Reflux advice please - I don't have a clue!

[JW37]

After reading some of the severe reflux posts on here I feel a bit embarrassed about asking for help about this but here goes.

My 17 week old ds2 has been ff for about 7 weeks. He was always sick after bfing but since he's been on the bottle it has been dreadful. Straight after a feed he will posset with just a little bit of milk coming out with a burp but over the next 3 hours he will be sick around 4 or 5 times. Milk just pours from his mouth with no warning to start with but by the end it is saliva with smelly droplets of curdled milk.

It doesn't appear to affect him much. He's putting on weight and isn't in pain from it so the gp is very reluctant to do anything. Where it is affecting us is that nobody wants to cuddle my baby including my family as they're too scared of being vomited on. We go through umpteen changes of clothes, muzzies etc and I and ds2 constantly stink of sick.

I've tried anti colic bottles, comfort milk, gripe water, infacol, changing brands of formula and have now got gp to prescribe infant gaviscon (but only half a sachet 4 times a day). None of it makes a difference but I don't know how long the gaviscon may take to work. He takes 7 oz bottles 5 times a day and nearly always finishes it all.

I know im lucky he's not in pain but please can anyone give me some advice on other things to try to help control it as I have no clue.

Thanks

[blondefriend]

Sounds like a cows milk intolerance to be honest. The fact it got worse when moved from BM to FF plus the fact none of the medications seem to make any difference. My DS had this and needed Neocate to sort him out.

Do you have any family history of allergies, asthma, hayfever etc? This was one of the key questions that our feeding specialist used to diagnose DS.

[JW37]

I asked the gp about a cows milk intolerance and he dismissed it. We have mild allergies, and I have perenial rhinitis but no asthma.

[narmada]

I think milk allergy too. GPs often dismuss it as the required formula is £££ in script costs and often they are not aware of prevalence of CMPI.

If I were you I think I would throw one last bit of money at the issue and obtain an experimental tin of aptamil pepti 1 from boots. I say this over nutramigen and neocate because it is far more palatable (we've had em all!).

Hope you find an answer soon.

[narmada]

The fact it is coming up in curdled lumps hours after the event is poss important. CMPI babies cannot move food through systems quickly enough because the milk is kind of undigestable. So it comes back up instead...

[Notquiteinsane]

I would so agree about CMPI!! My DD, now 2, has it and am currently going through it with DS who's 5 months. DS unfortunately has the pain rather than the sick, my DD was really really sick (although despite whole feeds coming back, HV's still called it posseting!!)
Aptamil Pepti was the turning point for DD. If GP is being funny, ask the HV's if they can refer you to a community dietician. Not everywhere has them, but is worth a try!

[JW37]

Update on ds2 and reflux. I bought a small tin of aptamil Pepti 1 to see if it helped the situation. Oh my god that stuff is disgusting when it comes back up. Unfortunately it made no difference to ds2's being sick and the smell made me want to be sick as well! So I'm going back to the gp on mon to see what he suggests or if he can refer me to a dietician/nutritionist.

Thanks so much for the suggestions so far. It's good to have options.

[narmada]

Sorry no joy. Pepti is not hydrolysed enough for some babies - he might need nutramigen AA or neocate. Now, if you think Pepti smells bad......... !

Hope you get your answers soon.

[narmada]

Or it might just be reflux. Stupid q but is he overfeeding? Taking v large quantities at once? Dd was a relatively hsppy spitter and absolutely gorged herself on milk - a right chubber!

[FiveGoMadInDorset]

Sounds like DS, who was given Gaviscon, as was silent reflux, still puking, not projectile and putting on weight, ended up he had a mile intolerance to milk protein, so we switched formulas and he was much better, on a dieticians advice we reintroduced milk at a year and he was fine.

[Boggler]

Why are you only giving 1/2 sachet if infant Gaviscon? My dd 20 wks is on it due to reflux and we give 2 sachets with every feed, which is the correct dose. Why not try the correct dose it works fir us.

[JW37]

Boggler, Half a sachet 4 times a day is what we were prescribed by the gp. He told us to try that for a week then if ds2 wasn't constipated to go up.to one sachet 4 times a day. I had to beg for that by the way as he didn't want to do anything. He barely gave us enough for ten days at the dose he prescribed but I will be insisting on more.
Narmada, not a stupid question at all. he takes 7 oz 5 times a day. I tried him on a smaller amount more often to see and it played havoc with his sleeping patterns making him miserable. He was sick a bit less tho but it still came back up.

[narmada]

Doesn't sound like it's too much milk then.

IMO that amount of gaviscon isn't going to do anything. Your GP is right about the constipation potential though. IT makes poo go like playdough.

There is a product you can order in from Boots called Carobel - it's made (I think) by Cow and Gate, and is a feed thickener so works in a similar way to gaviscon. I seem to remember the constipation wasn't anywhere near as bad on that, though. Failing that, have you tried the anti-reflux formulas like aptamil anti-reflux? You would need a thicker 'y' cut (or variflow) teat as it gets stuck in the usual ones. YOu could use that every feed and see if it made a difference.

[narmada]

I think SMA do one called staydown as well.

[Boggler]

Jw37 you can buy infant Gaviscon over the counter if you need it. My gp was reluctant to prescribe at first and I had to battle a bit but it was worth it as the Gaviscon has transformed things for us. Dd has 4 feeds a day and 2 sachets with each feed in accordance with Gaviscon instructions, no issues with constipation although she's on comfort milk which makes things easier. I only got the Gaviscon by demonstrating that dd was throwing up 20-25% of her milk. I did this by weighing her towelling (absorbent) bib before and after feeding and subsequent throwing up, the difference in grams roughly equates to the ml that she is throwing up. Eg 10g increase in weight of bib equates to 10ml of milk if full feed was 100ml then 10% lost etc. When I gave this to gp he agreed that she did have reflux even though she wasn't losing weight. Btw when I asked why he was reluctant were there side effects etc he couldn't give me any. Good luck.

[Pobblewhohasnotoes]

My LO is on Neocate and ranitidine.

What I found was you have to be pushy with the GPs and find one that knows about children. It's no good them saying he'll grow out of it, that doesn't help you now.

If the gaviscon isn't working you need something else. Have you tried increasing the dose? My son was on 2 sachets per feed and although it helped the reflux it just made him constipated. We tried various milks, Nutramigen and Aptamil pepti until eventually we got Neocate. We did have to see a dietician though. Our GP referred him. We saw a paediatrician too, but he also has ezcema. Something else our GP couldn't treat adequately.

It's possible it's a milk allergy (which is different to a lactose allergy). In which case they can also be allergic to soya.

Try upping the gaviscon. If this fails go back to the GP. Some GPs ate great, but some are dismissive and make you feel neurotic so you have to be a bit demanding.