silent reflux - will enfamil A.R formula work if instant carobel milk thickener hasnt?

[sweetuphoria]

Just started my DD on carobel in her bottles after gaviscon not working, the carobel is not working either. Is it worth trying the enfamil formula? I don't really want to back to the gp as she has admitted she doesn't know what to do next and is in fact not taking it seriously at all.

No, sorry to say if gaviscon and carobel have not worked, then enfamil unlikely to as it is simply a thicker milk. What are DD's symptoms? If it's reflux, eg.., pain/vomiting/ food refusal, then the next steps to try are an acid surpressant, usually ranitidine, often with a motility drug like domperidone. Alternatively you could ask to try omeprazole.

If your DD also has diarrhea and/ or a skin rash as well as vomiting, you might want to consider the possibility of a cow's milk allergy - in which case she'll need a hydrolysed or milk-free formula on prescription. Cow's milk allergy can mimic reflux.

It's definitely reflux - struggling and crying while feeding, cottage cheese like vomit, frequent drooping and hiccoughs. GP says if this doesn't work then DD will be referred to a pediatrician so I guess then we can discuss the other meds.
thanks for your advice.

Cottage cheese-like vomit hours after a feed might suggests that milk/ food is not emptying from the stomach very quickly - this can be caused or exacerbated by cow's milk protein intolerance [CMPI]. Likewise the struggling and crying while feeding - intolerance to cow's milk can cause allergic inflammation of the oesophagus which makes it uncomfortable to swallow. I would ask the consultant about this - CMPI is quite common and the symptoms can be identical to reflux.

You can get other meds like domperidone, ranitidine and omeprazole from a GP - if you can find one who is OK about prescribing them - no strict need to go to a paed. They are not licensed for use in infants so that's why some aren't so keen on prescribing them, but many do. I just don't want you to be hanging around waiting for months for a paed appointment if you can get cracking with some (hopefully) more effective treatment in the meantime.

Oh ok that's interesting - I will mention to the gp but in all honesty don't think she seems to know much about reflux so she is very reluctant to prescribe anything. DD only started like this from 9-10wks old though, would she have the cows milk intolerance from birth?

No, not necessarily from birth - the cow's milk protein thing can take a while to come on if it is a non-IgE allergy (e.g., delayed onset). With my DS it was about 5-7 weeks after he went onto formula that they symptoms became very noticeable.