silent reflux

[spanna74]

I have been finding things really really tough with my second daughter (I also have a 2.5 year old) who is 15 weeks on Tuesday, in fact i would say other than certain points on a week's holiday we had with my in-laws just over a week ago i haven't enjoyed a single minute of her since she has been born.

She has been a very fretful baby who cries a lot, feeding was difficult at the start and i have been up with her pretty much three hourly through the night since she has been born (she is exclusively BF at the mo as she won't take a bottle) and i know she is still young so didn't have too high expectations at this stage.

Things have now hit rock bottom, Tues and Weds she cried on and off all day, Tues, Weds and Thurs night I was up one to one and half hourly with her screaming, my husband was away on Thurs night so i put her in the bed with me but that didn't seem to help. I have been to the doc twice this week as she has had a bit of a cough and cold but there didn't seem to be anything to sinsister wrong other than slightly red ear which doctor gave ABs for but said to wait and only give if she had a temp that wouldn't go down (she doesn't have a temp but i've started them anyway). I called the HV in desparation on wednesday day and he suggested she was teething but i don't see how it can just be that. Last night my husband kept her downstairs on the sofa with him till 1 and she slept on a cushion, then I fed her she slept for an hour in her cot till 3 then screamed took till gone 4 to settle her she was awake at 5 at which point I let her sleep on me.

I am now wondering if she has silent reflux. I have thought she suffered from wind as she is always arching her back and jerking around, she isn't sick but brings up mouthfuls quite often of fairly smelly part digested milk. She doesn't like to lie flat very much (to the extent that on holiday she slept in the Maclaren buggy each night which was on a slight incline and she slept much better in this) and there are often times in the day when she seems to be screaming with pain till she falls asleep in the end. Has anyone's LO had silent reflux and do you think this could be it? I am going to go back to the Docs on monday but why would it have suddenly got so much worse if that is what it is?

Sorry for the lengthy post and thank you for llistening.

I feel sorry for you, it's so difficult when they are like this.

my DS most probably has reflux (drs suspect he has, I am pretty sure). He would arch his back, scream and gag whilst feeding, refuse to feed, cry so much he stopped breathing. it was hell he also cried (or rather screamed) a lot throughout the day. (he still does, but not as much.)
he would also bring up quite a lot of formula and projectile vomitted a couple of times. I could clearly see he was in pain and now I am fairly sure it was the acid coming back up to his throat.
he's now on omeprazole (prescribed by gp) and special formula - enfamil ar (my own decision). He has been much better. still screams mind, but mainly when hungry/ tired/ wind/ not in the mood

I do hope you find out what is up with your DD, it's awful when they cry so much and seem to be generaly unhappy to be here.hard to enjoy motherhood.

I had to be quite persistent with the gp, wrote down all his symptoms, etc.(they kept telling me babies cried and all the usual...)

this website may help:
heartburn.about.com/od/infantschildrenandreflux/qt/infantgerdsympt.htm

good luck!

Yes it does sound like what I went through with my dd who had silent reflux which wasn't diagnosed until she was 6 months old, it started when she was 6.5 weeks old.

It was absolutely awful.

The good news is that infant gaviscon is pretty harmless if taken and they don't have it so I would suggest going to your GP and asking for a weeks worth of infant gaviscon if there is a big improvement then you can probably conclude that it is silent reflux.

My dd only slept about 8 hours of 24 - fortunately all at night because she didn't nap during the day all she did was cry/scream unless being held in very particular positions such as facing outwards over my arms so the pressure was on her tummy etc. She grew well and was a big baby. When she posseted it was ALWAYS really curdled even though she had literally just fed it was never runny.

INfant gavsicon is tricky to mix with water, the best tip I ever got was put the powder and the water in a small lidded container and shake hard much better than the mixing into a past and then adding more water IYSWIM.

I've just remembered she was always worse when she was teething even though she was on solid food by then, dreadful nappy rash and in pain - I think it makes their tummies more acidic than usual?

OP, you also asked if it could suddenly get worse. this was the case with my DS. he was gradually getting worse from about 6 w.o and then at 8 it became pretty much impossible to feed him.

plenty of very helpful people on MN with experience of reflux, I'm sure they will be along to help.

Firstly huge hugs and you have written a post I could have written a few wks ago

ds3 is 16 wks, ds2 22 months and ds1 3.5yrs and ds3 has been a fretful baby, who refused a bottle until a couple of weeks ago when my other 2 had one at night from 3 wks. He is breastfeed all other times. We were in hospital for full septic screen and iv antibiotics at 4wks and he seems to have had a cold every since. Has never slept for more than 2.5 hours until a weeks ago

We suspected silent reflux due to all the reasons you list but the infant gaviscon did nothing for us - it is so worth trying so you know what you are dealing with.

