Silent Reflux

[sleepyheadmum]

Hi! Im new to all this ...mumsnet and motherhood...so any advise VERY welcome!!!!
Not sure if there is already a thread out there on this but would love some advise!
So...my little girl is 4 weeks old and took her to doctors last week as was concerned she was showing a lot of the symptoms of silent reflux...HV and Doctor agreed so have been given some infant gaviscon to give her but need some advise on best way to give it!!
Doc said to give half a sachet 4 times a day in some expressed breast milk and give at the end of a feed!
HV said to use same amount but mix up as per instructions on back of packet and give before a feed!
My main probs are...
quite difficult to guess how much is half a sachet!
When to give it????
Finding it difficult to express any/enough milk when i spend most of the day holding her as very distressed when I put her down and to be honest when I do put her down just want half hour to myself before it all kicks off again

So far I have been making up the whole sachet according to instructions and giving half by a small syringe in her mouth (keeping the rest for another feed)

• but she finds this quite unpleasent as before a feed she just screams and afte she is normally asleep so will either not take it or wakes up and then we have to start the settling process all over again! Do you think its ok to keep the gaviscon/water solution in the fridge and use for a later feed? Also any tips for when to change her nappy! - lying her on her back straight after a feed makes reflux worse, wakes her up and gives her major hiccups and then she is very difficlt to settle Changing it before often results in screaming baby as hungry - so she gulps in loads of air and therefore is full of wind which also seems to make matter worse! Oh and to cap it all Gaviscon seemed to work over weekend - much more settled and finally sleeping a bit as not being woken up by horrible acid shooting up her throat - but last night and this moring we are back to square one! she did eventually sleep from 11pm to 4.30pm - presumably becase she was knackered from howling from 5pm til 10.30pm! Is that too long for a 4 week old to go between a feed (5 and half hours at night)?Shes been really unsettled this morning - cant tell if its hunger or reflux bothering her?? And finally gaviscon seems to have made her constipated!!!weve gone from about 4 or 5 dirty nappies a day to 1 not very full one! she done lots of farting but after a lot of straining and crying but nothing else seems to come out! so she also seems uncomfy from that!!! Sorry to waffle on but am tearing my hair out...just want to see my baby settled and happy...not in pain! Basically HELP PLEASE!!!!!!

Hi, we had a premie baby who has had lots if problems with reflux so I feel your pain!
The doctors always start with gaviscon and you may find this helps but often they add in ranitidine too so that may come later. We make the gaviscon up in advance in a sterilised pot (although that's probably being way too careful!) with 5ml of boiled water and leave to dissolve. We have now started using two sachets which does dissolve in the same amount of water. We always give before a feed in a syringe as he isn't interested in taking anything after! Our ds is bottle fed but we found that it thickened the milk so much he couldn't suck it through the teat!
I don't store the gaviscon in the fridge. I have to say that gaviscon did make a difference at first but we found we needed something else after a few weeks. Reflux babies are often unsettled during the day (and at night sometimes although we didn't find that) and eventually we found that ds was helped by sleeping on his belly- this always terrified me but with the help of our angelcare breathing monitor I made my peace with it. My ds is almost 6months now and still sometimes has problems...he doesn't like to spend time on his back for very long so we are looking at an activity centre so he can sit up and play. You could try tilting the changing mat with a wedge just to slightly raise it??
Hope some if this may help?
Good luck!

Ps my feeling re time between feeds at night is probably different to what the official line is! I think if they want to sleep let them at night but wake during the day to feed and fill them up! If you are BF though I guess you just have to make sure you are keeping your milk supply in. Gaviscon does make them constipated sometimes, we tried giving every other feed which seemed ok. Please be assured that this will get better and you aren't the only one I promise! Do go back to your doctor if you aren't seeing much change but like all things with babies you need to try for a couple if weeks really.

