A question about early weaning...

[bumpsnowjustplump]

I am really struggling to cope with my babies reflux. He is 15 weeks and is constantly sick and screams for hours on end. He has dropped two centiles in four weeks and is a very unhappy little man. Paediatrician first prescribed gaviscon but that didn't work so he has been on Rantitidine and domperidone for four days. I hate to say that this seems to be having little effect as well! I am bf and am going to try going dairy free as of tomorrow to see it this helps him at all. I am now really struggling to cope I hate the fact I can do nothing for him and I am not enjoying being a mum at the moment . My DD is also suffering (age 2)!! Added to this there is the pressure from the hospital that if in 4 weeks there is no improvement with his weight then they are going to stick a tube down his throat into his stomach...

I was wondering what would be the implications of me weaning him early if the meds dont improve the situation in a couple of weeks.

[Verity79]

You are doing really well, breastfeeding a reflux baby AND having a toddler is a real challenge. You are doing lots for him. Each feed he has is SOOTHING his throat as breastmilk has antacid properties, you are looking out for him and doing your best to manage a very painful condition that has no easy solutions.

Before going for early weaning, how are you managing the reflux in other ways? I apologise if you have done these/are doing these already but it can't hurt to repeat!

Does DS spend most of his time in an upright/semi-reclined position? You can even feed like that if you want.

Have you tried feeding then tried giving a dummy?
That worked with my DD for a few weeks until she realised dummies didn't have milk in them! The sucking on the dummy seemed to help her not sicking up as her oesophagus was working to take the non-existant milk down rather than bringing it up. Also she wanted to feed as she was in pain and the feeding would make make her tummy even fuller making being sick more likely. Though she had minimal pain whilst feeding it was when she overfed she was in most pain.

Winding mid-feed (maybe even more than once)?

Baby wearing in a sling?
DD seemed to get less distressed in a sling so less likely to be sick. Another plus is you can do something with your DD while you are slinging DS.

If you do cut out dairy then expect to have to wait 2 or so weeks for a difference in DS. It takes a while for diary proteins to get out of your body. Has your Dr suggested you do this or is this because you feel DS is displaying some of the signs of dairy intolerance? See here for advice on diary

Give the Domperidone a little while to take effect. Is the dosage based on his weight not his age? Remember as he gains weight the dosage will have to be increased.

Is the chart being used the new breast fed baby chart or the old FFed baby chart. This could make a real difference to how his weight gain looks.

How much does he weigh now/at birth? Does he put on any weight between weighings (same scales I hope!) or is he losing actual weight week on week i.e. he may be going down the centiles but is he gaining anything?

Normal weigh gain is between 5oz and 7oz a week, though with reflux I always felt anytime DD didn't lose weight was a successful weeks.

Also see here for soem great advice on breastfed reflux babies.

[AcademicMum]

There are still more meds that can be tried yet, so just because a couple of ones didn't work out, doesn't mean they will all fail. Omeprazole is another option - though this is pretty strong stuff as its a proton pump inhibitor, but sometimes used for reflux in babies.

Dairy free might be worth a shot, but just bare in mind it's not easy, can severely restrict you diet and make sure you are taking calcium supplements. If dairy free helps and you think you'll be on it for a while do get professional support to ensure your diet is OK.

To be honest, I can't imagine weaning early will help too much as although I know that sometimes thickening milk feeds with baby rice can help FF babies with reflux, this in effect only does what infant gaviscon does i.e. thickens the milk and makes it physically harder to sick up.

[AcademicMum]

Oh, would also second what Verity79 sayes about the dummy. My father has suffered for years from reflux and he sayes sucking on stuff helps as the extra saliva generated is temporarily soothing. Good luck!

[bumpsnowjustplump]

Sorry I have only just been able to get back on.

I have tried him with dummy and he wouldn't take it. however i havent tried it after a feed he may well do then...

The charts we have are breast fed charts he was born 8lb 12 oz and was putting on a lb a week but in the last four weeks he has only put on 4 lbs. He is now 10lb 5oz. he has never lost weight but his weight gain has been very slow, which is a shock as he feeds every two hours still.

I have not been advised by health professional to give up dairy but someone has suggested it may help. I was going to do it for 3 weeks and see if it has any effect. I was going to get calcium tables and use rice milk... Should I check with my GP before I do this?

I usually feed him in an upright position and then put him staight into his chair (that is in the most upright position that it can go in.) He can be in there an hour and as soon as I move him he is sick!!

Thank you for the advise re weaning I will hold off on this as you are right thickening the milk hasn't worked up to now.

[bumpsnowjustplump]

sorry that should be he has only put on 4oz in the last 4 weeks not 4lbs!

[Verity79]

Don't forget this will pass, it may take time but he won't have reflux forever. It may take some tweaking of meds/new ones but if you can find a drug/solution that makes him comfortable until such time as he WILL grow out of it.

I know 4oz in 4 weeks sounds too little but it is a GAIN not a loss. Every ounce your DS puts on is because of the fantastic job you are doing. I just wish I knew of MN when my DD had reflux, I was just told 'all babies posset' and 'did I think my milk was good enough?'

My DD1 was 7lb 12oz at birth, 9lb 13oz at 9 weeks, 10lb at 10 weeks, 9lb 15oz at 12 weeks (domperidone started then, obv not just posset), 10lb 4oz at 12+6 weeks, 10lb 13oz at 16 weeks, then suddenly 11lb 11.5oz at 17 weeks. The dom. took 5 weeks to really work but when it kicks in it really does the trick! She went from the 50%ile to the 2nd%ile to the 25th%ile.
She's now 3ft 3" and 15.9kg (I think thats about 34lbs) which is the 75%ile. Her reflux disappeared after she turned 1 and she went from 19lb 10oz to 23lb 4oz in 3 months.

Reflux does affect weight gain but it is only temporary babies will go back to 'their' curve when it resolves and you will be on here complaining that your 16 month old eats more than you ever could!

Good luck with the dairy and the new meds.

[bumpsnowjustplump]

Thank you so much for all your advise I am feeling a lot less issolated and on my own!!