Cheerful but constantly vomiting EBF baby - could this be reflux?

[stillfrazzled]

DS2 is 5 months old so I feel a bit daft asking this, but he's been puking what seems like almost constantly for several weeks now.

Type of puke varies - sometimes a mouthful or so of fresh milk during or right after a feed, sometimes lots of saliva with some milk in (think he's about to start teething), sometimes half-curdled ages after a feed. But it just keeps on coming.

Quite apart from being sick to bloody death of both of us being constantly soaked, stained and smelling of yoghurt, he was premature and IUGR (only got to ten pounds at 4.5 months) and I am frantic at the amount of feed he's losing and what it must be doing to his weight gain.

It has got to the point that every time he's sick I want to either scream or cry, which is absurd but his weight gain's pretty erratic anyway and I've been through huge ups and downs because of it.

The vomiting does not bother him at all, he's a very cheerful and placid baby.

Any advice very much appreciated.

DD wasn't prem but she brought up loads of milk until she was 6 months old. I think I got used to the constant cheesy smell! But it never caused a problem apart from the inconvenience - she followed the same centile curve and was fine.

DS2 (my third) was spectacularly pukey until he was about 11 months.

Several changes of clothes a day and plenty of wetwipes.

He was cheerful though, gaining weight and was never remotely bothered by the sickiness.

It could be reflux. My DD was similar - rivers of vomit, all the time. She didn't get to 10 pounds until she was 6 months. The GP gave us Gaviscon but I didn't find that worked at all.

She was like your son sounds, happy, placid, sleeping, which is what helped me to ignore the HV's pressure to stop BF. The vomiting stopped when she was (sorry) about 14 months old and, two years later, she hasn't been sick since, so try not to panic.

Hello stillfrazzled, i remember you from the reccurent mc thread (have namechanged, was GrumpyFish). Glad your little boy arrived safe and well.

My DS2 (only 7 weeks) is just like this. Happily chucks up what seems like at least half of his feed pretty much every time. I've noticed are that he does it more if he's not had a good gap between feeds (less than a couple of hours), or is comfort feeding in the evening, so I think he's just throwing up what he doesn't need. He is very placid and settled otherwise. It's just an issue because of the amount of washing he creates!

DS1 had full on reflux and it was quite different. The volume of sick wasn't much more (possibly not any more), but it was much more violent - sometimes projectile - and he was VERY bothered by it, he was a really unsettled baby, he would scream in pain during and after feeds and couldn't really lie flat (crib / pram / mat on floor) comfortably until he was about 8 months (when it all suddenly stopped).

The Dr Sears website (I think it's askdrsears.com) has good advice about refulx so you could try following this - keeping upright after feeds etc. I also find that winding DS2 a couple of times during the feed helps a bit (although at 5 months you may be past the windy stage). Have you spoken to your GP / HV about medication? We didn't really find that Baby Gaviscon worked for DS1 (it's hard to use if your BF as you have to syringe it in after the feed, so it's often just the first thing to come back up), but it might still be worth a try if you are worried about his weight gain.

Hope it all gets better once you start weaning, even with DS1 I think we saw a little bit of an improvement once he started on solids (but also then had orange sick to content with, which was harder to clear up!).

DD2 is the same, she's 4mo and has been like it from day 1. She's cheerful with it too. AFAIK if they are unbothered by it, it's a laundry problem, not a health problem. Try not to stress out too much.

My DD was just like this - fountains of vomit but totally unbothered, she stayed bang on her centile for growth until she was 18mths old so I don't think it did any harm...

Is his weight gain going okay so far?

Weight gain is mostly OK but nothing spectacular. Used to average 5-6ozs a week, last month averaged 4ozs for three weeks, then put on 10ozs in one week. Haven't checked for two weeks.

He's following the line below the 0.4th centile but isn't catching up at all, which is a huge and separate worry.

That weight gain sounds pretty good to me (not an expert though). From what I've heard, so long as he's following a line then don't worry too much. Is he developing normally otherwise and does he seem bright and alert?

Some of them are just pukers though. DS1 puked constantly until he was one. Gained weight well, slept well, cheerful soul. Just a puker.

If he's following the line I really wouldn't worry, but if you are you can always talk to your HV/nurse/GP/specialist/whoever medical sees him and ask what they think.

My little girl is 8 weeks old and we have had the same problem. Doctor said as long as she's not bringing up anywhere near half her feed and seems well otherwise it's perfectly normal. My little one pretty much wears a bib for most of the day. We have found that we've been misreading her crying as a cue for food and over feeding her. She's gone from every 3 hours to every 4 and is much better.

DS screamed blue murder before he was diagnosed with silent reflux, stopp once on gaviscon but was still puking cheerfully, turned out he also had an intolerance to cows milk. Could you possibly cut out dairy in your food intake for a couple fo days and see if that makes a difference.

Another possibility is oversupply.

does any of this apply?

It's normally fairly easily remidied if it is oversupply

Both of mine were pukers. I hated it! But - a little sick goes a long way - it seems a lot at the time but probably isn't. As long as he's gaining weight and is contented, I'd say you don't have much to worry about.

Actually - could you just stop getting him weighed? My second wasn't weighed at all after a couple of weeks old.

He is developing normally - v bright-eyed, alert and chatty although a lazy beggar at trying to roll.

The Dr saying up to half the feed is OK is interesting, and I know it prob looks like more than it is, I just panic. Fairly sure it's not oversupply, the only thing on that list that does apply to us is the puking (but thanks for posting the link to rule it out).

I think I will go to monthly weigh-ins - don't like to stop completely because he's so tiny and I don't want to miss any problems. Will invest in some bibs, though!

Mine always had a bib. And I always had a muslin over my shoulder. Happy little chap, though. Gained weight like a demon, went from the 50th to the 91st in his first few months. And a real skinny minnie now, has been since the age of about 5....