Bodensmummy...do you just use 5ml of water for a sachet or 2 of gaviscon?...is that enough??packet says add 5ml then another 10ml!!which to be honest I do have problems getting down her before the screaming commences!!!so 5ml would be easier! So i guess I could give her half one feed and keep the rest for later??Thank you!

Been back to GP as finding gaviscon really difficult to get down her - she is breastfed and having to syringe about 7mls down a screaming baby before a feed is a lot easier said than done!!couldnt do it after as shes often fast asleep!! Much more helpful GP prescribed Ranitidine - much smaller amount!
Any one else have any experience of how long it takes to kick in?
When do people give it?before or after feeding?

Hi sleepy, my twins were prem and have major silent reflux and are on gaviscon, domperidone and ranitidine - the ranitidine took a couple of days to kick in. They are formula fed so gaviscon goes in the bottle, the ranitidine and domperidone we give 20 mins before a feed as the ranitidine needs time to work but I guess that is easier with ff as we know what times we are feeding.

I would really recommend raising her cot / moses basket, we have wedge sleep positioners in their cot and their carry cots downstairs are raised on a load of books. We keep them upright for 15 mins after a feed and bouncy chairs are a godsend, I can feed one and wind her and pop her in her chair while I feed the other - the chairs seem to be at just the right angle.

We have also added infacol into the mix - its helped with the wind but also seems to have eased the constipation caused by the other stuff, gone from one dirty nappy every couple of days to two a day and they seem so much more settled.

DD2 is on ranitidine. We give it 3 times a day, approximately with my meals but I do forget sometimes. It tends to be between DD2's feeds. It took about 5 days to really kick in. She is on the maximum dose for her size. With DD1, we started on the minimum dose but had to increase to the maximum to have an effect. Luckily I have a lovely GP who just started DD2 on the maximum. Also you have to keep an eye on it so that you increase the dose as your lo grows.

I used to express in the evening and then decant into multiple bottles in order to add a sachet of gaviscon - I was instructed to give 1 sachet 4 times a day by the GP. I would always give before a feed as although it delays the feeding it was better this than the alternative of a potential wakening after a feed.

As for changing, for the same reasons as above, I always did before a feed and sing nursery rhymes to block out the screams :(

My little one really didn't settle with the gaviscon and I kept going back to the GP eventually taking up his blood/puke covered sleepsuit and demanding to see a paeditrician who then prescribed omeprazole. He ended up taking the omeprazole/gaviscon combo till he was 6 mths and it worked.

Don't be afraid of keep going to the GP as I got the impression I was being brushed off as a neurotic first time mum!

Sadly, during this I moved onto combo feeding as he didn't settle when feeding on the breast due to the position he was in and I was sit him up when giving him the bottle.

Good luck with it all, it will eventually get better!

hey how is your LO, are things any better yet? mine was diagnosed with silent reflux about a month ago, she is 6 weeks now. she has tried gaviscon which i think made her worse, and she has constipation anyway which doesn't help. and infacol she is still on, i don't know if it helps. so now we have the ranitidine, she just started it yesterday, she is BF during the day and gets 1-2 bottles at night and her feed is now Enfamil which is prescribed - a thickened formula, which really did help a bit. i really hope the ranitidine helps. it seems to have kicked in a little already but i really hope it takes full effect. good luck!

Nothing to add in terms of advice, but we've just joined the silent reflux club, too. My LO is eleven weeks, and has been showing signs since eight weeks, with three stop breathing episodes, lots of pained screaming, wet burps etc.

The lady who was my doula came by today and showed me a new feeding position, which basically has baby facing me, straddling one of my legs, and I place one arm behind his back, the other hand behind his neck, and keep him bolt upright. It seemed to really work, as I have an extraordinarily fast flow/letdown, which isn't causing the problem, but it's certainly exacerbating the issue.

