4mo always very sick after feeds

[sillyily]

Dd (4m) will have a feed and about five minutes after, throw a lot of it back up. usually about half the amount but Often what looks like the full amount. Sometimes its just milk, sometimes it's a lot thicker, almost chalky.
She is currently formula fed, but i expressed with the odd ff for the first three months. She's on cow and gate 1st stage milk. She acted the same with breast milk too so I don't think it's the formula. She has 7oz approx every 3-3.5 hours, feeding on demand. Hv suggested giving her a dummy to encourage further swallowing, which worked at first, but makes no difference now. She is the 50th centile, but weighs the same as my fatty ds did at two months, so seems small to me. I don't know how she can be putting on weight, when nothing seems to stay in her.
Sorry for long post! Any advice on how to keep it down her/why she is doing it/ whether it's actually a problem would be greatly appreciated :)

My neice was exactly the same as this. She either refused the milk or drank it and threw up every single time. The HV was really unhelpful and just said to force her to drink it . She wasn't gaining weight and no-one seemed concerned.
In the end my Mum stayed with her when the HV came and after no help from her (even with my Mum getting a bit shirty with her), in desperation after she left my Mum went and bought some baby rice and they started weaning her. She was only 10 weeks old but they didn't know what else to do.

Fast forward 5 years when my nephew was born. He did exactly the same and the HV suggested changing to Soya milk. Worked a treat and he never threw any of it up. Might be worth asking the HV whether that would be worth a try?

Has anyone checked dd out for reflux? My dd used to bring some milk up and GP was worried about reflux for a while but she never brought up a large amount. We discovered she just needed a change in milk. GP did say that if she was bringing up half or more he'd have thought reflux was the problem.

Can I ask why you expressed for the first three months? Trouble latching?

What everyone else said and also maybe check the teat isn't flowing too fast? Perhaps try out a slower teat and see if it helps. Also give her a few breaks during the feed maybe? My DTD2 is 9 months and will still sometimes auto-chuck her bottle if she's had it too fast.

From what I've read about reflux, as long as she's happy and gaining weight well it's not a problem.

It's when they refuse to eat, or throw up so much that they don't gain weight, that you need to treat it.

Some babies are just pukers. If she is happy and gaining weight though there isn't a problem.

Sounds like either reflux or dairy protein intolerence to me - dd2 had both, if they have one, they usually have the other too. You can get soya milk formula on prescription I believe. (nutramigin?) probably not spelled right. If it is dairy, ask to be referred to a paediatric dietician for help and advice.

I agree it sounds like reflux which can be treated with a change in milk, or meds like infant gaviscon.

Have you tried the comfort milk?

Speak to your GP.

On phone so can't look back, so sorry if I'm repeating myself, or if I reply in the wrong order
Hv told me not to worry, as she is gaining weight, however she sometimes seems to wretch and she looks like she is in pain. Also, I'm having to change her clothes and often mine almost after every feed. Not that big a deal but I could do without it.
Iv tried both newborn and size 2 teats, same prob with both.
She often has one break half way through a feed, but not always.. Will try that every time.

Had probs with both dcs latching on, so expressed with both.

Will look into soya milk, should I try baby rice? I bought some on offer so it's in my cupboard ready :-) or hungrier baby?

I asked about latching on because I am wondering about tongue tie.

Often tt babies are sicky because they take in a lot of air when they feed because the tongue is not moving correctly. Many are diagnosed and treated for reflux but it doesn't improve things, because it's not reflux that they are suffering from.

good article here from Dr Kotlow there is a case of a "reflux" bottle fed baby further down.

Could tongue tie be a possibility for both this baby and your older one?

My ds never had an issue with eating, aside from wanting more after every feed, but he did too have a prob latchin on. Assumed it was my fault tho since it happened with both.
Can't open the link on my phone, taking too long, will have a read tonight on laptop tho

Could be reflux, but half of all babies with reflux have cows milk protein intolerance. Please don't use soya milk as babies who are CMP intolerant can also become intolerant to soya to if feed that instead. Go see your GP and see if they will give a specialist formula. TT is also a possibility if she couldn't latch, does she dribble with the bottle at all as that would be an indicator to.