For me the following helped
Upping my fluid intake to 3.5l a day and snacking with my older too.
Giving ds3 a bottle of water between feeds - to get him used to bottle and keep him hydrated - he feeds every 3-4 hours
Boots Gripe water - NOTHING else has helped clear his wind/colic/what ever it is like this and I've tried infacol, gripe water and colief since he was born
Introduced dream feed at 10am - with bottle
Inclined cot - on a stack of books at one end
Slept him on his front in different room - feel free to ignore this I'm well aware of current advice but I have got to the point where if I didn't sleep I would become a danger to my children, during one horrendous day I walked out of my house, leaving older 2 boys in house, handed ds3 to first neighbour who opened their door saying I needed a break and walked home, my mum arrived within 20 minutes and helped out (honestly is sounds worse than it was but I'm well aware of how emotional it can all be)
and taken ds3 to chiropractor
Introduced a dummy

I hope visit to docs is good and that if it is reflux you get help you need, my friends little boy had silent reflux and she described it like the colic came back at 14 wks so (anecdotally) it could suddenly get worse, they are changing so so much at this age

Come back and let us know how you got on x x

re read my post and couple of mistakes - ds3 did sleep through for about 4 days at 10 wks and then went through growth spurt and horrendous after that so now I've re read your post it does sound more likely to be reflux...

doc gave us infant gaviscon and said would notice difference in couple of days - we didn't so just stopped with it - good luck for tomorrow x

My DS had silent reflux diagnosed finally at 4 months after crying (me, not the baby!) at the baby clinic to get help. We had tried the infant gaviscon at about 3 months due to problems sleeping flat but it didn't make any difference. I should have gone back to the doctor earlier and tried something different - ranitidine worked immediately and we had a different baby. Apparently, different ones work for different babies.
I would say that the positioning problems are classic signs - our HV suggested putting DS to sleep in his car seat for an hour or two and then setting an alarm and getting up and lying him down once he could do so - it used to take me two hours to get him to lie flat after his evening dream feed.
DS was rarely sick but refused feeds after a couple fo minutes at the breast. Responded better to a bottle but had sucking difficulties.
I totally understand the despair that you may be feeling. I would say see the GP again asap and be very specific about the symptoms and request one of the medicines to try.

I feel that I've learnt so much on this subject and ran out of room above!
The idea of it coming back was another thing that sounds familiar. I took DS to see a cranial osteopath early on and seemed to get rid of colic. Then later on I thought it had returned - there was definitely a gap, though I haven't read anything that can suggest why.

I hope that you manage to get this sorted out. I remember how frustrating and difficult it was to deal with (especially when breast feeding as you get all the screaming - and I always felt I should be able to do something to help and couldn't )

Try to feed with baby in as upright a position as you can and rub for wind not pat or jiggle. These were the two most helpful hints I have found but ultimately, go back to the GP until they listen! Mine was great from the start. You know from your motherly instincts that your baby is not just crying like babies do!

Come back and tell us how you get on. Good luck!

Definitely sounds like silent reflux - my dd was in so much pain with it that my partner and I would take it in turns to sit up through the night with her sleeping upright on us as it was the only way she could sleep - and we didn't have a clue what it was. Doctors were just dismissing me as an over-anxious first time mum. I diagnosed her from the internet in the end, and went down to A&E with a full list of the reflux symptoms ticked off. Gaviscon didn't help, ranitidine helped a bit, but then at 5 months when I was still despairing they put her on lansoprozole, which was much better although a bit scary as it's not officially diagnosed for babies. Be persistent - the doctors don't see the pain the babies are in, or how stressful it is - but keep on pushing till they recognise it. (btw, managed to wean my dd off the meds from 8-12 months and now it's just a horrible nightmare from the past, so it does get better!).

