expert bf help please

[alfiemama]

little one is 16 weeks and has reflux, currently on, ranitadine 3 x day, domperidone x 2 a day, gaviscon and co lief.

She is exclusively bf.

I have 2 problems, one which is quite urgent. Last night I very stupidly had garlic, which has resulted in Millie being very sick today, not kept anything down. Do I express of my milk or just keep bf, how long does it hang around for if its the garlic which has made her worse?

My second question is, I am struggling to get her to take a bottle (I re lactated and now exclusively bf) I have tried lots of different ones and the only I am able to get her to have is the breast flow bottles, but she just sicks the whole lot up. Any ideas why this could be? Paed has said she has a slight tongue tie but shouldn't affect her.

I'm not an expert - have you called any of the helplines?

With the bottle, does she take too much maybe and that's why she's sick? With breastfeeding she might be taking just 2-3oz a time. Also, are you using the slowest/newborn teat?

Is there any reasion why you have been avoiding Garlic? I know some mum's find the odd thing in there diet can upset there babies (caffien being quit a common one) but garlic is a new one on me.

As she is 16week's have you though about just moving her straigh onto a cup rather then bothering with bottle's. The free flow type one's that you can use from 4 months.

Sorry I think I worded the bit about expert wrongly, Just in panic mode as she won't stop being sick today. Any one willing to help is more than appreciated.

I haven't, I was going to ring hv but they've gone home now, I'm almost sure it will be the garlic making her worse as I had it late at night, and ever since she has been sick, every time I try and feed her, she has always been sicky but we seemed to have it under control although not gone fully.

With regards to the bottle, only trying a few oz as she just wouldn't take a bottle at all, and didn't want to waste my milk.
I have tried every newborn teat going, she seems to like the breast flow bottles as she can control the flow but still the sickness seems worse than when she is bf (normally that is)

I am going to express milk off, and if need be I have a carton of formula, but really dont want to do this as she has never been able to tolerate formula, hence me relactating.

Thanks Rita

Hi MiGrill, I haven't really avoided garlic, but don't eat masses (had quite a bit of garlic bread last night) and its the only thing I can think of that could have made the sickness come back, as much as it has. She seems ok, no temp or anything, just normal teething.

thanks I will have a look into the cups, but think we may struggle, as she doesn't take to teats very well, think maybe because of slight tongue tie.

Tongue tie can affect feeding massively. Not sure why but there seems to be a weird attitude to it in the NHS. I'd see if you can get a second opinion on it.

Secondly please don't beat yourself up about the garlic :) Like Mig said, unless you've noticed a specific pattern with it it's unlikely to have caused a problem. Some babies are sensitive to foods through their mum's milk but it's unlikely - and it can be hard to pin down as well. I'm sure garlic wasn't the only thing you ate yesterday - if she's reacting to a food it might not even be that. I'd keep feeding her rather than pumping and dumping. It's much more likely to be a coincidence. The sickness could be caused by a virus, or the reflux itself as well.

With the bottles yes you could definitely try a cup, but generally just keep breastfeeding if it's not an urgent thing to get her to take one, because bottle-refusing can be a phase which they grow out of.

If she's really not keeping anything down at all she might be at risk for dehydration. Keep an eye out for these symptoms:

fewer than 2 wet diapers in a 24-hour period
baby not behaving normally (more irritable, less active, sleeping more)
lethargy
listlessness
weak cry
no tears (in an infant older than 3 months)
dry mouth
skin that stays wrinkly-looking when pinched (pull up the skin on the front of the hand; it should pop easily back into place - not stay pinched or wrinkly-looking)
eyes that look sunken
cool, clammy extremities, especially the fingers and toes
fast breathing, or a heart that is beating faster than usual
fever

Any of these you need to take her to A&E as she is so tiny.

If she's never tolerated formula, could it be a cow's milk protein intolerance? How often do you eat dairy?

She's probably drinking the bottled milk too fast for her to handle, even with the breastflow bottles. I'd stick at bfing tbh - it could be coincidence that she's been sick today and even if it was the garlic, it'll ease and she'll be sick less feeding off you than having bottles of formula you know she can't tolerate.

If you really think she isn't keeping anything down, I'd see a doctor TBH. Any signs of dehydration? Is it projectile vomiting or just lots of possetting?

Just seen your other post - garlic bread has butter in it. If you've been avoiding dairy this could have been a trigger.

FWIW my doctors surgery told me today (DD has cold so rang for advice) that they will always fit a baby in as an emergency appointment - might be worth ringing the GP now as the HVs have gone home.

