How to give infant gaviscon?

[JoeBongo]

So our 1 month old boy is having reflux signs and symptoms and the GP has prescribed it.

However there's one small problem - after winding the crying starts, and we can't get him to take the liquid you make up with the powdered gaviscon and 15mL of water.

Can anyone advise how to do this? He's sat with his mum in the lounge crying away right now.

15mL of water when measured using syringes makes it quite runny, whereas guesstimated 15mL using 3 teaspoons makes it much thicker.

Do we:

1. Give it before a feed when he's looking for something to eat.
2. Give it immediately after coming off the breast and before winding.
3. Use the 3 teaspoon method and make it up thicker.

Any advice would be great!

Cheers,

Joe

[FiveGoMadInDorset]

Sorry DS was FF so we put it in his bottle but bumping for you for someone else.

[slumby]

I sympathise totally. My son has had reflux for 16 years (along with other medical problems) and it is extremely painful. I would advise that you do whatever you need to get it down. None of what you have suggested would do any harm, and its basically trial and error to determine what works best for your little one. However I might add that positioning is key. I would suggest you don't lay your baby totally flat as this makes the reflux worse, by allowing the stomach acid to travel back up the oesophagus, hence the pain.Hope that helps! Good luck!

[Igglybuff]

Give it immediately after a feed with a syringe. It will be runny using the correct measurement of water because (I assume) you're only using one sachet?

Stick the syringe in the inside of his cheek and slowly inject so he can swallow.

My DS has reflux and this is how I give it (am breastfeeding)

[Igglybuff]

By the way you must use the correct amount of water. You don't want it any thicker because the gaviscon has salt in it so needs to be dilute enough!

[JoeBongo]

Thanks for the replies. Ok, he's feeding again (acid relief type feeding we think) so the wife's going to try the spoon once more then the syringe in the side of the mouth next.

Am I right in thinking he will aspirate (breathe in) the liquid if squirted in when he's crying his little head off? I know babies can only breathe through the nose for some time but I assume this doesn't prevent aspiration.

[smokinaces]

I gave gaviscon before feeding when DS2 was breastfed. (DS1 was FF so it went in his bottle) I know its meant to be afterwards, but his reflux would start immediately - if we gave gaviscon first it neautralised the acid in his tummy. I would make up 3 x 5ml syringes and give 1 or 2 before a feed (depending on how refluxy he was that day) and the remainder after a feed.

The other thing that worked with was 5ml of gripe water (works a bit like an antacid too) before the feed, and then the gaviscon during (in bottle) or afterwards (breastfed).

[Igglybuff]

joe that's why I put the syringe in the inside of the cheek (between the gum and cheek) so it doesn't go straight down their throat. You gently squirt tiny bits in and they swallow as it goes to the back of their throat.

The problem with a spoon is that they can push the liquid out with their tongues as they have a tongue thrust reflex.

Alternatively you can use a bottle?

[JoeBongo]

Ok, syringe in side of mouth used. I don't think I got it to the side enough as the tongue managed to eject a good portion but some went down.

Can I ask what position the baby was in when given the liquid? Upright, angled or horizontal. I figured upright would be best to minimise aspiration like in adults but I'm not 100% sure now.

Just need to refine the technique now and get him taking it properly.

[JoeBongo]

PS: I was squirting in 0.5mL first (which he flicked out mostly) and then about 0.3mL which seemed to go in better but then again he seemed to gag a bit so maybe not a big enough volume to trigger his swallow reflex?

[smokinaces]

I used to give it in the breastfeeding position - e.g. cradled in my arms, not lying completely flat.

you'll all get used to it - and in a few days will be pros at it

[Igglybuff]

You'll get the hang of it! After a while the baby gets used to the syringe and will start swallowing while you slowly inject it.

If he gagged it must have gone far back into his mouth and he would have swallowed.

Position wise - have him as if you would bottle feed, so angled back a bit in your arm, spine straight.

Don't worry about aspiration - as long as you are injecting slowly enough and into the side of the cheek you'll be ok.

Also how are you winding? Best to rub not pat as patting can make the acid come back up. Rubbing does get the wind up, although I was dubious at first myself!