Is it a possible that she may be lactose intolerant? My son was a good feeder but would fuss about on the breast. He would cry or should I say scream in agony and arch his back throughout the day and night. You say you thought she had wind but does she actually pass wind either up or down the way? My son had terribe wind which was a pretty good sign that his digestion was not working properly. Has anyone suggested you cutting out dairy in your diet as a trial? This may not be what your daughter has but I know that I would have tried anything to make my wee man more comfortable as I am sure you will for your daughter. If it is reflux she has Gaviscon does seem to be very good but she may also need an anti acid which the doctor would have to prescribe. May I suggest you writing a diary for a few days regarding your daughters daily pattern, I have also known parents to take videos as they felt their HV was not listening to them. It is the most awuful thing to have your child screaming and for you not being able to comfort them. I do hope that you get this resolved soon for your own sanity and for your childs comfort. Good luck!

now expressing dream feed and come back after a think on this - is silent reflux consistent? ie every feed/the way they feed/after a certain period of time lying down? I know with ds its not which is why I don't think it is reflux, but is that right??

spanna74 - hope you didn't think I was flippantly suggesting other things to try its just that after gaviscon didn't work for us I felt in despair again as I needed another plan of action in the hope I could help ds in some way

Haven't read the whole thread as in a rush, but my DS had silent reflux. Gaviscon didn't work - it made him constipated .

What did work was:

• Giving him a dummy
• Experimenting with bottles (my DS was FF) - settled on the Avent ones.
• Lifting one end of the cot
• Putting him in a rocker chair after a feed
• Infacol (beofre each feed)
• Ranitadine and domperidone (prescription only) - you MUST insist on your doctor listening to you. I saw 3 GPs until I was finally referred to a specialist. I don't know if you can afford to go privately, but it will mean you will see someone this week? I was horrified to hear that 60% of silent reflux babies go undiagnosed...

I hope things improve soon

Thank you everyone for all your help and advice. Well we got Gaviscon from GP on Monday, I also went back to the Cranial Osteo on Monday.

We had a better night last night was still up with her but nothing like the every hour thing we had been having. The Gaviscon is very hard to get her to take as have to mix it with water and give off a spoon (she won't take a bottle yet).

The GP and HV both are unconvinced about the silent reflux thing as they think she would have had more symptoms before now. I just don't know, she doesn't react after every feed and it tends to be the night that is worst (which seems the opposite of what I have read many silent reflux babies sleep well at night as so worn out from day...) that said she slept on me over my shoulder for 2 hours today, she wouldn't sleep lying down kept crying and even would sleep in car seat.

She has had terrible wind, really really smelly and it has been 3 days now since she poo-ed so that is causing discomfort too.

GP said for us to go back in a week's time and HV is coming again this week.

funnily enough i nearly got OH to video her the other night to show the doc...! am writing everything down to take back next Monday to doctor.

Thanks all for listening to me.

Well done for getting somewhere with the GP! Our DS was worse at night. Used to have some feeds that were fine in the day (particularly if he was sleepy at the start) but at night it took over two hours to get him to lie down after a dream feed as he was so uncomfortable he just kept waking every time I lay him down. I videoed his feet and legs going up in the air at right angles to show the GP.
The not pooing thing could be to do with constipation from the gaviscon - DS did a solid poo (when only breast fed!) after a few days of gaviscon.
Ranitidine was much easier to administer as DS only has to have 0.4ml - in a tiny 'syringe'. It does taste horrid - very strongly minty - but has never bothered DS. I do give him a sip of water (off spoon for your LO?) to get rid of the taste before giving milk as think that combination would be vile.
Personally, I think silent reflux (and even fairly bleeding obvious vomiting reflux!) is really underdiagnosed - but I don't have evidence to back that up obviously.

My little one had silent reflux and it was dismissed by the HV and GP but I knew there was something wrong. From birth he was never really happy lying flat and it came to a head around 6 weeks. Other symptoms were a funny gaspy cough, especially after a feed, acidy vomit which squirted out of his nose, wanting to be carried and held upright all the time.

We started on infant gaviscon - he would only take it mixed in breastmilk in a bottle. This became such a nightmare, to express and give six times a day completely exhausted me (combined with him not sleeping hardly at all at night). We started omeprazole and there was a huge difference. It took about 5 days for his sore throat to settle down and he became much happier, he was still refluxing but it didn't hurt him. The omeprazole basically neutralizes the acid. We also kept him upright for half an hour after every feed, kept his moses basket at an angle, had a wedge on his changing mat and I often put him to sleep on his side with a rolled up towel behind his back to stop him rolling back. I think we learnt how to handle it better and things got much easier.
He's now five and a half months and we have just stopped the omeprazole. We weaned him early to help the reflux and we still keep him upright after feeds. He still does reflux but no where near as much and it doesn't seem to bother him.

Good luck

spanna74, how is your LO?

Dorchies, it's great to hear your DS is now off omeprazole and doing well. My 11 w.o boy is on it and it does make a huge difference. I hope we will be able to wean him off it in a couple of months as well.

