BLW and EBF, dr advice is to spoon feed and use formula.

[BashfulBunny]

So.
I have just come back from seeing a paediatrician. Ds is 11 months old and has serious wind issues - he wakes screaming in the night arching his back and kicking his legs. Sometimes it can take 2+ hours to get the wind out (if at all) before he is either comfortable enough or just so exhausted that he falls asleep again. He therefore gets around 9 hours on average between 7pm and 6am.

He's been on solids with blw since 6 months and eats anything but only teeny tiny amounts. He's ebf (refuses a bottle) and still feeds 5 times a day about an hour after meals plus two at night, sometimes with another small one if that's the only way I can get him back to sleep.

The advice from the dr is to stop his post-lunch bf so that he is more hungry for solids, and that I should give him formula instead because by this age of 11 months he needs more iron.
I should also spoon feed to get more solids into him (how this will be achieved I am not sure since he has recently decided he doesn't like spoons!)

Basically, while I am willing to try anything to get him to sleep better/be in less pain this seems contrary to more up to date advice - especially about formula.

Does anyone have any thoughts or experience of doing this when they started with blw?

Thanks

Has anyone else had to stop

Any thoughts from anyone?

[BashfulBunny]

oops. That sentence was going to say; Has anyone else had to stop blw/ebf due to their DC not catching on to solids 'fast' enough?

[ExBrightonBell]

Do you give him daily multivitamins as that would sort out the iron issue?

It's a bit off of your GP to suggest stopping bf. Would you be able to go back and ask for ideas that support bf as you don't want to stop?

It does seem reasonable to try dropping a daytime feed to see if being hungrier might encourage him to eat more. You could give him water instead perhaps in case he is thirsty. If it doesn't work you can always go back to the bf in a few days.

[BashfulBunny]

Thanks for the reply Brighton. To be honest, I'm not sure there is an iron issue. I mean, there haven't been any blood tests to suggest it is low. He wasn't a premie or anything. She just assumed I should be giving him iron as my breastmilk "would not be sufficient".

It was the Paediatrician so needed a referal. She has referred me/DS to for behavioural support as she thinks the not eating is an attitude thing.

She didn't really want to talk about the wind issue at all, she basically just wants me to stop bf and wean him...

[ExBrightonBell]

My understanding is that ebf babies need multivitamins from 6 months as the level of iron in bm does start to decline. Food is eventually meant to pick up the slack by approx 1 yr as they eat more and more. The multivits are just an insurance in case not enough iron is taken in from food.

It does sound though like the paed was trying to add weight to her opinion by mentioning iron levels - even though as you point out there are no actual concerns about this! Can you get a second opinion? How do you feel about the referral to the behavioural specialist?

[NomDeClavier]

If definitely get a second opinion, although I did supplement DS with iron (EBF and BLWed).

Have you considered the possibility of food allergies or intolerances? It sounds like your DS is in done digestive discomfort :(

[TurnipIsTaken]

Sorry I don't know about the wind. Do you mean burping or farting?

Just wanted to say ds was like that blw but tiny amounts, bf a lot. I tried dropping a feed on hv's advice, he was miserable and ate even less and lost a tiny bit of weight. So I stopped messing with him. Around 15 months he just started eating of his own accord. To give you a bit of hope!

Have you tried offering loaded spoons or toddler forks? Would he suck some strips of steak, that is what I tried with ds to get the iron worry off my mind.

[Ragusa]

She sounds really crap, the paed, and knows v little about bf from what you have said.

An 11 month old child should not be waking in digesrive discomfort durung the night. Could he have a food or cow's milk allergy?

[BashfulBunny]

Ah ok. Thanks re the supplements.

I'm willing to go along with the referral to a behavioural person. If it helps then great - though I honestly do not think this is the problem.

I did wonder if it was an intolerance and hoped the paed would help with this... she gave me some stuff in case he is lactose intolerant (I suspect to placate me!) but I did try stopping dairy a while ago and it made no difference. He doesn't show any other symptoms such as a rash etc, but as I said, I had hoped she'd suggest working through some things to rule it out. He is definitely in serious discomfort though - he wakes screaming, arching his back and lifting his legs. The issue is farting rather than burping. Farts sound tight (if that makes sense!) rather than loose, but if he does manage to do one, he calms immediately, even if he's then thrashing a few minutes later again wanting to do another.

