How can I get fussy baby to drink more? (Reflux,allergies)

[Alexa007]

Hi there

First time I've posted I'm hoping someone can offer me some advice, I am feeling so downhearted.

DD (pfb) is 8 weeks, she was 7lbs at birth and on 25th percentile. DD is formula fed (initially Aptamil) as I can't BF. At 2 weeks GP diagnosed reflux due to refusing feeds, back arching, inconsolable crying & DD started infant gaviscon. Family history of reflux in DH side.

At 3 weeks DD still not drinking well & bad eczema on face, ears, chest & referred to paediatrician. Managed to get her in on a cancellation pretty much straight away (private insurance) and paediatrician agreed with reflux - prescribed ranitidine (adult dose) and Aptamil Pepti for possible cows milk allergy.
After an unsuccessful 4 days I was back to the paediatrician - baby allergic to Aptamil Pepti. He prescribed Neocate formula and advised to continue with the ranitidine.

Seemed to work - once DD had got used to the taste of the formula. We had a great week - DD drinking her bottles 90-120ml, rash disappeared quickly, I thought fantastic - we've figured it all out.

Now - the back arching is back and she seems uncomfortable but she's not crying like she was - DD has 40-60mls and doesn't want any more constantly - pushed teat out with her tongue and turns face away from bottle. Vomiting but not every feed. She's now under the 9th percentile for weight.

I am in tears - how can I get my baby to drink more I know she needs to have about 650 mls per day at her current weight, I dread every feed time as it's a battle to get her to drink enough. At postnatal groups it seems all the babies love to drink, mine hates it. I am scared of giving her bad connotations with food, I just want her to grow and be happy.

Has anyone else experienced something like this who can offer some hand holding?

Just want to add - when it doesn't involve drinking she's a happy, cuddly, sunny baby, who is easy to look after and can take her anywhere. As long as it's not bottle time!

I have a baby with a severe milk allergy so I know how awful it can be. Well done on managing to get a diagnosis so fast, not many people get it sorted by eight weeks.

I'm not sure what's going on. Neocate should certainly deal with the allergy side of things in a way that most of the other hypoallergenic formulas won't, so I'd have expected a real improvement and it's great to hear it's better. It might take a while for things to totally settle down though.

I have a few ideas on why LO might be refusing the milk:

• It tastes absolutely disgusting! It can take them a while to adjust but as your LO is very little this shouldn't be a problem. Don't be tempted to flavour it as some (usually American) websites suggest.

• Are you giving the ranitidine with feeds? It is also not a very pleasant taste and the association might put LO off feeding.

From our experience, if the reflux and other symptoms are caused by the milk allergy the ranitidine shouldn't be necessary any more (it never did a thing for DD and you have to keep upping the dose as the weight increases anyway).

Babies with a severe milk allergy can continue to have stomach discomfort and vomiting for a while as the whole digestive tract gets really inflamed before you get onto the right formula. The arching could be a left over from that and should improve in time. My DD continued to vomit a bit after every feed (then after every meal once on solids) until she was 12 months. It does take a while to totally improve. You're not giving her anything else are you? Not adding anything to the feeds, not trying solids? Have you stopped the Gavisgon? I only ask these things as people with refluxy babies are often given some old fashioned advice that doesn't actually help.

The fact that she's so settled in between feeds does suggest she's on the mend. My DD screamed constantly and never slept before the Neocate, so I'm sure you're on the right track.

If I were you I'd go back to the paed for advice, esp. as they are private and you should have better access. It might just be a case of keep trying. Have you changed bottles recently by any chance? Have you tried a faster or slower flow. Just thinking back to having a fussy eight week old!

You're right I think i'll have to go back to the paed but to answer your questions: we have stopped the gaviscon and she gets the ranitidine 0.8ml 3x per day before a feed. Nothing else added and there is no noticeable difference in what she takes whether its medicine time or not.

I thought that maybe since we'd had one really good week on the neocate that she might have gotten used to the taste.

Argh, poor little baby I just hope we can get this sorted for her. Thanks for answering.

She'll be fine, and she's definitely on the right path if she's more settled and her skin is better. I honestly thought the hell of allergic reflux would never end but it did, and DD is now absolutely thriving. I'm really trying to remember if we had issues with her taking the formula at points - I know she did refuse bottles on and off. She started Neocate much later than your DD (had been on Nutramingen before which only partly helped) and still happily drinks it now at 13 months, so hopefully it's just a case of time.

