Reflux tips....please

[Hazeyjane]

ds is 6 weeks old, has just been diagnosed with reflux. He doesn't vomit loads, but is very gripey and unsettled. He grunts, and whoops and screeches and hiccups all the time.

We have just moved onto formula, and he is on infant Gaviscon.

I just wondered if anyone had any tips to help, especially with getting him settled at night.

thankyou

We just persisted with Gaviscon and it sorted itself out quickly, but I think we were fortunate.

In hindsight, wish I'd used a front carrier more so I could get on with things when he was too unsettled to put down.

We used swaddling to help out DS settle for naps, day or night, but I don't this had much to do with the reflux, except that having it got us into the habit of holding him all the time so he didn't want to be put down .. ever!

Keep him upright as much as you can. Put a wedge under the mattress at the top of his cot so that he is sleeping on a 45 degree angle. Put telephone directories under the top two legs of his cot. Put a rolled up towel at the top of his change mat. Basically never lie him flat.

When he sleeps, it is better for reflux babies to sleep on their left sides than on their back.

Minimal handling after a feed, wind him gently with upward strokes to his back, or simply by holding him upright.

Keep him upright for 30 mins after a feed. This is a bugger in the middle of the night.

Give him a dummy, the sucking action is very very good for reflux.

No tight clothes around his waist, so all in one babygrows are better than leggings.

Other natural remedies which you can give a newborn for heartburn include Tissue Salts no. 10.

Feed smaller amounts more often, rather than having one big feed.

I found infacol really useful with the wind.

Remember that this will pass, but is hard going on you. Get as much help as you can, and take shifts in the night with your dp if possible so you can get some rest.

Excellent point from Ilove about the front carrier, my dd would sleep for hours in an upright position whilst I had 2 free hands.

This is really essential for maintaining your sanity, I went through a variety of different carriers and slings before I found the perfect one - remember he must be upright, and not slumped into the sling.

thankyou, this is so helpful

dd1 had colic, but it was never like this!

I am so tired, I have dd1 and 2 (3 and 4), and ds all day atm, and trying to work out a way of keeping everyone happy, on very little sleep is a tough one!

Interestingly ds will only sleep on his side, and last night ended up sleeping lying on his tummy on my lap, whilst I watched tv.

I have a sling, but can't really use it atm because I have in infection in my c-section scar. I'll look into a front carrier though, my friend offered me her Baby Bjorn.

The keeping upright at night thing is a killer though!

If anyone else has any tips, or is going through similar refluxy stuff, please post.

We went through the same thing and the good news is that is does get better.
I bought one of these baby pillows My DD also rolled onto her side most nights.
We did have a wedge but DD preferred the pillow. Also had a cradle swing chair which kept her more upright for daytime activities.

Dummy was also a life saver as well!

P.S We found that ready made cartons if you can afford them were also better for reflux.

Just wanted to agree with those who said keeping them propped up and a dummy did wonders for our ds.

Also it may be an idea to enquire with GP if there is a possibility that he may be intolerant to cow's milk protein, as my ds was lots better once he moved on to a prescription formula + gaviscon.

The one thing that was an absolute life saver for me was a motorised swing which can keep them in a propped up position whilst rocking them to sleep. My DS would sleep in it for 3 hours at a time, whereas before that he would only sleep on me and would scream if put in the pram or a sling.

It will pass, but you have my sympathies as I know how difficult it is.

Another vote for the swing chair. We had a Fisher Price one. DD too big for it now but I can't bear to sell it yet!

I will mention possibility of intolerance to dr when we go tomorrow, we are quite an allergicy family.

I love the look of the swing, if ds is really gripey the only thing that sends him to sleep is dh swinging him in the Phil and Teds carrycot, knackering though! Tesco has them on offer, so I may check out how many clubcard vouchers we have.

ugh had a dreadful night, dh and i both up all night.

what do you do when the only position they will sleep in (well for 10 minutes!) is on their stomach?

he just seems like he is in such pain, i thought the gaviscon was making a difference, but now i'm not so sure.

are there other medicines or milks that help?

Hazey, lots of research shows that in fact lying on their stomachs is the most comfortable for reflux babies, second best on their sides, worst is on their backs.

I didn't mention it earlier because we are all told now not to put them on their tummies, but you could discuss this with your doctor, and go online to find advice about him sleeping on his tummy safely.

infantrefluxdisease.com/infant_acid_reflux/

In terms of meds, gaviscon has a short term effect, the next step is to move to something like omeprazole, often branded as Losec, which is in a different class of drugs that are called proton pump inhibitors, so basically reduce the production of acid in the stomach. This should obviously be discussed with the doctor. Once prescribed, it takes about 5-7 days for the drug to kick in, and must be administered correctly - the tablet must be dissolved and not crushed before giving it in a spoon.