Turnip that's interesting... maybe I should just be patient on the eating. I did try dropping the post lunch feed (as per paed's instructions - I feel I should try what she says just to rule it out) and he was utterly miserable and clearly starving later.

I think I need a second opinion. Thanks for the encouragement to get one. Any more ideas still welcome though!

[JiltedJohnsJulie]

My DS was very much like this although he was spoon fed. The solids actually made him worse though not better.

The problem with him turned out to be tongue tie and upper lip tie. Do you think that could be the issue?

[JiltedJohnsJulie]

Just reread your last post. I'm CMPI and don't get a rash, just wind and an extremely uncomfortable tummy. If you do suspect CMPI there is some good info on the allergy uk website

[JiltedJohnsJulie]

Don't forget too that if you are in the uk your Paed may not have received any bfing training, so she's basically working off the same info as you...

[BashfulBunny]

Interesting links JJJ. I had dismissed both of those, but reading that info makes me think they are both worth checking out. Thanks

[FoodSchmood]

Another one here with a a previously tongue & lip tied DS who suffered horrendously with wind (similar issues to your son) who is also not so into his solids! (He's 15 months and still exclusively breastfed! My thread is here if you want more info). Cutting his ties made his latch much better and fixed the wind problems to a large extent. I am on a very restricted diet as my son has allergy types issues with various foods in my diet giving him severe silent reflux - cutting those foods out is the other thing that has made a huge difference to his sleep - he now lies still instead of constantly rolling from side to side, bringing up his knees, moaning and writhing about. You say you cut out dairy, did you do it ruthlessly, as it's used in many many processed foods in various forms and can be quite hard to avoid - and how long did you cut it out for? It can take weeks to clear it from first your system, then your childs. It might be worth giving it another go if you only had a short break from it before.

The iron thing - my DS had his iron and vitamin levels checked at about age 1 and they were all absolutely fine. I take a breastfeeding supplement (the pregnacare one) even though the research suggests that mothers diet makes very little difference to vitamin etc levels in milk - as i figure it can't do any harm and could possibly help ensure my milk is good.

I'd definitely see if you can get a 2nd opinion / see a specialist on a feeding team, instead of a generalist paed. Our area has a feeding problems clinic that our HV can do referrals to - it might be worth checking to see if your area does something similar?

Good luck!

[BashfulBunny]

That's really interesting Scmood. I'm seriously kicking myself for letting the paed dismiss me with something I feel is missing the problem. My GP is lovely and had got me the appointment because I'm back to work in 2.5 months and I have to have this sorted both as I won't manage on this little sleep and also as DS will be in nursery and needs to eat during the day!

I'll do the dairy again - there were some things I did eat (eg bread) which did have butter in and it was only for a week.

It turns out my Borough doesn't do 12 mth checks but I think I'll try to insist on one.

I feel so stupid and cross for being a pushover

[JiltedJohnsJulie]

It can be so easy though, please don't beat yourself up about it. Is there a le Leche group near to you? They may be able to check for tongue and lip tie.

I've just had toast with Leon curd. Yummy and dairy free

[MultipleMama]

My twins are 10m EBF and BLW. They don't have supplements are at a healthy weight and height. They don't have any other fluids except BM. They have 3 meals a day, snacks and they still cluster feed constantly.

Does he refuse all bottles? Or just the brand you're using?... Anyway, you could try adding more iron rich foods. I don't know if she asked you to stop BF or just one fees. You could try it and if it doesn't work add back in his feed.

Just suggestions.

[BashfulBunny]

He refuses all bottles. The milk just runs out of the sides of his mouth.

JJJ Thank you so much for the stuff on tongue tie. I had sort of come across it but I had dismissed it ages ago as DS can stick his tongue out. Having read that stuff though, so much rings true. He has an obvious upper lip tie and I suspect posterior tie as he shows lots of the signs. He's fussing while 'feeding' as I write this and I can now add 'doesn't lift his tongue while crying' to the list. It makes a sort of cup shape going up at the sides and s tiny at the tip.

I saw the GP on Monday and she's seeing me again on Wednesday after having some time to ponder the problem. I'll talk to her about it

[Ragusa]

It sounds so much like tt. Beware that many GPs are reliant on evidence from the 80s and 90s which appeared to show tt to be of little consequence.... but only because bottle feeding was even more prevalent than now and usually tt doesnt impact on intake of bottle fed infants as much. You could Google more recent studies by mervyn griffiths et al to make the case, and also the NICE guidance on ankyloglossia.