Can a baby with Silent Reflux who is unsettled all day sleep OK at night??

[rowanrowow]

DS is 6 weeks old,. screams and cries all day, very very rare moments of contenment Yet at night time, after much back arching, pulling off feeds, crying, dummy sucking goes to sleep and sleeps OK til next feed 3 hours later. How does he do this when day time sleeps are a night mare? I am desperately seeking a diagnosis for him, he is so so unsettled every waking moment. Can't feed without back arching, going red, gagging, crying. Yet when he does posset it doesn't seem to to cause him any pain. Help what's going on?

Bump

Hi Rowan my baby (now 14mo) was horrific in the day but once she went to sleep at night slept all through - I think it was because she was exhausted and I'm pretty sure that on one of the websites I (subsequently) found sleeping well at night is recognised as being possible with babies with silent reflux.

My DD started with this on Xmas day 2010 and it went on for about 7 weeks until she got given some Infant gaviscon and it worked wonders for her. Other things that the HV had mentioned prior to this were possible allergies (ie cows milk). I will say at the same time as I started infant gaviscon we had also been for 2 appointments with a cranial osteopath as I really was desparate by then. I cannot honestly say if that helped or not as the two were around the same time but I do know that when we came out of the appointments with the CO she was much more relaxed and on both occassions slept for quite a few hours immediately following the session (which was otherwise unheard of).

Are you BF or FF?

I really feel for you as I know how desparate I was and it was all such hard work.

Firstly, you have my enormous sympathy. It is a very distressing and exhausting time, especially when most HCP's just tell you to ride it out and that it is what babies do.

In answer to your question, and from my experience - YES. DS2 slept like a log at night time - I think he was so exhausted from the day. And actually, he never fed a huge amount in the night either. The main night time symptom he experienced was huge nasal/sinus congestion from about 3am (he used to wake gasping for breath) and this evolved into him waking EVERY morning at 5am in a coughing fit. His specialist said that this is very common in silent refux babies as they are lying flat and the stomach acid starts to irritate.

DS2 never settled well in the day until I started putting him down on his tummy. He used to then sleep endlessly. Apparently all babies in special care are always on their tummies too as digestion occurs when they sleep and it is a lot more comfortable to have pressure on their front. I bought an Angel Care breathing monitor for peace of mind. I could then settle DS2 by gently tapping his bottom when he stirred.

If you have any questions - please ask xx

Hi chocolate your experience sounds very similar to mine.

However my DS (not the lo who suffered with silent reflux) was only placed on his tummy once for about 2 hours (due to possetting) when in special care and I never noticed any of the others on their tummies - I think they try and avoid this as much as possible to prepare them for going home.

sorry chocolate my last post didn't sound right when I read it - what I should have said is that I can understand why they would put babies on their tummies for relief if required, as I saw in my DS when in SCBU what a difference this can make. I think that it would probably be better to only do this after trying meds though as the meds in themself may make enough difference.

I could not believe the difference in my DD when she had it - once we started the meds she was like a different baby, although I do realise this isn't the case for everyone and we were fortunate that the IG worked for her.

I know what you mean - thank you!

Funnily enough though, DC3 is due in a few days and I will probably, out of choice, place the baby to settle on its tummy also. The baby will be in a cot next to our bed, I will use the breathing monitor again, we don't smoke etc. The main reason why I would do it again is that when on their tummies, babies don't startle themsleves awake every 40 minutes - DS2 could just resettle himself because he didn't have his arms waving around. It is personal choice though and I am comfortable with that decision.

Ooh how exciting due again very soon - good luck :)

I think with having the monitor it makes all the difference and in those circumstances I would probably do the same.

When my eldest DS was born you were told to lie them on their fronts - how things change

In my experience, yes. I used to find the nights easier than days. My DS even used to feed better at night, which drove me mad as I could never understand why. I was told it's quite common.

BTW, we had a massive improvement when we also diagnosed CMPI so something to bear in mind.

I really feel for you. I used to be sobbing by 8am some days, just at the thought of having to get through a day of feeds. If you can, get a referral to a dietician. Omeprazole is very effective for silent reflux, it blocks stomach acid, it takes about a week to get going. Infant gaviscon is pretty useless I found.

It gets easier, they do grow out of it. Feeding little and often helps too.

www.mumsnet.com/Talk/breast_and_bottle_feeding/1306414-All-new-deluxe-reflux-support-thread?pg=11

thankyou so much joE that link is very helpful :-) Today he has barely managed 30 minutes of contentment. It must be awful for him. Something is clearly bothering him every waking moment. It's heartbreaking and I just can't take him anywhere. Poor little guy. Yes funny you mentioned the night feeds they seem to go much smoother, much less wriggling and backarching.

Argh, just wrote a long post and lost it. In summary:

get a sling and get out and about if you can. Being at home with an unhappy baby all day is very, very hard. I did lots of long walks with buggy or sling. It rereally helps you both.

