Is this silent reflux or temporary lactose intolerance?

[Bambinocino]

DS, 17 weeks, was diagnosed with silent reflux at 6 weeks. Paediatrician put him on ranitidine. DS improved and by 14 weeks was sleeping midnight-6 a.m. and more settled during the day.

Then he had a week-long tummy bug (diarrhea) and since then has been worse than ever - constantly uncomfortable during the day unless asleep, pulls off during feeding (is fully bf) and wakes every 2-3 hours at night - often windy/in pain rather than hungry, but seems to want to feed too. He also has cradle cap and red spots around his mouth.

Paediatrician changed the ranitidine to omeprazole last week and suggested I express milk and thicken it with carobel.

Paediatrician said either the reflux has worsened due to the tummy bug, or the bug has caused temporary lactose intolerance. He gave me another appointment for April and said that if the omeprazole didn't work I could reintroduce the ranitidine as well after a few days. But didn't seem to have any other solutions and I got the feeling I'd just have to put up with it till I wean him and hope that helps.

The carobel has caused constipation - DS woke 5 times last night straining and crying and his nappy in the morning was very thick and paste-like. Not sure if the omeprazole will work as DS just spits it out!

I am feeling a bit desperate and exhausted. I'm living far from family and close friends, have a toddler to look after and am having Cognitive Behavioural Therapy for depression and anxiety (partly PND I think and partly due to more long-standing issues) and I'm sure some sleep and rest would help.

Has anyone experienced anything similar? If it's still reflux, any hope that these medications might work and are there any other avenues? If temporary lactose intolerance, how long might it last and might something like colief help?

[Chulita]

Have you tried cutting dairy out of your diet? DS is 6.5 months and if I eat any dairy at all he is v windy, pulls off while feeding but wants to feed more, screams in pain and throws up. He has silent reflux (which is getting better slowly) and a very obvious lactose/dairy intolerance. Maybe you could try cutting it out for a couple of weeks and see if it makes a difference. It took 10 days to see a change with DS but he's a completely different baby since I did. We didn't use any meds because it completely constipated him and wasn't worth the added pain for him imo.

[Rycie]

I think you should give him a probiotic, its possible that the tummy bug has upset the flora in his gut. Also, cut out the carobel. I have read all the research on thickening feeds (my dd had horrendous reflux) and there is nothing to show that thickened feeds help so if the carobel is causing trouble I'd get rid of it.

You're prob doing this already, but lifestyle changes are really important for reflux - the head of the cot must be raised (put telephone directories under the legs), minimal handling after a feed, keep him upright after a feed, sleeping on the left side is best. Don't lay him flat at all, he must always be raised.

[larrygrylls]

We had a v refluxy baby.

The "upright" bit is good advice. I am not sure about expressing and thickening. It sounds like hard work! Why not just give him gaviscon (mixed with water) directly after a feed? It is all the same once in the stomach.

I would give him a little while longer to get over his bug before making any lifestyle changes. In my (and our paediatrician's) view, dairy intolerance is not the first choice of diagnosis and it normally has other signs; a rash and watery poo.

[Bambinocino]

Thanks very much all. I've thought about cutting dairy out of my diet - haven't done so far as there seem to be various schools of thought on whether it works, plus I live on dairy products so would be v hard! But I think I'll give it a go as you suggest Chulita - definitely worth a try after another night of 4 wake-ups.

Larrygrylls - how long do you think it might take for him to get over the bug? If that's still causing trouble then maybe there's hope for improvement in the relatively short term!

[larrygrylls]

Bambino,

I would be really careful about cutting dairy out. If you do, you have to be very careful about replacing the nutrition. The calcium, especially, is not that easy. Otherwise you risk damaging your teeth and bones.

As to your question, I would give it a week after he stopped being sick. If still problems, then time to seek another opinion.

[Chulita]

bambino I lived off dairy too but have slowly got used to it. At first I thought I'd never manage but now the only thing I miss is cheese and I won't be bfing for ever. As for calcium there are supplements, after all vegans don't eat dairy and that's a lifelong commitment whereas this is for as long as you're bfing. I only tried it in desperation and it worked, if it doesn't, it'll only have been a fortnight dairy-free and you can get back on the yogurts :)

[Chulita]

Oh, and re gaviscon it clogged DS solid, he didn't poo for 12 days and was in agony cos he just couldn't get it through his system. Just a warning cos not all babies get on with it!