wrong. DD doesn't leave the house unless it's to see the doctor or HV as she doesn't like being in her pram for long and absolutely hates the sling I feel like I barely have a life anymore and I can't see when it'll end.

[quackojuliet]

This sounds really hard.

If I were you I would just go to a and e and see if you can get a definitive answer. Nothing you have said suggests any progress is being made and you really need the advice of a paediatrician ASAP

[Doodle1983]

What's the difference between dwtinox and Infacol?

[MissRatty]

Sorry to hear about your situation...it almost mirrors ours with the exception that LO is mix fed.

If it is silent reflux, Gaviscon is not particularly effective, as it thickens feeds to stop regurgitation (typical of 'regular' reflux). Its the stomach acid coming up which is the issue in silent reflux, so ranitidine may be more helpful as it helps with the acid burn.

Our LO also eats very little still now (20 wks), and has almost exclusively green explosive poo (symptomatic of the acid in the tummy). He has slipped down from 25 to 0.4 centile, and is being referred.

I would definitely recommend that you go back to the GP and tell them that the gaviscon isn't helping, and they can discuss further options.

Just don't use gaviscon with the comfort formula, as both thicken.

You definitely need to be seen again. Can you ring today and ask for an appointment? X

[MissRatty]

How is she to wind? Our LO is also a very windy baby and we have to spend ages winding him, otherwise he just keeps waking up 'hungry' but only snacks.

[Elednor]

Just an update - not much of one really :/ After a few more trips to the doctors, our GP decided to refer us to the paediatricians at the hospital after he weighed her and she's now losing weight. He told us to wait at home whilst he contacted them to see what time we should go up. When he spoke to them, they said there was no need to be seen, there's no conclusive evidence for ranitidine so we should stick to the gaviscon and that wait a few weeks for the gut to mature. The Dr wants us to come back on Friday to have her weighed again and if she's still losing weight, then he'll push for a referral. For the time being we just have to 'hang on' and use the lactulose when she gets constipated (which is brilliant but we have to use it every day or it comes back).

On Friday night and sat morning she drunk so little (6oz in 15 hours) that I thought we would have to take her up to the hospital. In desperation I went out and bought some Hipp Organic ready-mades cartons to see if another change of formula would help. She has had 4oz of pretty much every one! However I bought the Hipp powder today after using cartons over the weekend, and she's gone back to drinking 2oz and crying if you try to get her to drink anymore :( With DP now redundant, it's completely unsustainable to buy the ready made cartons - it works out at about £17.50 a week with just 4oz bottles, in a few weeks it'll be even more. I read somewhere that the heat used to treat it makes it easier to digest and that's why some babies prefer cartons. She definitely has some reflux as when we tried her without gaviscon on Hipp, she screamed for ages and was really unsettled all day :( If it's a problem with digestion, would a hypoallergenic formula even help her? I feel really let down by the paediatricians, I thought they would help us.

[tiktok]

What a worry :(

Is she actually losing weight? Literally weighing less than she did last week? On trustworthy scales, weighed naked? So you are confident the weight is correct?

[Elednor]

Yes, weighed on the same scales she was 4.14kg then three days later she was 4.09kg. That was last Thursday so no idea where she's at currently :/

[tiktok]

OK - but weights 3 days apart are not very accurate with such a tiny difference (50 g - less than 2 oz). You need to be comparing weights a week apart for a clearer picture. I am not minimising the whole thing - she is clearly not gaining as she should. But it cant be certain she is currently actively losing weight. This is why the doc has asked you to return on Friday, I would think - by then the picture will be clearer.

It sounds to me that this is what you need to do - continue doing what you can, in terms of getting her to eat, and seeking further advice on Friday.

Cartons are more costly than powder, but powder works out at about £10-£12 a week, so we are prob talking about an extra £5-£6 a week for the moment, temporarily. If your income has fallen significantly and you claim any form of benefit, then of course you can apply for Healthy Start vouchers which will help with all of this extra.

www.healthystart.nhs.uk/healthy-start-vouchers/do-i-qualify/

Hope things go better this week.