Need help for friend's baby - possibly reflux

[timeforanamechange]

My friends ds2 is nearly 5 weeks old - born by elective section - no complications at birth. She is formula feeding - first week or so he was fine but then started to bring up a lot of milk after every feed.

I haven't seen him vomit but she said it is in very large quantities and quite forceful. It goes up his nose and causes him to choke. It gradually got worse over a few days so she brought him to the GP who mentioned possible pyloric stenosis (sp?) and referred to the hospital.

The hospital checked to see if the baby was dehydrated and he wasn't. They were there for a few hours but he didn't vomit and they sent them home. My friend asked them about Gaviscon and they said it was up to her to try it.

She is understandably concerned so tried the Gaviscon but no improvement over a couple of weeks. If anything he got worse and has become increasingly cross, crying and not sleeping well so she decided to change formula to a stay down one.

She started that a few days ago but on Sat night he vomited a lot and brought up what is described as 'coffee grounds'. This is highlighted as a cause for concern so they took him back to the hospital.

After several hours of observation they were again released this time with a prescrption for ranitidine and told to come to clinic in 6 weeks.

She is really worried about him now. He has gained weight but seems very unsettled. The hospital isn't giving out much information and she feels they aren't listening to her or taking it seriously enough.

Does this sound like reflux. How long does the Ranitidine take to work?

Could it be an allergy/intolerance rather than reflux? Any recommendations for a good formula to try or any other tips to help my friend.

I am trying to help but breastfed my two and no problems with reflux so have very little to go on.

Thanks.

[timeforanamechange]

bump

She really needs some advice

thanks

[thisisyesterday]

so did they check for pyloric stenosis? or just watch to see if he was sick???

it could be a cow's milk intolerance, in which case he would need to be prescribed a hypoallergenic formula such as nutramigen or neocate

[timeforanamechange]

Thanks for the reply.

Both times they were at the hospital they observed and did a blood test to confirm the baby isn't dehydrated. No other tests done at this stage.

[thisisyesterday]

is baby gaining weight? I believe most babies with PS don't really gain much because hardly any milk is staying down
I have a friend whose little girl had it and it was diagnosed with an ultrasound scan, but there were other symptoms too, ie, not gaining weight etc

def worth another trip to the GP to ask about allergy testing and hypoallergenic formulas though
i would imagine that ranitidine and gaviscon ought to start working straight away really..

[duende]

yes, it sounds like it could be reflux. "coffee bits" in the vomit could be from irritated oesophagus (sp?) - it happened to my DS a few times. ranitidine should start working quite quickly but it doesn't work for all babies and sometimes it takes a while to work out the right dose. My DS improved dramatically and pretty much immediately once put on omeprazole.
In his case it turned out that he also had cow milk protein intolerance and had to be put on nutramigen (I wasn't BFing anymore by that time.) Good luck to your friend.

[timeforanamechange]

Spoke to my friend again earlier.

Baby gained weight as expected in the first 3 weeks but weight gain slowed down after that.

He didn't gain in the past week.

She has managed to get a private appointment with a paediatrician tomorrow. The hospital do not want her to go - saying baby should be under a different consultant and to wait 6 weeks for clinic appointment.

[thisisyesterday]

i think she is doing the right thing tbh

why on earth shouold she wait 6 weeks if baby is ill, being very sick and has stopped gaining weight?
she needs a definite diagnosis so they can treat it.

if it's PS then it needs to be sorted and if it's an allergy baby will be really very uncomfortable and better once he is on a proper formula for it, and if it's "just" reflux then she can get a second opinion on meds

do keep us updated, I hope all goes well at the appt

[timeforanamechange]

Just a quick update. My friend saw the consultant today. He is fairly sure it is not reflux but a milk allergy and has told her to try Soy formula.

If that doesn't work she will be trying Neocate or something similar.

[thisisyesterday]

oh am glad she has an answer.

don't want to scare, but soy is not recommended for babies anymore, particularly boys as it's full of oestrogen and has been linked with infertility.
in fact, i didn't think they were supposed to prescribe it any more

so if i were her i would really push hard for the neocate

[timeforanamechange]

thisisyesterday I started a new thread but forgot to update this one.

She took him to the hospital last night as she was really worried.

Saw the consultant and they finally agreed to do an ultrasound - turns out he has the Pyloric Stenosis the GP referred him for weeks ago

He has had a feeding tube put in and has been moved to a bigger hospital to have the surgery.

My poor friend is exhausted and stressed but glad to finally have the proper diagnosis.

Thanks for checking in.

[thisisyesterday]

oh wow! tell her well done for fighting for him.
so many people would have just gone off with the first diagnosis and struggled on, good on her for listneing to her instinct

I hope the surgery goes well and he's back home and doing better really soon