[fanzine]

I used to give this to ds before a bf and with a syringe to begin with as others have said, squirting a little bit at a time. As he got used to it I would use a spoon and he would take it from that.

[Igglybuff]

One last thing - it might be worth getting narrower syringes (2.5ml) as they're better than the bigger 5ml ones. My GP gave us some.

[SuperAmoo]

May i suggest that your wife tries changing her diet rather than relying on gaviscon. Eliminating dairy products and anything acidic like fruit or tomatoes, anything windy like onion or leak. Also cut out caffeine. If your wife follows a relatively bland diet, you should see a vast improvement in your son's reflux within 3-5 days or so. Both my DDs had/have reflux and responded very well to bland diets while being breastfed. Combine this with positioning - keeping baby more upright whilst feeding and whilst sleeping and you shouldn't need to faff around with gaviscon at all. Doctors always recommend gaviscon because they generally don't know anything about reflux, IMHO!

[JoeBongo]

Thanks for the tips ladies and gents - most helpful. I'll get a battery of syringes from the chemist.

As for diet she's been on decaf for maybe 8 years so we're ok there. For no fruit, tomatoes and cutting out dairy, how does that work then? Sounds like a recipe for constipation hehe or is that the Total Elimination Diet you are referring to? Any keywords we can use to find the kind of diet guides?

The only reason dairy hasn't been chopped out is we read the calcium needs for the milk need to come from somewhere and you needed to sort out alternative diet through talking with a HV or GP. What can you use instead? Soya? Feed her some chalk sticks every other day ?

[JoeBongo]

PS: We've had quiet now for over 30 mins. Something is working - all thanks to your help ladies and gents! Probably won't last long but it's a start.

[Igglybuff]

That's great news. I'm glad you caught the reflux early - we didn't realise until 12 weeks as our midwife kept brushing aside our concerns

yes the total elimination diet is the one. There are also a few websites on infant reflux if you google.

I've cut dairy out which has made a difference in terms of my son's wind. But I didn't go any further and cut other foods out as I wasn't sure. Plus it would be very difficult for me to find decent food as it is.

As has already been said, make sure your son is in an upright as possible position for feeds. Also hold upright for 30 mins post feed.

Finally - random question, but does your son choke or splutter during a feed? It could be a sign of an over active letdown caused by over supply (milk comes out very quickly) especially if your son has green poos. Sometimes this can cause reflux symptoms.

[Igglybuff]

As for calcium, I don't eat chalk but use rice and oat milk substitutes (soya is no good as could cause similar reaction) and take supplements to be sure.

[JoeBongo]

She says right boob is much chokier and grumpy, and left one is much happier. The lady down the shop (stuff NHS direct - she knows tons about kids having had 4 or 5) said to use fingers around the nipple to slow down the flow but my wife thinks she did it wrong and squirted more milk in when she did it

Any good tips about slowing the flow down?

Little Bongo is about to go to bed and we're bushed so I'll check back in the morning when I get to work.

Fingers crossed for a better night!

Cheers,

Joe

[Igglybuff]

I hope you got some sleep! It might be worth putting the cot/Moses basket on a slight angle as helps reflux babies.

You should not use fingers to slow the flow as can cause plugged ducts.

The best thing is to feed in a reclined position with baby as upright as possible. Or feed lying down. Also only use one boob per feed unless baby is having agrowth spurt and wants more!

I have this problem with my milk and the best thing I did was get a breastfeeding counsellor to come to my home and show me the positions especially lying down feeding. It was free. Speak to Le Leche League 0845 120 2918 or NCT 0300 330 0771 and they can send someone over. They can also talk to your wife about block feeding to reduce milk flow although in the early weeks I'm not sure if this would be advised. I've used both helplines and found Le Leche League more helpful but that's just my opinion! You can also email Le Leche League (google them to find their website and go to contact us)

It really pays off to speak to someone qualified!

[SuperAmoo]

Hi Joe, I followed the diet I mentioned no problem. I didn't need to cut out everything. I lived on jacket potatoes with tuna, and rice and chicken and beef and rice, and toast with honey, or marmite or avocado for three months and it did me no harm whatsoever. Follwoing a restricted diet in the short term is no problem to mother or baby. Basically the baby takes whatever it needs from the mother and the mother just tops herself up with supplements.