There are also some other ways to go medically, but you must discuss this with your doc first.

And by the way, my sincere sympathies. My dd had very bad reflux and it was just horrendous having to deal with it - the exhaustion combined with dealing with a child in pain is so debilitating.

He will grow out of this though, most reflux babies improve a lot at 3 months, and then again when they start sitting and being upright.

Solid food also really helps, we did this under advice obviously and our dd wasn't gaining weight because she couldn't keep milk down, and didn't want to eat, and so started on solids at 3.5 mnths and it was such an improvement. But this is an exceptional situation.

What I'm trying to say is that it will improve as he grows and develops, and that bit by bit you will get there. Something like Losec might make a massive difference though, it can be transformative for many reflux babies.

Good luck, this won't last forever. But it is rough, so be as kind to yourself as possible. I have been told by mothers who have experienced colic and reflux that reflux is much harder. Is there any way you and your dh can do shifts in the night so that you get some sleep rather than you both being up all the time?

Sorry you had a bad night - I remember it well.

I think you need to go back to the GP and ask about the possibility of milk intolerance, especially if you have a family history of allergies. It is really quite common, and a high percentage of us are intolerant to cow's milk without even knowing it - it is very difficult for the human body to digest.

My son was prescribed Nutramigen 1 which worked within a few days. He still has the Nutramigen 2 at night and he is 2 now!

Does he arch his back? Classic sign of reflux.

Would you consider trying a dummy?

If you can get an appointment with the GP today, I would do so, as another night like that could send you over the edge. I'm not being a drama queen - I just know what it's like (awful), and how much better it became once it got sorted out.

Just seen this, my DD 14weeks has severe reflux too.
By the sounds of it the doc's given the wrong meds for the symptoms. As others have said Omeprazole works really well. Gaviscon only really thickens the feed to try and stop regurgitation. Ranetadine helps to neutralise stomach acid, they may suggest this next. If that doesn't work, Omeprazole is a proton pump inhibitor that prevents acid production, they may start a low dose then referal to a paed if a higher dose is needed. We have more good times than bad nowdays.
DD hates her dummy, but has finally found her thumb which is comforting to her, but she can only get it in certain positions. gravity still beats her at times.
Good luck, let us know how you're getting on.

DD3 has reflux and I think I spent the first 2 months with her sleeping on me and me semi-upright! We are lucky now that her worst time seems to be the evening, by night time she is knackered as she never sleeps longer than 30 mins during the day and actually sleeps really well. We have Domperidone and Omeprazole which seem to help most of the time but still get days which are really bad for no discernible reason. I would get a referral to a paed as soon as poss - it took 6 weeks for dd's to come through and we really suffered for those weeks - I just couldn't put her down and it had a big impact on the other 2.

Baby sleeping on her left hand side seems to be the most comfortable position. DD really likes to suck and as she is BF it sometimes makes it all worse so a dummy helps on those "desperate to suck" occasions - I think the saliva helps with the acid. Gaviscon was useless, particularly as we were BF. We also found the baby swing useful.

This website is fab for info and a good supportive forum too

www.livingwithreflux.org/

thankyou so much everyone

saw the dr yesterday, who was useless, he just said keep on with gaviscon, and he would grow out of it. he seemed more concerned about me not getting enough sleep, than ds being in pain - which he clearly is.

he was diagnosed by the paed at the hospital, who he saw because he was in scbu for a week with lung problems (although he was only a week early - elcs, he was defined as premature, because of the condition of his lungs). i'm not sure if it is possible but i may contact the paed directly and try to see him again.

he doesn't really vomit, milk will trickle out of his mouth if laid down, but it does come out of his nose with quite some force. for ages after a feed he arches his back and squeals, and he periodically makes a sudden high pitched screech and whoop, followed by lots of wheezy breathing and grunting.

we have propped up every surface, i try to carry him in a sling, he has a dummy, and i'm thinking about getting a swing.

has anyone tried cranial osteopathy?

oh and when i mentioned intolerance to the dr, he sighed and said everyone always thinks that, and it is very unlikely!

Definitely try to contact the paed directly, it doesn't sound as if your doctor took you that seriously. A lot of babies have mild reflux and is maybe why the dr is a bit dismissive, but it sounds as if your little guy is in pain and needs something stronger.

I did try cranial osteopathy, and she used to work on my dd's stomach which would be very helpful in the short-term as one of the side-effects of reflux is lots of wind, bloating and gas, and it really helped with that. But you need to go quite regularly. Its worth a try, but I think you need to get his meds sorted first.

