gp refusing gavison for reflux

[Thefaceofboe]

First off I just want to say my baby was born at only 4lb but was perfectly healthy. At around 3 weeks she started spitting up some of her feed (breastfed) and as the weeks have gone on it’s got a lot worse. She is now proper vomiting after every feed but is gaining around 30g a day, no idea how!

She is clearly in pain and only manages to settle after she’s been sick. I’ve done all the suggested things like changing position to breastfeed upright, winding, holding upright after feeds etc.

At her 6 week check up the gp just told me she would grow out of it and gaviscon wasn’t necessary.

At what point do they think gaviscon would be necessary? Losing weight? She’s still only in tiny baby clothes at 7 weeks and I’m worried that even though she’s gaining weight, she would be gaining a lot more without the vomiting it’s making us so miserable and I don’t even want to leave the house at the moment.

Sorry op forgot to mention, you can give the carobel while breastfeeding, you give it on a teaspoon after mixing it. Not sure if as effective though as mixed in with the milk.
If the gaviscon is working for the reflux you can try movicol to ease the constipation, they usually prescribe laxatives if babies are suffering on gaviscon but it may take a couple weeks to settle.
If she is in pain you definitely need to keep going back. Gps are useless when it comes to reflux but you shouldn't need to suffer in silence.

"She’s been so unhappy since and is constipated"

This is why the first GP advised as they did re the gaviscon. I hope you get somewhere with the health visitor OP.

My baby was crying, throwing up, and after every feed clearly uncomfortable and in pain. He'd had tongue tie so I went back to the doctor who had seen him as a newborn. He was about 7 weeks by then, and she suggested CMPA and said I should keep off dairy and soy. She also said it takes up to a month to get it out of your system, but there should be an improvement after 2 weeks.
He was a different child after that - still fed every 2 hours though!!!
It is so tough, but there are solutions available.

My dd did this and was prescribed Zantac drops, worked brilliantly though they did ultrasound etc to rule out various things, she was 6lb 13 born and only regained birth weight at a month. She's still smaller now, at 20

The HV phoned them and booked me in a call back but instead of a call back, I’ve just received a text to say a new prescription is at the pharmacy at the HV request. She didn’t request this, she said I wanted advice on the gaviscon. I’ll pick it up anyway and see what it is.

Gaviscon can be combined with giving lactulose. The gaviscon stops the reflux but the lactulose goes through their system without breaking down so keeps constipation at bay, both of my babies had reflux and have needed the combination.

So she has been prescribed Omeprazole? Anyone had any experience with that?

That's the standard for treating reflux. One of my DC had it and it was a bit of a pain to administer (this was several years ago - not sure if things have changed) but it did work.

I see it's been mentioned but mine had CMPA too and sounds like your baby exactly. The change to prescription. Nutrimigen milk was life changing for us both.
Stand your ground OP, they do not prescribe it unless you're on your knees in my experience.

So the omeprazole comes in a capsule with small beads inside? No idea how to administer to a tiny baby and in the leaflet it only says to mix with food for older infants? So bloody annoyed. It doesn’t dissolve in water like I thought

You have to mix it with water and give with a syringe, but as a nurse I can you that the beads don’t dissolve particularly well and they can get stuck in the syringe. It takes ages to dissolve. Omeprazole liquid is really expensive and that’s why they don’t dispense it. We rarely see the liquid version and when we do, we cheer.

However it does work well so try and give it. I had it for my children, we also used ranitidine and Gaviscon but the Gaviscon just made them constipated so it just created a new problem.

Was going to suggest you ask for omeprazole.
Then I see you have.
Hurrah
Yes mix with hot water it will dissolve and syringe slowly in.
3 kids here all had it from v v young.

The beads won’t dissolve at all, and won’t even fit up the syringe they provided? She’s tiny so only needs 2.2ml

@Thefaceofboe

The beads won’t dissolve at all, and won’t even fit up the syringe they provided? She’s tiny so only needs 2.2ml

Hi my daughter had this and don't get fobbed off with the tablets they do this as it is the cheaper option by a mile, she would just spit it out as she was as an newborn and all bitty and horrible. Anyway luckily my pharmacist was kind and told me you could get a liquid form but it's made to order and it's £100 a bottle for 3 weeks use, so very expensive. My daughter was very poorly and had the silent type of reflux so in agony as acid was just coming up as no sickness at all, it may be worth you trying to ask for this and seeing if they deem her health at risk enough to help you. Good luck

My DC is prescribed the omeprazole suspension with a fruit flavour added so it doesn’t taste as horrible. So I’d push for that if I were you. The little balls in the tablets are enteric coated so are designed not to dissolve until they’re in stomach acid. It’s really rubbish that the don’t prescribe the suspension for all infants.
I agree with previous posters that it would be worth trying cutting out dairy and soya for 2 weeks. If it is CMPA you’re likely to see an improvement quickly.
Things like orange juice and strawberries can also be an irritant in breast milk, so worth keeping a good diary as well.
They should be referring you to a Paediatrician as well, or if you can afford it I’d see a Paediatric Gastro Consultant privately, it’ll be quicker and you’ll get a longer appointment. At my youngest first private appointment the Consultant have a look up her nose and down her throat with an endoscope there and then, which showed redness and inflammation so they knew then it was reflux and could rule out floppy larynx etc.