I was never constipated! Although I felt abit deprived, it was worth it to have a happy relatively reflux-free baby. And it wasn't long before I could add things back into my diet. DD2 is now nearly nine months and I can eat almost everything now, except for pineapple and citrus fruits which are absolutely notorious for aggravating reflux. And I'm avoiding spicy stuff for now too. I get my calcium from supplements - there's loads of good ones out there. Like others have mentioned, don't replace diary with soya as reflux babies often have the same pukey reaction to soya that they do to dairy.

Incidentally I too had an overactive letdown in my right boob and so I fed DD in a semi-reclined position in bed so she was more on top of my boob and this worked a treat.

Good luck!

[JoeBongo]

Ok, good tips there thanks! I'm going to get the wife to log onto here on my account and have a good read in case I forgot to tell her something.

Overactive letdown in righty is the same here as well - that's the main problem time.

Little one had 6mL of the gaviscon liuquid this morning and has slept for an hour so things are a bit better I think, but it's only day 2 of gaviscon.

I need to look up this diet thing after work - is tuna, tinned chopped tomato and spaghetti ok for tea tonight?

[SuperAmoo]

Honestly....chopped tomato is very acidic. This will no doubt sound gross but I mixed tomato ketchup with olive oil to make a very tiny amount of sauce that I mixed with tuna and ate with pasta - as I only used a teeny bit of ketchup I got away with it. But it depends if you want to carry on with the gaviscon. If you do, then your wife may get away with eating some acidic things. Having said that all babies are different and it might be helpful to keep a food diary - a record of any reactions to the previous day's food. It shouldn't take too long to start noticing a connection between certain foods and worse reflux. It's easier to make the connection if she only tests one reflux trigger at a time however. If you see what I mean??

Generally dairy and soya are a no-no with most refluxy babies.

Good luck!

[SaraBas]

hi, i'm new.
my baby girl has bad reflux (when i have longer i need to start a new thread as i need some advice) She is bottle fed so we put the gaviscon in her milk. If i were breast feeding i would give it before the feed when baby is hungry. I suggest making it up to whatever thickness works. Giving it before the feed will help neutralise the acid before feeding and so will help. It will also dilute it, if you are worried about the sodium levels in gaviscon. I wouldn't be worried about this as it is very safe.

I wouldn't use a syringe and sometimes you can not control how quickly it comes out and babies can choke easily. Putting a syringe inside a cheek could be a bit risky, they are not soft! Use a spoon.

I wouldn't worry too much about your diet, just plenty of water.

Then I have done all the other simple stuff like sitting upright after feeds, making the head of the moses basket higher, changing nappies with head higher that tummy etc etc.

Apparently they grow out of this. Good luck xx

[alypaly]

You should have a leaflet with it.Check with your GP but this id from the patient info leaflet

HOW TO USE GAVISCON INFANT
The dosage and mixing instructions depend on the age and weight of your child and the feeding method
you use. Gaviscon Infant should not be used in infants under one year of age except under medical
RB001100
supervision.
Open the sachet and mix the contents immediately before use as directed below. Each sachet is security
sealed. Do not use if damaged.
-
Breast fed infants: Under 4.5 kg (10 lb) - one dose (one
sachet).
Over 4.5 kg (10 lb) - two doses (two
sachets).
Add 5 mL (one teaspoon) of cooled, boiled
water to the powder in a glass, mix to a
smooth paste, add another 10 mL (two tea
spoons) of the water and mix again. Give to
your infant after each feed using a spoon or
feeding bottle.
-
Bottle fed infants: Under 4.5 kg (10 lb) - one dose (one
sachet) to be mixed into not less than 115
mL (4 fluid oz) of each feed in the bottle
and shaken well.
Over 4.5 kg (10 lb) - two doses (two
sachets) to be mixed into not less than 225
mL (8 fluid oz) of each feed in the bottle
and shaken well.
-
Young children: Two doses (two sachets), prepared as for
breast fed infants, to be taken after
each meal.
Do not give more than six times in 24 hours.
If a dose is missed do not give a double dose with the next feed. Just carry on with the recommended
dose.
Do not use more than the recommended amount of Gaviscon Infant.
If you accidentally give too much Gaviscon Infant ask your doctor or other health professional for advice.