Just another thought - have you tried holding the bottles at a horizontal angle, so the milk isn't directly dripping into her mouth? This can force them to swallow more than they need. I know we're always told keep the teat full of milk to avoid air bubbles but actually I think this has been disproved now, or something. Certainly if you are using anti-colic bottles the angle shouldn't matter.

Thanks BertieBotts.
No she isnt showing any signs of dehydration, I know she will be getting some milk down her, as even with her severe reflux and sickness she puts weight on, as she comfort feeds.

I think I was panicking as we seemed to have her sickness more under control and now today it seems to be back. It could even be that she hasnt managed to keep enough of the domperidone down.

We were sent to the paed as they suspected a cows milk intolerance but they now just think its the reflux.
Her sickness is more like a possett but very mucusy and lots of it, your talking oz's (I know it can look worse but it really is a lot). I know she deffinately has reflux as it runs in the family, son has childhood reflux.

If I spot any dehydration signs, I will get her to A & E but when she is not having an "attack" she is quite smily.

I say "attack" as you can hear her get very raspy and panicky and then she is normally sick.

I just thought with the sudden sickness and her not showing signs of being poorly, it was probably something I have eated.

Bertie, the bottles are special bf ones, they can only get what they suck, any other teat and she just licks and bites it.

Thanks Japhrimel, I was hoping the medicine she has now would enable her to tolerate the formula, we havent tried since she was prescribed the meds and the paed didnt say we should avoid it.

thanks for the advice on Drs, good to know.

Well it could be something you've eaten, but there is no way to tell. No way to tell how long it will stay in your milk either so as someone said above, better to keep feeding her breastmilk that might affect her, than formula which you know will affect her. Garlic isn't a common one, but then, my mum always swore she could never eat strawberries when breastfeeding me, and that isn't a common problem either. If you have a gut feeling there possibly is something in it. But it could just as likely be that she hasn't kept her domperidone down.

If she is being sick more than normal though and it is out of character for her - raspy and panicky doesn't sound good, though I don't know a lot about reflux - then you shouldn't hesitate to get her checked over. As she's so little you wouldn't have a long wait in A&E. Or try phoning your doctor's surgery to see if they do an evening surgery.

Alternatively if it's mucousy it might just be that she's got a bit of a cold and the phlegm is making her sick.

Thanks Bertie, the mucusy sick and raspiness is normal for her I'm afraid, she just gets like this before she is sick. I honestly don't think its anything too serious, if I had any doubt I would be there now, banging on the doors lol, but I will be keeping a close eye on her. Sorry if Ive made you panick

I think its either something Ive eated or the meds not being in her system.

I wasn't worried :) It just wasn't too clear from your post whether or not this was normal for you.

I don't like to do the "u no ur bb best hun" thing, but I think you know as a mum when something is wrong, or not.

Thanks Bertie, appreciate your help.

alfiemamma - it's fab you have relactated. I remember your probs from a few weeks back.

Garlic is not a common thing for babies to react to, honestly - my bet would be she is (as is clear) a baby who is liable to throw up. Sometimes the throwing up is worse and sometimes it's not....that's the way of it....and the garlic is a coincidence. It could be the amount of milk she took, the speed at which she took it, how she was held or inadvertently jiggled a bit.

Those 'mechanical' explanations are more likely than the highly unusual and subtle one of a flavouring/food causing such a dramatic effect.

Hope things are better soon.

Hi tiktok, thanks, I honestly couldn't have done it without everyones support.

You have it spot on, she is a very sicky baby, hence the meds to help her. I did express off my milk a little but didn't give in and give her formula (yipppeee, just couldn't do it) and well to be honest she was a lot better. But I have a feeling this could be the lactose at the beginning of the milk (I was reading an article by La Leche). I was quite engorged, which is an amazing thing to say as a while ago I couldn't pump more than 1/2 oz. Now I seem to have an oversupply, not complaining though.

She seems back to normal today.
Thanks everyone

Hi tiktok, thanks, I honestly couldn't have done it without everyones support.

You have it spot on, she is a very sicky baby, hence the meds to help her. I did express off my milk a little but didn't give in and give her formula (yipppeee, just couldn't do it) and well to be honest she was a lot better. But I have a feeling this could be the lactose at the beginning of the milk (I was reading an article by La Leche). I was quite engorged, which is an amazing thing to say as a while ago I couldn't pump more than 1/2 oz. Now I seem to have an oversupply, not complaining though.

She seems back to normal today.
Thanks everyone