I think silent reflux and CMPI are very closely related. As my doc said, reflux is just the top of an immature digestive system. If you are breastfeeding try cutting out dairy. If you are formula ask GP for Aptamil Pepti. I had to jump up and down to get it but we got there and it made a big difference.

It's awful but it will get better, I promise. My DS is a million miles from the baby I had who was either asleep or crying. It's so tough.

Ask for help. MN is very helpful. Sorry, gotta dash. Give me a shout if you have questions.

I would second the suggestion of cutting out dairy (including hidden dairy - check the labels!) but also soy (including hidden soy - it's in all sorts) for a week or so if you are breastfeeding. It made a huge difference to my DS's silent reflux. Dairy and soy proteins are very similar and it's common to be intolerant to both, whereas cutting just dairy did not. If you're formula feeding,you would need to switch to a non-dairy formula which you can get on prescription. Definitely worth a try!

Hi Rowan. My little one will soon be 1yr. He was diagnosed with GERD at 6 weeks, but only when he was not gaining weight at all and not poo-ed for 9 days (I went to the GP and got referred to A&E paeds). Every midwife (4) and hv (5) that have seen me and baby up to that point were all rubbish at recognising all the signs that you are describing. They were not concerned about no poos as there were plenty of wet nappies! Saying that I just needed to feed him more as he was not gaining weight, to try anti-colic medicines, gaviscon and anti-colic bottles, cranial osteopathy, that he could be allergic to cow's milk (formula.......I was doing combination feeding as I had problems with my supply) or just plain leave him to cry as some babies are just more cry-i than others . My little one was exactly the same, screaming, back arching during and after feed. Vomiting milk curd (it turned out that all he was getting was the whey, hence the wet nappies and no poos!). Never slept during the day., but fine at night apart from waking up for night feeds). He is my only child and I had no experience with babies whatsoever. I had no idea that his screaming was not normal. All I knew was that it just didn't feel right. Once diagnosed, he ended up taking 2 medications until he was about 6-7 months old. Once he started solids, we reduced his medications gradually over 3 weeks to none and he has been fine ever since. He gained weight BTW as soon as he started the medication as it kept the milk down long enough to absorb nutrients and although he was still 'in pain' during the feeds until about 4 months old (as it takes a while for the meds to kick in at the right dosage), he was so much happier straight away. Had to keep him upright for at least 30 mins after each feed and propped up all the time including his cot. We invested in a chair-rocker so he was sitting in that all the time whilst he is not in my arms. I ended up not able to do any tummy time at all with him during the first 6 months of his life as he would get so distressed from vomiting. He is fine now BTW, in fact started going onto his tummy on his own at 7 months and started crawling at 9 months. Go with your instinct, Rowan. I wished I did with mine a lot earlier and just ignored the midwives and hvs. But then...they were meant to be the experts!

Thank you so much to everyone who has replied. Your posts have been a comfort and the advice has been much appreciated. It seems to be so unfair when I see happy gurgling babies when I take DS1 to school and my DS2 is screaming and red faced in the pram. I have started using a sling to do the school run with as at least after a little protesting he will gleep in there. I was breast feeding for the first 5 weeks but after I told my health visitor how unsettled he was she recommended formula as he ma still be hungry. I now know this was wrong and seriously BAD advice :-( but I can't go back and breast feed ever again and I am feeling guilty about that too. It's basically been a horrible time for us all, mostly DS2 who is just never ever content and awake which breaks my heart and poor DS1 who never gets a word in or any time with me without the noise of a crying baby drowing him out .

Anyway, my Health visitor came to do 6 week check up today and she saw how unsettled he was. I told her I thought he had milk intolerance and or reflux and she basically told me that silent reflux is a myth, it doesn't exist but people like to have a reason for their baby being unsettled. She then said that in the 6 short weeks my son has been out of the womb he has learned that if he cries he gets attention....ummmm . Apparently babies are cleverer than we give them credit for and I love him too much. Seriously these were her words that I am a good mum but I love my children too much and upset myself over things. What the hell does that mean? She asked why I didn't leave him to cry so I told her I felt like he was in pain or at least upset over something so wh would I leave him. She then asked how DS1 ever learned to be independant when I am so clingy???? I told her it wasn't me who was clingy and amazingly DS1 became independant when he could wak and talk, not at 6 WEEKS OLD before he even had full head control or knew he had hands! Basically then she said I was 'defensive'. I feel so alone now.

sorry for typos. Have screaming baby on me :-(

Go to the Dr and skip the HV who is clearly an idiot. I went to the Dr (encouraged by my HV) every week until they referred me to the paedetrician who instantly diagnosed reflux. I got Omezaprole and infant Gaviscon. He is now 10 months, still takes the Gaviscon and is a happy healthy boy.

It was hell but like you my little one slept all night which meant I at least could face they day with a full night's sleep. I did during the day however, go into the other room or stand outside for a few mins just to get some respite from the screams and it did help to get my sanity back.

Oh and if anyone tells you that formula is the cause, make sure you tell them you had all of the symptoms before you introduced it - they tried that one on me a few times and I put them straight.

