10wk old screaming her head off after every feed

[DomesticGoddess31]

For the last few days my 10wk old (who was 5wks prem) has been pulling off at the end of each feed and screaming her head off. She'll tell me she's still hungry (thats how I'm interpretting it anyway) but when i try and feed her more she sucks till the milk starts flowing and then pulls off while just about taking my nipple with her and screams. She's then inconsolable for [insert a length of time between 1 and 4hours] and just won't settle. When we do finally settle her she won't stay asleep for more than 10 minutes at a time. I'm tearing my hair out.

She's been on infacol for a good couple of weeks now and I'm confident that certainly not all the screaming is wind.

She had her first set of jabs on thursday and has been worse since then but was already behaving like this before her jabs if I'm honest.

Does anyone have any ideas??? I am at a total loss as to whats wrong....is this just a baby thing and a stage that will pass? If so please tell me it won't last for long....

[kangers]

Sounds like colic to me. May pass may not.
Could be soreness in mouth (thrush).
All latching on position Ok?
How are poos?
Does she draw up her knees?

[DomesticGoddess31]

I think latch is ok but I shall go to my local bfing group next week and get it checked just in case. My husband gives her a bottle of expressed milk every day and she's doing the same on that feed too mind you.

Theres no white patches in her mouth so didn't think it would be thrush???

Poos have been 1or 2 a day for a little while now but she did recently go nearly 3 days without one....we've therefore had 2 exploding nappies over the last 2 days.

She's not drawing up her knees really.

Bowel pain maybe??

[RitaMorgan]

Does she need to burp when she does it?

[MeriNisipPoissons]

Reflux? Domperidone helps close the valve at the top and the tummy and 'push' volume thru the stomach.

[babycham42]

I"d definately go with reflux as a possibility.

[DomesticGoddess31]

Just googled reflux and think you might be right....she does seem to vomit a lot, I just thought all babies did.

[33goingon64]

Are your nipples burning or itchy? If not you can probably rule out thrush, but DS and I had it without him having white patches.

[Athrawes]

Reflux 99% sure. One way to tell/self diagnose is to give Gaviscon after a feed/half way when the screaming starts, or even before - not really impt when, I used to do it after a feed. If Gaviscon works you have reflux. Ifit doesn't work you have another problem.
When it says mix with 15ml - its OK to mix with 5ml, just makes it thicker, suck it all up with a syringe and squir into the back of her cheek.
This is a really good site
www.cryingoverspiltmilk.co.nz/
You will feel so much better once this is sorted

[DomesticGoddess31]

Great....after a reasonably good day of her settling and sleeping much better (we've elevated her cot and been keeping her upright for as long as possible after feeds ) I just tried to feed her and my stupid forceful let down has just rendered her hysterical again, and what I am now convinced is acid reflux is worse than ever. DH gone for a walk with her in the sling to calm her down so we can resume her feed.

I'm so upset :( Just when night times were beginning to get better and bf was starting to get easier, this reflux rears its ugly head.

I do realise I'm probably being a total wet blanket about this and other people have far worse problems but please can someone give me a virtual hug and reassure me that its not as hopeless as it seems right now?

[Gumps]

Hug on it's way to you.
Ds2 had silent reflux and it sounds quite similar. I would go to the gp ASAP and make them listen. Gaviscon will be the first thing they prescribe but you can buy infant gaviscon yourself over the counter.
It is horrible to see your lo in such pain. I remember sitting in the car crying as I couldn't do anything to help. He is a very happy 2 yo now with no lasting effects.
Sorry this is a rubbish post but I just wanted to offer you some support. 37+ 3 and dying for baby to come out and brain not functioning. Became a bit of a silent reflux expert with ds2 so happy to answer questions/ give advice if you need. Up right is the best thing and ds quite often slept in car seat until we went to bed. His cot w like a ski slope!

[IsSamNormansDad]

Sounds like reflux. DD (22weeks) has this, and thankfully, it does get better. Can you maybe give more bottle feeds? I ask this as the holes in the teats may help her eat and digest a little more slowly (my DD is FF so not sure about BF and expressing etc).
yy to sling - we found it a lifesaver! See GP or get Infant Gaviscon through Minor Ailments service at chemists. The screaming and vomiting will pass, but it will be one of the longest periods of your life. I know its hard, but try and share some duties with DH, wear the sling constantly, if its a wrap type, there may be a breastfeeding hold (my moby wrap had a wee bookle with it, detailing all the different holds and there was a BF one.
With you in spirit and support!

[CantSleepWontSleep]

Sounds quite like milk intolerance. Have you eaten more dairy products than usual the last couple of weeks when you say she's been worse? Best way to test this theory is to give up dairy completely for 2 weeks (takes this long to clear system totally) and see if it makes a diff.
Since you mention having a forceful letdown I would also take a look on kellymom at the second on oversupply and strong letdown, as there are some tips there on how to handle it. I would think it unlikely that this is the only problem though, since you say that she reacts to the bottle of expressed milk too.

[narmada]

It sounds more likely to be oversupply and fast letdown than reflux to me. Is she stacking on the weight??

[narmada]

Another idea - if you have fast letdown and oversupply she may be done feeding quite quickly but still want to suckle for the comfort of it. Trouble is, she's generating another letdown and getting more milk which maybe she doesn't want at that particular time. What happens if you use a dummy when she starts to fuss?

