switch to formula to improve reflux?

[fizzypigs]

hi was wondering if anyone switched from bf to formula to help improve reflux? i am at a bit of an impasse - baby was 1st prescribed gaviscon but after taking it for the 1st day baby refused to take it, became really constipated and very distressed when i tried to give it by syringe - it was a total nightmare! have now been prescribed ranthidine which i have since discovered doesn't actually affect being sick - deals with stomach acid production - which is good but means i am still feeding every hr and baby is often sick mid feed all over my boobs! i am at the end of my tether - feel like i am stuck indoors as i all do is feed and change baby's and my clothes! so i am wondering if anyone found that formula feeding helped with sickness? i understand that breast milk is digested more quickly but was wondering if using formula that is / can be thickened could reduce sickness episodes as it may have a similar affect to gaviscon if you see what i mean?

In fact (sorry) formula feeding is likely to make the regurgitation worse as the feed tends to be faster and the stomach less quick at emptying than with BF. so not much help there......

have you tried gaviscon after the feed given from a medicine spoon dripped in rather than syringe...lots of babies find a syringe full of fluid appearing in their mouths startling and distressing. It should form a layer over the milk and reduce the regurgitation (tho some babies will manage to be sick wahatever!!! my 3rd never seemed to keep anything down).

I'm sure you've been told about leaving a short (2-3 mins) gap halfway through feed, keeping baby upright in between.

ranitidine will help as reducing the acid will stop the oesophageal surface from being irritable and thus less sickness.

I feel sorry for you both...it is a very trying time. i spent soooo much time with sick all over everthing....think calm thoughts, the older your ababy gets the lee s/he will sick up and one day this will all be a bad dream.

Well done for BFing thus far....if you can keep going.....it's brilliant.

PS

also raise head end of crib on blocks or books, invest in uprightish baby chair that does allow him./her to be held slanted with head above feet without squishing tummy. trying to give an hour between feeds probably feels completely impossible at the mo. but it would help your baby to empty the stomach the preferred way and give you sanity!! I knoew lying a baby on his/her side is not recommended but during day for a short nap with you around you could also try lying baby on the left side....sometimes this helps....If you ever get to put him/her down that is!!!!!!

have you enough support ( eg friends, mother, granny) anyone who will come over and be sicked up on instead of you???????? once you've fed him/her

My eldest DD had reflux and I spent most of my time bfing her while our sofa looked like it had spent the best part of a decade on the top of Nelson's Column. It did get better (we had domperidone which worked well for her but obviously different meds for different folk, etc) and she did gain weight finally.

Bfing releases endorphins in the baby (body's own pain relief), it acts as an antacid, it's less likely to cause aspirational pneumonia (where vomit is inhaled into the lungs and as bm is antimicrobial it shouldn't be a breeding ground for bacteria), it's quicker to be digested (the longer milk/food sits in the stomach the longer the time for vomiting is) and bm going down the oesophagus can be soothing (as can using a dummy but then introducing a dummy too early might interfere with bfing).

You don't say how old your baby is but if they are very young (say under 6w-ish) hourly feeding would be fairly common (that's not so say desirable from a parent's POV though!). Are you in contact with a bfing counsellor/lactation consultant/knowledgeable HV or MW or a bfing support group? It may be a slight tweak to latch/positioning/attachment might help you and baby feed more efficiently (that's not to say you aren't doing it spot on now but I haven't seen you so I can't say either way).

How ever old baby is (not on solids though) are they doing 6 wet disposable nappies/8 cloth nappies, and at least 2 £2 coin sized poos a day (they may skip the pooing if they are older than 6w but as long as the poo is soft and unformed when they do go [assuming not in gaviscon anymore])?

How old is your little one?

Reflux usual goes hand in hand with dairy intolerance so normal formula won't help.

Also you need to consider whether baby is overtired because this can cause them to want to feed more frequently to try and get to sleep. How much sleep are they getting? Little babies usually get tired quite quickly - after 45 to 2 hours (usually at the lower end). Keep baby in a sling so they can sleep when they want.

There are other medications to help with the sickness - but please consider whether overtiredness is an issue first.

I give my BF DS gaviscon made up with a little warm water in a bottle before a feed. Usually, but not always, he'll drink it ok. When he's fussy about it it goes down a lot better mixed with some expressed milk. Sometimes I just end up syringing it in but he hates it so I don't like to do it that way. Sometimes I give up and just try again at the next feed.

If BF is getting too much for you, you could consider mixed feeding. That's what I ended up doing with DD, then she had gaviscon in the FF a couple of times a day which was just enough to make things bearable. Also the FF helped break the cycle of continuous feeding with her, which helped things to settle down more as well.

I hope you find something that works for you, it can be such hard going. It really doesn't last forever though. DD was ok by 6 months and DS is showing signs of getting better now, he'll be 12 weeks on Thursday.

Iggly it can go hand in hand but it doesn't usually.