It could also be that she just wants little and often if she has tummy discomfort, maybe she arches if she feels a bit full? Have you tried offering her smaller feeds more often? I know it seems counter intuitive if she seems to hate the bottle, but you may get more into her that way (you might also get less reflux).

Good luck, I remember those days so I really feel for you.

Really good advice here but i just wanted to suggest something else - could she just be a bit off colour? It could be putting her off milk a bit? As a mum whose had to give neocate, if shes been drinking it no prob for a week, you've cracked it, imo!

Oh bless you huge hug, yes I've been there with ds1. He had severe silent reflux which resulted in severe inflammation and he decided that starving himself was better than the pain of feeding, so he point blank refused to drink and was admitted to hospital. He had 8 or 9 hospital admissions with this and had an NG tube. He didn't respond to gaviscon or ranitidine and was prescribed omeprazole and neocate - a slight improvement but by then he had a milk phobia and only had to see a bottle of the dreaded white stuff and he'd start screaming. I couldn't feed him when he was awake - my dh would come home from work at night and I'd be in tears as he'd drunk 5oz milk all day. I had to set alarms and get up at night as he would 'dream feed' - where he looked asleep and didn't seem to know he was feeding, but not so comatose that he couldn't drink from a bottle. If a noise or anything woke him, he'd wake up fully and then he would refuse to drink anything. I tried everything and every position to get him to drink milk, short of hanging him upside down by his toes.

I haven't had time to read all the above posts so sorry if I'm repeating a point that has been made, but have you been back to the dr to have the dose of ranitidine increased? Remember that the dose is worked out according to weight and needs to be increased often or the effect of it will be reduced. If things aren't improving - go back to the paediatrician. I can't emphasize enough how important it is to ask for help and support. I had PND as I was so depressed at the constant struggle with feeding and the fact that we could barely leave the house as I seemed to spend all day trying to feed him.

My ds1 eventually ended up under a paediatrician who is one of the UK's experts on infant reflux and feeding problems. He said that ds1's feeding refusal was pretty extreme so I don't want to alarm you and have you think this is where you're heading, when it is very unlikely. I say this to try to reassure you regarding long-term health, as I worried so much about ds during that time. He wasn't weaned until 15 months, as he refused solids until then - by then I was very anxious about his weight as he was so skinny, but the weight did improve when he began to eat. He is now 4 1/2 and while he has had some eating issues, he eats a good volume of limited foods. He drinks cows' milk morning and night! (I never would have believed that was possible). He is happy and sociable and developmentally absolutely fine.

Sorry this is such an epic... I so feel for anyone going through similar to my experience so I can't help but write a ton in response to your post! My biggest advice apart from getting more help from your paediatrician is to try not to get totally hung up on milk volumes. Believe me, that drove me crazy for a year. I knew what he needed to be having for his age and weight, I recorded every feed he drank, and every day he was getting nowhere near the number of ounces he "needed". That gave me so much anxiety at the time but despite that he is and has been fine.

Sending you a big hug and a which you definitely need and deserve! x x

You are describing my dd a year ago

Have you tried feeding showing her a cartoon or other distraction? Spacing feeds 3 hours apart helped too.

It's so hard...

Yes also try feeding when asleep. I used to push dd in her pram or feed her asleep in taxis to get her to drink

Where are you in the UK? If you can go private google Mike Thomson

Hi my DC1 was like this, terrible reflux. I developed a technique of a tiny bit to drink without laying back too far, carefully tilt her upright with no sudden movements, rub, rub, burp, little bit more to drink... and so on. It became a habitual technique I did without thinking in the end.

The problem with reflux is once the oesophagus gets burned by the stomach it can be painful for a while after.

Just a quick one re the rantitidine - we were advised by SCBU to give it 30-40 minutes before a feed so it has a chance to work...

YY MiaowTheCat
That's what I was thinking - the movements described sound a lot like trapped wind which needs a vertical baby to bubble out of.

Thanks all for your comments, think probably right on the wind. I wonder if she's had a bit of a bug she's picked up again over last 24 hrs
Never knew having a baby would be this worrying!
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