Bf baby & reflux - advice please!

[bessie26]

DD2 (12 weeks) has been suffering on & off with reflux for the last few weeks. Last week I got her a wedgy pillow for her bed & she slept 10hrs straight! Unfortunately it was a one off, and nights have been getting steadily worse again with her back to waking every 45mins when she's in her cot.

Today I'm going to start giving her gaviscon - any tips? If seems to be a real faff if you are bf, why can't you just get it in a bottle?! And do you give it before or after a feed?

I'm keeping her upright for 30mins after a feed, and avoiding tight clothing. Is there anything else I could be doing?

And my diet, I was reading last night that the foods in my diet could make her worse but the list was huge! I think I would be living on plain baked potatoes & toast if I followed it, but I'm thinking about giving it a go...

Try just eliminating the most obviously "windy" foods first - cabbage? - and work through a process of elimination. Or start by eliminating things you might not have eaten when pregnant? Or things that are hard to digest, maybe salad and raw foods?
Don't rule out the whole of the "might be" list or as you say you will be eating nothing that gives you any energy, just when you really need it to keep going with a sicky, colicky baby. But maybe add "soothing" digestive foods like plain rice, which might help.
Gaviscon is awful stuff. I used it in desperation with my DD but it seemed to give her awful awful acidy smelling poos, and nappy rash. I tried to give it by syringe rather than bottle, but you could add it to EBM.

Been, seen, done etc.
Right. First off mix it thicker than the sachets say - rather than 15ml, you can get away with 6-8ml of liquid. I used to just squeeze a bit of breastmilk out into a small measuring cup - the 1/4 cup size - and mix the power up in that. Then syringe it up and into baby before the feed (aim the syringe into the back of the cheek and he will swallow). If BM too hard to get out before baby latches (if you have a slow letdown for example) then a wee bit of warm water will do - but keep the liquid as little as possible as the less you have to syringe into the kid the better).
Every feed.
Yes its a hellish palaver but the look of peace on their face when the burning in the throats/gullets stops, is worth it.
If gaviscon works then you have reflux.
If you have reflux then ask doctor to step you up to rinitadine - a smaller dose and only twice a day, less stress for everyone. It does take a few weeks to kick in - it works differently to gaviscon - so will need to do both together for a while before weaning off gav.
I weaned my DS off rinitidine at 10 months - once he was much more mobile and eating solids and his system was more mature he didn't need it any more.
Good luck.

www.reflux.cryingoverspiltmilk.co.nz/

this is very helpful

Hi there, sorry to hear that your LO is bothered by reflux, I have been there too with my LO. My GP was a bit more understanding of the difficulty of giving gaviscon when BFing & went straight to ranitidine. I suggest that you go back and demand ask nicely for it instead. By all accounts does the same job as gaviscon only more effectively, easier to administer and does not cause constipation. Both drugs form a 'raft' over the top of the stomach acid to stop it. Gaviscon also thickens things a bit but can cause more issues than it solves! My LO responded to ranitidine in 3 days. It takes a while for the oesophagus to heal too, so possibly longer depending on extent of issue.
I would advise that you also cut out dairy for 2 weeks to see if this improves things as this can be a massive contributing factor, esp. in silent reflux.
Lastly, work really hard at making sure your LO has naps during the day, do whatever you can to make that happen. Sling, pram walks (I put my LO in the upright seat early so that she was elevated in the pram), swaddling, rocking etc. The more sleep they have, the less effect the reflux seems to have. I know that might sound impossible to do (it took me over an hour to get my LO to have a nap yesterday but as a consequence didn't have any refluxy issues and no meds given!) but it is worth it if you can manage it.
My DD is on Losec/Omeprazole which inhibits the acid production in the stomach, that is your next move if the ranitidine & dairy elimination don't work.
The crying over split milk website is great & gives a great treatment pathway.
Hang in there & pop over to the reflux support thread if you fancy a chat or advice from some of the pros over there. :)

I would have to second what others have said about dairy as it helped massively for DD. Dairy and soya are what affects her and if I cut them out of my diet, she's completely fine.

HV and GP weren't really keen to prescribe anything as she was gaining weight well (she made up for the milk she brought up by feeding every 2 hours night and day [hhmm]).

I could tell it was something I was eating because she would get completely better for days here and there. Also, it didn't fit the pattern of true reflux- she needed to be upright to be sick and never improved with being upright or with weaning.