I tried cranial osteopathy, but she screamed so much the 2 treatments were very stressfull. She could only be treated whilst I was BF her at the same time, didn't do much good either for us.
This has been a life saver. DD will sleep for 4.5 -5 hrs at night only on this...
www.sootheyourbaby.com/ProdsPosSleeping.htm
Sounds very much like reflux, possibly silent.
I'd either go direct to the paed or go back to doctor and demand to be refered if they won't help you. I had to be quite heavy handed to get the help I've had, and i think i'll be arguing for more soon. It is quite possible there is a temporary milk intollerance too. I'm still BF and if I so much as sniff anything dairy, she has a really bad day or two.
I'm also about to try an infant probiotic to see if that helps, but DD is a heavy chucker!
Where abouts in the country are you, are there any other reflux mums nearby, it can help to have someone experienced to talk to.

Yes! to cranial osteopathy!

My poor little ds was sooo unsettled I would have sold a kidney for him, so I literally tried everything.

I can't be 100% certain that it did anything, as it was around the same time as buying the swing and going on the formula.

TBH I am at your GP's attitude. When I took my ds to the GP at 6 weeks, it was her who suggested the milk intolerance as she said it was common, especially in those parents who are atopic. The paediatrician also agreed with her. Surely trying a hypoallergenic formula wouldn't hurt? That is what they did with my ds - tried one tin to see if it made a difference.

TBH if I were you I would be asking to see another GP for a second opinion.

Of course, he may be right, and it may not be that, but if you want to rule it out, you can buy Nutramigen 1 at the chemist over the counter (though it is about £13 a tin!)

If you are on formula, see if the paed or GP would prescribe Enfamil AR, DD had terrible reflux and that (with a combination of ranitadine and domperidone) was life changing for us. From the first bottle of Enfamil AR you could see a difference, suddenly she was happy to eat and sleep. It is a pain getting formula on prescription, you can never run out as you can't pop to tescos and get some more, but it is free.

There is another thread going on at the moment with a mum having a very hard time with her reflux baby. See here

this thread

i saw the hv yesterday, who said i should see another gp, and go back to the hospital. she seemed to think it would be worth trying ds on nutramigen, as it may be an intolerance. typically ds wasn't so bad last night, although he still has to be kept upright for a long time after a feed.

she could see how uncomfortable he was, arching his back and squealing away. he also has an intermittent wheeze, which she thinks is another reason to go back to the hospital.

i am nervous about going down the route of nutramigen, and i'm not sure why. if he had an intolerance, would it show itself in other ways, or just reflux?

My advice would be to see a paed as quickly as you can, ideally one who specialises in gastro. My experience of GPs is that they have limited knowledge of reflux and often think it is the mother being over-anxious which is less than helpful. In our case, it was a cows milk protein intolerance so switching to Nutramigen helped combined with going on Losec (omeprazole) - the paed diagnosed this by our descriptions of DS's behaviour at feeding time (similar to what you describe) plus crying, unsettledness at other times plus the way in which the problems developed (they built up over time which is consistent with an intolerance). He also had quite rough scaly skin in a number of places, not visibly red but very scaly to the touch. Apparently this can sometimes be an indicator of a problem with milk. We also have a family history of babies (all boys) with bad reflux and I have some allergies / intolerances myself.

In terms of sleeping position, I have one of the 45 degree wedges with harness which I can give / send you if you want (I am in London). Couldn't get DS to use it :( and he has been on his tummy since around 11 weeks with breathing monitor.

Good luck, it does get better but getting the right milk / meds combo really makes a difference.

I wouldn't be nervous about the Nutramigen - if you are on formula anyway. If you don't see a difference, then you can switch back to ordinary formula without any problems.

If it helps with your decision at all, Nutramigen is cow's milk. It is just that they hydrolise it to make the molecules really tiny so that they can be digested better by the body.

Agree with thebunnies re the skin - I was intolerant as a baby and I was covered in eczema.

My DS had no other problems, and is no longer as intolerant. What I mean by that is that he can eat chocolate, butter, cheese, ice cream etc in small quantities, but not a cup of milk IYSWIM.

Also I'm not sure if you read my suggestions on the other thread but I'll repost them here anyway.

Switching from BF to bottles - contraversial I know, but my ds was overfeeding on the breast, which can make reflux worse. With bottles I could monitor the intake.

Nutramigen formula plus Gaviscon - almost instant change

Baby swing - I have a Fisher Price rainforest one that goes back and forth as well as side to side - I found that the side to side motion was much more effective - he would sleep for 3 hours - bliss!

Cranial osteopathy - only went once but it really helped with releasing a lot of wind and poo!

Baby massage and yoga - he used to fall asleep in the class.

Dummy - again, contraversial but worked for us.

Hairdryer/fan/white noise - used to stop the crying and soothe him to sleep.

Wrapping him up warm/swaddling - must have made him feel secure/relaxed.