My DD (9 weeks) has silent reflux, and no, it's not consistent.

She's now on Ranitidine - but the thing which convinced the GP it was reflux was a spell on infant Gaviscon. See whether you can get a prescription for that - in our case it was like a silver bullet - the only problem was that it did make her a bit constipated which is why we moved to the Ranitidine. But the Gaviscon will be prescribed fairly easily, and if it works, you'll know what you're dealing with

• sorry Spanna, should have read more carefully, you've got the Gaviscon.

Have you tried giving it in a syringe? Much easier than faffing with a spoon.

Well we tried the Gaviscon for 6 days and were getting nowhere as you have to mix 2 sachets with 30ml of water and then give off a spoon (my DD2 won't take a bottle) we just weren't getting enough in her. Then saturday night just gone i thought stuff this and just mixed it with enough water to get it all in her in 2 spoons. Did that for the night feeds as well, OMG she was a different baby. Same thing the next night. The Mon morning I fed her but didn't give the Gav as she is better in the day, went to take DD1 to nursery while OH watched her got back and she was arching and screaming he had tried to put her in the cot for a nap and she hadn't had the Gaviscon. We had appt with GP that morning anyway for follow up when I told her all this she agreed was def Reflux so told us to take Gaviscon after every feed and just mix with tiny amt water.

She is such a different baby when she takes it but it is difficult as this morning couldn't get her to have it properly she spat some out so had 2 hours of on off screaming. Anyway we will stick with it for now are due back at GP in 2 weeks but if Gaviscon continue to be problematic i will go back sooner.

Thanks for the tip of shaking in lidded container that does the trick to get it all mixed up with less water.

It has been really hard and i am glad now we know what we are dealing with it has felt like no-one was listening to me, like GP and HV were saying she would have had symptoms before now, I was like she has but i thought it was v bad wind and thing have got so much worse in last month. It is just horrible seeing the poor thing in so much pain.

Thanks for all your advice it is really helpful to hear from others who have gone through this.

We only lasted using gaviscon for about a week as it is such a faff to give 6 times a day, and although it was better it was still not great. The omeprazole is just one dose per day, and although is meant to be given on an empty stomach that's the only faffy thing about it. If you do end up on it, make sure you get some 5ml syringes as we used to put half a tab in a syring, suck up some cooled boiled water, shake it around to make it disperse, then give it to him. (worked much better than the way the paediatrician suggested).

Hopefully you may not need it and the gaviscon will do the trick.

Well the joy with the Gaviscon was short lived, it gave her such terrible consipation that it was kind of like exchanging one problem for another and she was crying and crying with tummy ache until she managed to do a poo.

Anyway we have been referred to a paediatrician and have appt next week on Tues and are now on Ranitidine (only started it this week) so hopefully things will get better again. We had been back to two hourly wakings in the night with screaming.

Am a bit annoyed as went back and my GP was on holiday so saw another one who wouldn't prescribe anything other than Gav, but did the referral letter but I went to see my GP when she got back from holiday and she instantly prescribed ranitidine...

Am really hoping we turn the corner soon as it is unbearable seeing her in so much pain and discomfort and the knock on effect on the rest of the family has been dreadful, OH said he thinks he is getting a stomach ulcer he has been so stressed and DD1 has started waking in the night again too...!

I just keep telling myself this won't go on forever.

Hi my DS has silent reflux so I really sympathise, this is a horrific condition and so demoralising. He is just turned 12 months and still has it but he at least sleeps abit better now and can be distracted from it somewhat (I believe 95% grow out of it by one so I am hoping DS grows out of it really soon!).

His symptoms were very frequent choking/coughing episodes (rushed to hospital once as he stopped breathing), constant unconsoulable crying, some vomitting, gulping and splashing noises all the time from his stomach, back arching, terrible sleep habits (slept only 20 mins at night time for first 8 weeks- it was torture). Most nights we got between no and 4-5 hours sleep. An amby hammcok was well worth the money though as he slept better in that right away.

He was diagnosed with GERD at 4 weeks and given Gaviscon. Constipated him too. Then we were given Losec and Domperidone which he is still on. It helped abit with the irritability but didn't cure it. Weaning didn't help either. I bf till 11 months and tried dairy free etc.

My best buy was a book called 'colic solved' (amazon sell it) which covers everything on reflux and made me feel so reassured, it even covers the choking which no other book did and there is loads on meds etc.

Hope the new meds work for you and that things improve soon!