Newborn reflux - should I be worried?

[enigmaVariations]

Long time lurker, first time poster grateful for any advice...

My DS is just over three weeks old and doing well following a slightly rocky start (poor feeding, weight loss and threatened re admittance for jaundice). He is almost EBF with the occasional formula feed from my DH if I am having an evening sleep. He does seem to suffer with some level of reflux though and I'm desperate to try and help him with it if I can.

He is sick after every feed and in the last few days this has got worse so he is now sick at least twice and up to five times after each feed. He also seems to be suffering some discomfort with it, particularly in the night, arching his back, straining and grizzling. No amount of creative winding seems to shift this and he will be like this for several hours at a time at night. He is worse on his back but still displays all of these symptoms when upright too. Sometimes but not always the sickness is projectile. We struggle to settle him to sleep, especially at night as although he goes down ok he wakes frequently and seems to be in pain/discomfort. He seems to use the boob to settle his tummy but this makes him sick and we go round in a cycle of feed, sick, grizzle, feed etc meaning that he and I get very little sleep. I have introduced a dummy to try and break this cycle when I'm sure he has had a good feed and it does work for a few minutes but that's about it. I've tried lots of things to try and help (raising crib at one end, winding half way through feed, upright positions, upright after feed, infacol) but nothing seems to make a difference.

I took him to the GP last week but GP refused to prescribe anything as he told me it would be too difficult to get a BF baby to take gaviscon and that as DS is having plenty of wet and dirty nappies and is gaining weight he is not concerned. Thing is if this was a straight forward laundry issue I would just suck it up and buy yet more muslins, but I'm worried that DS is suffering and it is certainly affecting all of our sleep. I wasn't expecting to get loads of sleep three weeks in anyway but I'm worried that if this is caused by reflux we could be in it for the long haul and I obviously do not want DS lying there in avoidable pain.

So, does this seem like it's within the normal range of newborn sickiness or should I be going back to the GP and digging my heels in? I struggle to know if I am being a typically panicky FTM or if I have a point!

[SweetPea3]

Hi there - yes, I would say you definitely need a referral to a Paed and try to get on Ranitidine or Omeprazole (Losec MUPS) or something. Don't let the GP fob you off. Can you afford to go to a private Paed (in London it may cost £180 - 250 for the consultation) so you can see someone more quickly (and who is probably going to be more responsive)? I am actually just about to start my own post to see if anyone can recommend a specialist Paediatric Gastroenterologist for my DS. Btw, if a private Paed gives you a private script for medications you can go to your GP and beg ask him/her to give you the same as an NHS script.

Also, I would recommend getting your hands on a copy of 'The Sensational Baby Sleep Plan' by Alison Scott-Wright - it has some great info on reflux in Chapter 7. (There's a Kindle version if you want to get it asap!)

In terms of sleeping, refluxy babies do much better sleeping on their sides or their tummies as it helps keep the valve at the end of their food pipe closed (although contrary to SIDS advice obviously) and/or with the head end of their cot raised as you already know. You could look at getting a sleep positioner to help keep baby on its side while sleeping. Or Cocoonababy by Red Castle.

Re Gaviscon - most people find this inadequate or use it in conjunction with other medications. If you are giving occasional formula feeds you could look into using an Anti-reflux ("AR") formula (Cow & Gate; Aptimil; et al make them - ask at Boots) and see if that makes a difference. Don't use Gaviscon in conjunction with an AR formula though as they are already thickened. You may also need a faster flow teat.

Sorry this was a bit of a stream of conscious post - hope it is of help!

[SweetPea3]

I should also have mentioned that most GPs will not prescribe Ranitidine and Omeprazole as they are not licensed for use on babies under 12 months. They can be prescribed 'off licence', but GPs will often prefer that a Paediatrician prescribes them. That is why it is imperative that you see a Paed!

[MilkRunningOutAgain]

It is difficult but not impossible to get a bf baby to take gaviscon, I did it with dd, I crushed it up in cooled boiled water and squirted it into her mouth a bit at a time with a syringe. and it took up quite a bit of time doing this, but then again, it did help, though it also caused constipation, not that the doctor believed that either. If your baby is in pain, keep going to the doctors, it took me many visits to get proper help, I wish I had been firmer with them and more persistent. Reflux is horrid for mum and baby, but do remember that DCs grow out of it and improve, dd had bad reflux from 1-7/8 months, but then improved really quickly and by 1 year old was basically fine. She didn't get proper meds until about 4/5 months and once she had them, it did really help and she was able to feed better and sleep better.

[MilesHuntsWig]

Yes, as per other's comments persevere with doctors, sounds like classic symptoms of reflux which is really stressful and exhausting (and some GPs just dismiss it as "causing a bit of extra washing"). If vomiting is really bad and you're worried, you could accelerate access to a paed (and so prescription for meds) by going to A&E for the vomiting, though I may get flamed for saying that - tbh it's the only way we managed to get someone to take it seriously.

[enigmaVariations]

Thanks for your suggestions. I didn't know that about the licences for the medication so it makes sense to push for a referral. I guess I'll start by going back to the GP and being a bit firmer this time and then go from there.

On the one hand it's reassuring that reflux is a temporary problem, but on the other the idea of another 6-12 months of it is terrifying! Hopefully I can persuade the GP to refer us on but other wise I will definitely be looking at other routes too. I'll have a read of Alison Scott-Wright's book too, I've looked at her website and seen bits and bobs about her methods mentioned before but been wary of going against the SIDS advice, I think I need to educate myself a bit better on the whole issue and then I can make a decision on what to do regarding that at least.

As for going to A&E, I'm not there yet in terms of desperation but I can absolutely see how you might get there if no one is willing to take the matter seriously. Hopefully that wont be necessary for us.

Again, thanks for your help, it's good to know it's not just in my head at least!

[Ditsydo]

My DD has been suffering with reflux since 2 weeks old, now five weeks and have being giving her infant gaviscon for 2 weeks. She is BF and we struggled giving her the powdered gaviscon at first as we was mixing with water and giving in the middle of a feed... We now get on very well mixing the powder in to 15ml of expressed milk in a bottle at the beginning of the feed...

Not impossible just a faf ... But anything to reduce her pain and discomfort

[Mommaplaysthebanjo]

@enigmaVariations I could Pretty much have written your original post! I have a three week old lb who has developed reflux and it is really taking its toll! My DS1 also had reflux so I already knew how challenging it is!

Did you have any luck getting medication that worked in the end (I appreciate your original post was a while ago). we tried gaviscon with DS1 but it just created more problems with constipation. Have been recommended a milk thickener by HV (carobel). Local breast feeding peer supporters have also recommended I go dairy free (this made no difference to DS1 but clearly DS2 is a different baby).