Anyway, maybe this position might come in useful for other b'fing mothers of reflux babies :) We have a prescription for Zantac, and will use it if this new position, plus oodles of camomile and ginger tea consumed by me, fails to work.

I'm joining the silent reflux club too. Sorry to hear there are so many members!

Like stopgap I have very fast letdown which seems to be exacerbating the problem, and I'm also experimenting with upright feeding positions. I haven't found it too helpful yet though. Gaviscon has done nothing at all as far as I can see, other than ensure a giant battle before/after every feed, so we've given up with that for the moment. I'm in two minds about going back to the GP for ranitidine, as it seems so drastic, but if things don't improve I'm going to have to.

One thing I've noticed though, is that DS (8 weeks) very rarely has a dirty nappy these days - maybe one a week or even fewer. Although I know this is normal for an EBF baby, I've found that the reflux seems to get worse the longer it's been since the last bowel movement, and temporarily much better after the poo explosion happens. Has anyone else experienced this? I'm beginning to think that if I could solve the lack of poo, the reflux might not need treating. Of course, I could be barking up the wrong tree altogether...

Thanks, Sargesaweyes, but I don't think the gaviscon caused the constipation, because I only used it for 3 days last week and DS hadn't had a dirty nappy for several days before (the same pattern each week since he was 3 weeks old in fact).

It's good to know your son is doing better on ranitidine - I think this may have to be our next course of action too, unfortunately.

On another note, has anyone found a way to keep their baby upright at night? I know it's not good to let them sleep in the car seat or bouncy chair, but other than staying up all night holding DS, I can't see how to find a position he can sleep in. I've propped up the moses basket legs AND put in a cot wedge, but the only thing that seems to prevent the reflux is holding him really upright .

Has anyone experienced totally contented baby ( 10 weeks) suddenly refusing feeds, crying, not feeding?....Already on lactose free milk and Gaviscon....but so weird how it 'see saws' every few days from fine, feeding and happy to not feeding and unhappy....this is now the third time a normally happy and contented wee soul has had this happen..

My 13 week old DD was recently diognosed with reflux as well. I have recently moved from BF to bottles (first of expressed milk, and then lactos free formula). She also had weird mucus poo, so the doctor actually wanted to address any intolerance as this might make the reflux worse. As sad as I am to stop breast feeding, I am not sure I can handle a trial dairy, wheat, egg, and nut free diet on top of the rigours of new mummyhood. She is now on Zantac as well, and while it seems to help, I think she misses breastfeeding. For those who are BF, talk to your doctor about excluding major allergens in your diet. How long does reflux last in babies?

Hi,
Wondering how you all are getting on -- was just searching for information on acid reflux. Yesterday I took my 10 week old DD to the out of hours GP as she had spent the day screaming and writhing in pain. The doc there prescribed gaviscon, and told me it looks like acid reflux.

For weeks I have been concerned about her inability to settle and difficult feeding sessions -- she is breastfed. I had thought I had insufficient milk supply, and with the help of a lactation specialist I have gotten that improved. However my GP was not convinced it was anything more/else than regular colic that would soon pass. But yesterday I just thought that it cannot be normal to have to hold a hollering baby for hours. And now I am mad that I did not try harder, sooner with my GP.

Anyway, going back later this week once I see how we are getting on with the gaviscon. Just wondering if anyone has any suggestions for how to deal with the GP to get them to see this how significant this could be. Also my daughter currently has several soiled nappies a day of rather greenish liquidy poo. I believe that this could indicate too much lactose in the milk/diet or an intolerance to it on her part? Does anyone have knowledge if a baby can have both acid reflux and a lactose intolerance? I understand co-lief help with lactose -- but can it be taken with gaviscon?

Finally any other breastfed mums have suggestions/experiences re: dietary changes? I shudder at the thought of giving up diary, nuts, wheat and egg. To be honest, I am not sure what would be left for me seeing as I eat all those daily.

Thanks all, and hope you and your little ones are doing better.