Breastfeeding and infant gaviscon- tips please!

[clareanna]

my 8week old ds has just been diagnosed with reflux and prescribed infant gaviscon. I wondered if you had any tips in the best way to give it to them? On docs advice I am expressing and giving him BM mixed with the powder for feeds today and will introduce boob again once he realises feeding isn't hurting anymore. Any tips welcome!

I was told to mix the powder with a small amount of EBM or just water before a feed and then just bf as normal. Is easier than expressing a whole feed.

Thanks- I would have thought before a feed, but pack guidance says after???

I was told by the paed to express a little to mix the powder with. The hospital pharmacist quickly pooh-poohed that and told us cooled boiled water as per the instruction on the packet - which we did until we stopped using gaviscon (a few weeks as it didn't work).

If you aren't allowed bf directly until the reflux is under control using the gaviscon what did the Dr say will happen if it doesn't work? Is your baby refusing to bfeed because of the reflux? If they are have you spoken to a bfc/bfing helpline re the breast refusal?

Having expressed for a reflux baby then moved back to EBF (DD1 was mainly bottle fed formula/some EBM/a few direct feeds before EBF) it was really difficult to sustain, though this was before she was diagnosed (I expressed 12 times a day and didn't make enough to ex. fed her ebm by a long shot though I had supply issues too). Obviously this is only my DD but she would find greater comfort in bfing than she did bottle feeding (judging how much more settled she was with a bf than with a bottlefeed regardless of contents even before medicating).

Did the Dr give you information on how to express full time and keep your supply going/maximise yield (protocol I have used is:- breast massage to release oxytocin before starting to express, double expression with electric pump [pref. hospital grade], breast compressions during expressing, expressing for 2-3 let downs and until no more milk comes out, then hand expressing the 'last' of the milk [never empty though of course] at least 8 times a day inc. one over night)?

Hi. My dd had this. We tried it mixed with water/ EBM in a syringe. She used to scream and scream, made no difference whether water (warm boiled) or ebm. We did it before feeds as well. It was hideous. Tbh, didn't seem to help a whole lot, and it was so awful/ she was getting into a state, that we stopped it after maybe 2 weeks. Sorry, you're going through this, though. Brings back memories...lots of puke, crying and even some breathing issues. Horrid.

I gave before as easier otherwise DS was too full. Or I'd pop him in his bouncy chair to keep upright for 15-20 mins then give it.

I mixed up a sachet of IG as per instructions, using cooled boiled water. Then when DS seemed hungry, I would give him 5 mls in a syringe (squirt it quickly and gently into the inside of his cheek, not the back of his throat) before feeding, and another 5 mls when he'd finished. If I could. If he was asleep on the boob, I didn't wake him up to do it.

I tried giving a little before as sometimes I felt giving him IG when he was full after a feed was a bit distressing for him, and could cause a vomit, when we were trying to stop him puking.

After the first couple of days, I never gave the full dose of IG per 'feed.' For a start, DS was a snacker, so exactly what constituted a 'feed' I didn't know. It wasn't as if he was getting a measured bottle at timed intervals. If I gave him 5 mls and he only had a short feed, then I didn't feel like I'd shovelled a huge dose of IG down to cope with not very much milk. Also, it sorted his reflux but gave him awful constipation... so I reduced to dose to control the sicking, but without bunging him up.

Any chemist should sell you those small 5 ml syringes - much easier to dose medicine with than a spoon, or having to put it in a bottle.

Thanks for all your help. He's only had symptoms for a week and also has a cold which doc thinks is making reflux symptoms worse. The gaviscon seems to be working today as he is completely ravenous and not screaming quite so much when feeding.
truthsweet am only doing expressed feeds for 24 hours then will move back to boob.

clareanna - I had visions of the Dr expecting you to pump for months! Doable but bloody hard work.

Hope it all works out.

So... Yesterday he had expressed feeds with IG in and was fine, with bf at night. Today I'm bfing and trying to give hi
IG mixed with CBW from a bottle before and after feed and he hates it. Twisting off boob in discomfort, retching on the IG then throwing it up. Am going to try the syringe method next feed- thanks for your support, it's just so upsetting.

merry what breathing issues were there? Ds is very mucusy, but I put that down to a cold as ds1 has had one?

It is very upsetting when they are so unhappy (such a limited word but I can't think of a better one today!).

With syringing it's best to try to aim it at the back of the cheek with the end right against the cheek (gently of course) as that way they tend to swallow it with out tasting it. You can get big syringes (10/20ml) from the pharmacy but they might have to order them in or you could have 2/3 syringes loaded in advance to avoid fiddling about with refilling the syringe with a squirmy baby on your lap (depending on how many sachets is prescribed per feed).

It that doesn't work then cup feeding IG mixed with EBM or CBW, spoon feeding it, or even breaking off a bf to quickly syringe some in before resuming might be worth a try.

I hope it goes better today for you.

Thanks truth syringe is working well, So fx it will work!! Am wondering if modifying my diet at all would also help? With ds1 I could eat anything and it wouldn't affect him! Have heard avoiding garlic, onions, strawberries and fruit juice cam make a difference- and as I ate all of those things yesterday it might be true!!

Dd had/has reflux and would not take the Gaviscon properly, when I did manage to squirt some in her, it constipated her. She ended up having Zantac which was easier to give her and it worked really well. So don't despair if you feel the Gaviscon isn't working out for you. Dd also spent the first few months with her moses basket proped up at 45 degrees. Hope you get it sorted.