I hope something works for you.

Wow! Thanks for all your responses!

I tried giving her the gaviscon in a bottle, but the poor thing just sat there with it in her mouth not knowing what to do! (she's not had a bottle before & isn't interested in dummies) So I syringed it into her mouth instead. Will do as athra suggests and use less liquid next time.

Thanks for the info on rinitidine, I'll give Gaviscon a few days to see how that goes, then ask for an upgrade.

yogamummy totally agree with you on the sleep thing, even without reflux they won't sleep well if they're not well rested. Unfortunately DD2 has never slept well "on the move" in pram, buggy or car seat, which is a bummer as I really want to get walking for some fresh air & exercise (it's what kept me sane when DD1 had colic). But she did/does nap in her bed reasonably well & when she wakes I just sit in a chair & let her sleep on me. I find playing some white noise really helps her get off to sleep.

unfortunate DD2s symptoms seem to come & go like your DDs. and her weight is fine so they weren't keen on giving me anything until i pointed out that if she continued waking every 45mins throughout the night then neither of us would be fine!

So I will cut out dairy ( no more milk chocolate green & blacks!). But I'm not sure about cutting out foods that make me windy kite - I'm a vegetarian, so everything I eat (tofu,beans,lentils) makes me windy!!

Will go read that website now! Can someone point me at the reflux support thread?

My DD was given infant gaviscon and was ebf. You can mix it with much less liquid than recommended. I did it with 5ml at first but eventually I got it down to about 3ml and my Dr said that was fine. Also, I mixed it mainly with a bit of expressed milk. If you put it into a syringe you can put it slowly in small bits into inside of cheek. When I first saw what I had to do I was in despair and was all for going back and asking for ranitidine instead but we were lucky and got away with making it up with much less liquid and it worked for her too! Sorry, not sure if this repeats what others said but in a rush as am at work on lunch break and about to start back. Good luck xxx

Here you go www.mumsnet.com/Talk/breast_and_bottle_feeding/1024071-Support-thread-for-all-parents-with-reflux-babies

Thanks for info! The more I read the reflux support thread, the more I think she doesn't have it, her symptoms are nowhere near as bad as the ones discussed on there! Also, she doesn't do any screaming at feed times...

I spoke to my HV on Friday & we decided to give the gaviscon another go this weekend, then I'll go into clinic on Monday, get her weighed & chat about it then. The IG has stopped her big possets, but unfortunately both she & I have a cold, so it's hard to tell if it's made any difference as it could be a snotty nose waking her up

Othe ideas people have suggested are a cow's milk alergy/intolerance or milk over supply. I haven't started my dairy free diet yet as I had some nice cheese in the fridge I wanted to see what difference the gaviscon made

Bessie I'm in a similar position here but managed to get away with just cutting out milk and cream (so can still have chocolate, cheese, butter - phew!) and that stopped the majority of the screaming/sicking (we have the occasional odd episode but so infrequent I can't figure out what causes it). Now he is just sick. I could possibly eliminate that if I cut out all dairy but there has to be a compromise and the normal sick doesn't bother him at all. I notice an improvement within 3 days.

I miss dunking biscuits in a milky cup of tea though :(

Same here, if I just have a little, it's not too bad, but a milky coffee, cheese or some ice cream would really set her off.

Btw, if you do decide to try going without dairy, here are some good alternatives..

Milks- Oatly, Kara (coconut based), Rice Dream. I find the Oatly best for cooking. Nothing worse than finding the bechamel in your lasagne tastes of vanilla.

Butter- Pure spread, but not the soya one if you can help it. Olive oil.

Cheese- none of the alternatives really do it for me, and most contain soya, so I usually have avocado or houmous instead.

Cream- Oatly cream

Where we are, Tesco's seems to stock a lot more of these than Sainsbury's, and we've a few health food stores to choose from.

I had this problem with my youngest I changed to a different formula and she was much better after this, I only fed her a little milk at a time too, that worked well.

Dairy was the thing for my two - I tried everything else first as really didn't want to give up hot chocolate, fish pie etc. If elimination diet improves things after a week or so then you can probably get away with very processed dairy e.g. chocolate :). Make sure you don't have soya either when doing the elimination diet. Also skipped the Gaviscon and went straight to Ranitidine and Domperidone. DD was a milder case so didn't need the meds and was also a bit more tolerant of me having dairy.