[DomesticGoddess31]

I definitely think I have an oversupply and fast letdown problem but she definitely has some reflux too. She's been sick loads of times this morning and I can hear her refluxing and swallowing it back down poor thing. She ticks pretty much all the symptoms of reflux. Went to the docs this morning and he prescribed infant gaviscon (what a surprise) so will see how that goes.

Anyone have any tips on administering it, especially when out and about??? Tried mixing as directed and feeding it to her from a bottle and it was impossible...we both ended up in tears and dh had to feed her the rest from a syringe. Going to try mixing with EBM and just mixng with 5ml and giving to her with a syringe again, is this ok do you think? Haven't worked out how the hell I'm meant to do that out and about though?!?!?!

Thanks all for your replies by the way, I've been so upset about this and it helps to have the great MN support :)

[narmada]

Buy a bottle of baby neurofen solution just for the syringe - it's got a wide hole. It's fine to give it to her direct from a syringe but fraid there's no easy way to give it out and about - if you take a sterilised bottle cap and express a bit of milk in that and then mix in the gaviscon you could do it that way.

Don't necessarily rule out oversupply as a cause of vomiting in and of itself - both that and foreceful letdown can cause vomiting. Is your baby in discomfort when she vomits? does she arch her back and squirm? Having said that, reflux is more common in preemies than in full-term infants.

I would also consider cow's milk protein allergy/ intolerance as someone else has said, especially if your DD had early exposure to cow's milk formula as a supplemental feed in NICU. You could experiment with a completely cow's milk free diet yourself (no butter, whey powder, skimmed milk powder etc hidden in things) for a good two weeks and see if things improve any.

[DomesticGoddess31]

Hmmmm she's not always in discomfort when she vomits, but I think she is sometimes as it wakes her up, its the not sleeping thats the biggest change. She's so hard to settle and then won't stay asleep. She cries after burping sometimes too.

Having said that she slept alot yesterday whichni put down ti her being so tired from not sleeping at all the previous day, but then screamed for hours after my forceful letdown upset her. But then she did the same on a bottle of expressed BM a couple of days ago and normally she's fine with a bottle.

She seems better today so we'll carry on with the gaviscon and see. It might be more than one problem I guess

[Gumps]

How are you getting on op?

[DomesticGoddess31]

Gaviscon is working to keep the puke and refluxy vurping at bay and we have a far happier baby however now the wind is becoming impossible to get up and she thrutched around most of last night keeping herself and me awake. Arrrrggghhh! Trying her on half her normal dose of gaviscon today (as she's also heading towards constipation) and considering trying her on gripe water.

Far less screaming though and we've actually had some very pleasant feeds over the last couple of days. As she's calmer she's able to cope better with my fast letdown I think.

I don't know, you fix one problem just to end up with some more!
How are doing Gumps? Baby still snug in there?

[organiccarrotcake]

Just to clarify some things on this thread (I know OP understands this):

INFANT Gaviscon is totally different to "Gaviscon". PLEASE do NOT give a baby "Gaviscon"!

Infant Gaviscon (IG) will often treat the symptoms of reflux but may cause other problems such as constipation. It may be helpful to look for other causes of reflux as by treating them you may find that you can reduce or even stop giving IG.

Food intolerance is a common one (eg cow's milk protein - you need to cut out EVERYTHING, including reading all labels for anything which contains milk or milk products). Wheat can also be a problem. If you choose to try removing food items from your diet you need to try it for around 2 weeks to really see if it helps.

Tongue tie can cause reflux symptoms even if feeding is going ok (milkmatters.org.uk/ can help to diagnose this) and may be worth looking at.

There are other ways of helping to manage reflux including some of which you're already doing - small feeds, little and often, propping up after feeds and raising the cot or moses basket head a little (by raising the feet, keeping the mattress unbent), and so on. It can be heartbreaking but it really does get better.

[Gumps]

Sounds a little better. I remember constipation being a problem for ds2 and him having lactulose. I am sure the last thing you want to consider is more meds now though.
Baby still in there. Ds2 not felling well tonight. He is now asleep but baby is like a washing machine in my stomach so looks like I am up for a while....

[narmada]

domesticgoddess you will probably shout me down for this but....if your DD is still writhing and seeming uncomfortable please do consider whether it might be worth trying a milk-free diet. The thrutching around at night is typical of both reflux and cow's milk protein allergy - mightn't be wind-related. Cow's milk protein allergy can cause tummy cramps among other things and if there is an element of reflux/ acid burn there too....yeuuuuuch.

Part of the reason I'm so keen on encouraging people to try the milk free thing is because it was suggested to me when I was BF DS (now 10 months) and I poo-pooed it because I couldn't believe trace milk proteins could be that much of a problem. He had no rashes really, or anything like that. However, it became startlingly apparent after a few weeks on formula that it was indeed cow's milk that was part of the problem and he was so much more comfy when whole cow's milk proteins were removed from his diet. I so wish I'd given the milk-free thing a try, might have saved us all a lot of heartache :(

Gaviscon's well known for causing constipation in infants, absolutely everone I know who have had babies on it has reported it, although doctors always mysteriously deny that it exists as a side-effect . There's an alternative called Carobel (you can get it on prescription or OTC in Boots on special order) that I and many others have found less constipating. It's made by cow and gate.