Sometimes you have to be a little demanding.

Oh Rowan - you know that the HV is talking nonsense, don't you? Silent reflux is so hard to get a diagnosis for and as I think I said earlier, a lot of GP's dismiss it, especially this early on. I really feel for you because at 6 weeks you are on your knees anyway with a newborn and the gruelling sleep deprivation.

Where do you live? If you are in London, I can recommend the specialist we saw.

I second what others have said - silent reflux can also be a symptom of CMP intollerence. In fact, when DS2 was discharged from consultant care at about 14 months, he said he would never know what the exact diagnosis was - you just treat until the symptoms are relieved and adjust as they grow older. DS2 probably grew out of an intollerence or his stomach sphincter matured.

Anyway, he ONLY formula on the market which is truly dairy free is Neocate (all the others are made from milk and heavily broken down. Neocate is totally synthetic). The problem is that it costs £30 a tin, so doctors are very slow to prescribe it. I went to Boots and bought a tin over the counter (pretend your baby is already on it and that you have run out etc). From the first bottle he drained it, rather than take a few sips and scream etc. I also found the Dr Brown bottles helpful.

Then go to your doctor and, assuming your LO feeds better, insist that they give you an ongoing prescription.

Additionally there are meds which usually the doctors will try in this order:
Infant Gaviscon (you can buy this over the counter too so at least you can say to the GP it is useless if it is! I found it was!)
Ranitadine - this neutralises stomach acid so that although the baby will still reflux, they don't experience the burn. Sadly this didn't work for us.
Omeprazole - this stops all acid production altogether. It takes about 10 days to work. It was a godsend for us and the only thing that worked in conjunction with Neocate.

I also found that feeding DS2 in a baby bjorn chair really helped. He didn't like being held whilst feeding. Please also try settling him on his tummy - it really helps.

Thinking of you

Go to the GP.

My DD slept wonderfully at night but was very unsettled in the day. GP diagnosed silent reflux, prescribed infant gaviscon and DD's reflux disappeared.

Again: go to your GP.

And please don't feel guilty about formula feeding. My DD couldn't BF so was FF early on and is a healthy, chirpy, energetic little preschooler now.

Thank you ahain everyone. BsshBosh would you mind telling me more about your dd's symptoms and her behaviour if you are still about please??? I am doubing myself since the HV comments.

This is going back 3.5 years now but from what I remember: arching back, tensing body, rigid body as if trying to pass wind, rubbing back no help, crying constantly if picked and held or if left, all symptoms I had read about "colic" really that resolved itself with a few days of seeing GP, hated lying flat so we bought an electronic swing chair that always soothed her, hated being in sling or buggy.

Never doubt yourself but the GP is the expert here so go to him or her as soon as you can. As another poster mentioned, not all GPs will diagnose reflux - ours didn't immediately as babies that young with their immature digestions, well it could be many things - but I mentioned reflux and he said, "It's worth a try. Infant Gaviscon. If it doesn't work then we'll investigate."

I would trust a GP over an HV.

Rowan, please don't feel bad about ff your ds. You are trying everything you can to do the best for him.

You don't have to give him only ff, and even if he is fully ff you can still offer him breast if that comforts either of you. At 6w you will still be producing milk, even if you haven't fed for a week.

2 of my dc had reflux. One never cried from it, he was the happiest baby of all my 3, he would just projectile vomit all over me. The other hated her big lie-flat buggy, would scream blue murder whenever I laid her in it, and the first time she ever fell asleep in the buggy was at 6m, 10minutes into her very first trip in a buggy that did not lie flat. But at night she slept well. I put her to sleep on her stomach or side from birth. She, too, regularly covered me in vomit.

Both turned out to be dairy-intolerant.

rowan my DD screamed constantly as soon as fed. She was only 'ok' when she was being fed and them immediately afterwards she seemed to scream but wanted to feed quite frequently. she would get really angry and could not lie flat. Even if you got her settled she would wake the second she was put down. She did not settle all day, but at night (thankfully) slept right through. We tried everything and then eventually someone mentioned silent reflux to us and when I went to the GP and went through her symptoms she thought exaclty the same, tried the infant gaviscon and my DD was like a different baby. Some HV's should not be doing the job - and it sounds like yours is one who shouldn't.

I really feel for you as the time when my DD was un-diagnosed was pure hell, and my boss was also giving me so much hassle for not being back at work (she was 6 wks). I had no time for my 2.9 yo and felt so wretched and lonely with it all.

You can buy infant gaviscon sachets over the counter if no-one will prescribe it for you and try it for yourself but I do hope you get the support you need.

Good luck x

What a terrible HV - do not see her again! See your GP, gaviscon was no good for us, but ranitidine worked great. My GP didn't know much about silent reflux or bf, so I told him the symptoms, said I was sure it was silent reflux, that I had tried gaviscon which helped although was a nightmare to administer (easier in ff babies I think) and could I please have some ranitidine - he said..... hmmmmm..... yep! I do appreciate that not all GPs are as accomodating