OP don't rush into anything. Have you seen a gastro paed specialist? Our gp was only able to prescribe either gaviscon or ranitidine so we were between a rock and a hard place! However, since seeing the paed on Friday we've been doing both which helps. And we have free rein to get the 'harder' stuff if that is what we consider necessary.

Have you considered mixing the gaviscon with something? If expressing is too much of a faff (it was for me when I was bfing dd1) you could try mixing it with 1/2 oz of formula (or less)?

Seriously though (and I say this as someone who has had 3 with reflux and bf for between 5wks and 6m with 4dcs) it is easier to medicate for reflux with ff but I would have bf for far longer every time if I could've (I never stopped because of the reflux - I'm just no good at bfing). If you even think you might regret stopping then don't. Ask for more help from hv, gp, whoever...

Thanks for replies. Baby is 8wks. Yip have cot propped up and keeping baby as upright as possible. Plenty of wet nappies but dirty ones are all messed up because of gaviscon! Taking lactulose to try and remedy that but seems to be taking a while to get back to normal. Tbh the weight gain has been ok - 9oz last week - only reason we are down the medical route is cos hv read graph wrong! (I've just discovered that!) However for my own sanity I'd really like to try and reduce sickness as I am finding constant feeding & sickness demoralising & distressing. I had wanted to move to mixed feeding anyway as I'm starting back at work in nov (2days/wk) and would like baby to take formula so I guess I need to think about introducing that now. So I sort of hoped that formula might help with reflux too..ah well back to the drawing board!

I thought they did usually go hand in hand?

DS had reflux, gained lots of weight. We tried gaviscon but quickly stopped at didn't make a huge difference. Rantidine was better and we managed the sickness as follows:

• dummy after feeds
• winding for twenty minutes by rubbing not patting
• pressure kept off the tummy. No trousers, only dungarees or all in ones. Nappies kept very loose.
• feed little and often (reflux can cause discomfort so babies feed to soothe)

You can phone one of the BF helplines - they gave me loads of tips on managing it. I found cutting out dairy from my diet helped enormously. I did doubt the dairy (and soya) connection but when I tried DS with formula he'd be sick loads and if I had soya his poos were green!

Yip buttonmoon it would be much easier to medicate with formula. HV suggested I express to mix gaviscon and feed via bottle. I have no idea where I'd find the time to express 6 times a day to give prescription of gaviscon. I've found gp not v helpful - told to persevere with gaviscon despite baby refusing it and prescribe rantadine (sp!!) without being told it wouldn't reduce sickness!!

Have you looked into cranial oestopathy? It helped my friend with her reflux baby and I have used it myself for other things.

Worth a try!

this website was useful to me

The other thing to consider is whether you have an overactive letdown causing baby to take too much milk. I emailed LLL when DS was young and the three possible causes were reflux, overactive letdown or overtiredness...!

BF babies take gaviscon made with cooled boiled water. Obviously if you wanted to express to mix the powder to feed instead of mixing with water you could but you don't need to. Even then you'd only need about 60mls so that hopefully wouldn't be much expressing (though individual experiences do apply).

Other meds are available - omeprazole (losec MUPS) and domperidone are two that spring to mind though there are other meds. Having personal experience of domperidone it definitely didn't need formula to dispense the meds just a syringe.

TruthSweet IME bf babies are meant to take gaviscon with cooled boiled water. None of mine would ever countenace it!

Iggly reflux is far more common than CMPI. CMPI can present with reflux symptoms but more often reflux presents by itself.

I second the advice with the dummy though - it has really helped ds.

As for only needing medication when losing weight - that's a non starter. If a baby's in pain then weight is not an issue. And as my hv says, it's not just about the baby. It's about keeping you sane too!

DD1 did take it with cooled boiled water but we did it in a tiny bottle so by the time she had sucked twice it was gone. We stopped with in a week or so as her poo turned to marble with no reduction in feed length or vomiting duration.

DD1 did need meds for weight gain (she had started losing weight, you could see all her ribs, she'd only outgrown newborn by length not width and went from 50th - 2nd for weight but was on 75th/91st for height so looked emaciated before I was believed) but on dom. she did well. She was in a lot of pain too and feed for 1 3/4 hours at least every 2 hours at her worst point.

She is now 5.7y/o approx 117cm and 20kg though still skinny but most importantly no reflux for the past 3-4 years!

Funnily enough, it was my dd1 that was worst affected too but we didn't have to fight for treatment - she was admitted to hospital at 8wks. Bizarrely though, although her reflux was the worst of all 3 sufferers, she never complained once.

We had a similar centile story though - always above avg for length, but she didn't regain her birth weight (8lb15) until 12 wks. But she was never any bother so the fact that she slept really really well was a cause for congratulation. It was only later that we realised it was because she had no energy - she was conserving what she did have by sleeping all the time

However, she's now 14, def not 'skinny' - a perfectly proportioned size 8/10 and has not been troubled by reflux since 8-9months.