Don't give baby rice, your baby is too young and she's not puking because she's hungry.

and whilst she is gaining weight normally and you don't mind dealing with the mess, it can be painful for the baby when it comes back up. so for this reason alone it is worth seeing your GP to see if anything helps.

She does dribble a lot, not necessarily when feeding though, assumed it was teething tbh (tho there haven't been any teeth).
She has a scan tomorrow for something unrelated, not sure if I see the paediatrician as well- will def speak about this if so. Gp next week if not.
Keep feeding the cow and gate then for now?

If I were you I'd be inclined to rule out anything medical before changing milk as it can upset them a bit. But if nothing is found, try it. Your Dd may just want thicker or thinner milk. Also, I wouldn't recommend trying baby rice unless you feel like she is ready. I started dd on baby rice at 17 weeks, I knew she was totally ready and she loved it and did fantastically. But only you'll know whether that's right for your dd.

She tries to put anything in her hands, on her mouth ( including a teeny bit of banana ds shared while my back was turned) so I think she probably would be ready soon. Ds started on baby rice and porridge at 4mnths under advice of Gp and Hv cos he was a heffa, but she's literally half the size now than he was then.

in her mouth

Just to be clear I meant dribble milk out the side of her mouth when feeding.

Dribbling between feeds is probably just teething.

Sounds like when DD had reflux. It really hurts them! Thankfully she just needed help to keep her feeds down and infant gaviscon did the trick. We were lucky she didn't also have lactose intolerance. Definitely go to GP.

I would be inclined to feed less more often incase she just can't cope with a large quantity at once. So 3/4oz every 2 hours might stay down better. Try for a few days and see

It sounds like it could be reflux, but bear in mind that even if it is, there may be nothing you can do about it (my DS was about 11mo before he stopped throwing up after and between feeds - he was sick at least 10 times a day before that). Try to keep her as upright as possible after feeds as that can help. DS was bf to begin with and I started combination feeding from about 3mo because I was fed up of being puked on mid feed - I tried various different formulas but none improved things (I stuck with C&G eventually).

Are you sure it's as much milk as you think coming back up? You might find if you measure it that it's a lot less - I know from experience that it looks like a lot, but actually if you spill some milk you'll see that a little spill can look like a lot. It may also be worth trying to give her smaller feeds - perhaps she doesn't need as much as you're giving her?

For what it's worth, it sounds to me like your DD is doing fine - going over 3 hours between feeds and on the 50th % is very good if she does have reflux (and bear in mind that girls are often smaller than boys so it may not make sense to compare her with your DS). If she stops gaining weight or starts to lose weight that's when you need to speak to a GP.

Will def try feeding little and often, don't know why I didn't think of that.

It possibly isn't as much as it looks, but it often looks more than went in! Most of the time it's enough to drench a bib, and soak through to clothes underneath. Usually gets me too. When she wretches, it's thicker, but less.
Gp next week anyway :-)

Yep try little and often. And try keeping her upright for 20 mins after ( in bounces chair/ your arms) sure you are doing this anyway

Please don't thicken milk as suggested by someone! The formula quantities are that for a reason. She will get dehydrated on thickened formula

Yeah she is usually upright if not asleep!
No, don't worry- I wouldn't thicken the formula. Usually use cartons anyway

If you get to the point where you want to try different formulas Cow and Gate is more of the middle ground when it comes to thickness, so changing brands will change the thickness safely. Aptamil is meant to be thinnest, Hipp next then Cow and Gate and then SMA. But there's not much difference between the first three. However my DD needed a thinner formula and switching off Cow and Gate and going to Aptamil sorted this for her.

Though if this happened with breastmilk too you may want to try the thicker SMA formula first.