BF problems, reflux... advice please!

[Nessler]

DS is 4 months and BF although it took 4 weeks to commence this. He has reflux and is now on ranitidine/domperidone.

However for the past few weeks he's been arching his back, pulling/pushing onto the breast when feeding, and it's becoming a nightmare... he ends up either not feeding properly or feeding for ages and then bringing up milk (not massive amounts) for up to an hour post feed. I initially thought oversupply but he also is arching his back/thrusting when in the bouncy chair or lying on his back. He has always been gassy but we are now getting gurgly burps constantly and he also has some very smelly farts (TMI sorry!). The only way to settle him is to hold him upright and walk, and it's getting exhausting.

His sleep has deteriorated to the point where we are getting up every 45 minutes initially, the most he's managed is one 3-hour stint during the night. He doesn't usually wake up screaming, but generally wants to feed on waking- but then we are back to the arching/pulling on and off. I think he wants to suck for comfort but not sure if due to pain or just for comforts sake..

Does this look like a food sensitivity? I'd be grateful for any advice... am struggling!

Well a couple of things - 1, there's a bug growth spurt around 4 months so he'll feed more and it will make him sicker. 2- reflux peaks around now so it's a double whammy :(

DS had reflux and was bf so I feel your pain.

Best thing is to check his meds - he could have put weight on making the medication ineffective.

Consider a dummy for post feed suckling. I used one with DS and it never became a comfort for him - so no issues about getting rid.

There's also a develomental leap which will mean worse sleep. You could try getting your dh to resettle with a dummy (or you could try a dummy) to space feeds to 2 hourly at night?

Basically you need to pull out all the stops as it's bloody hard on you and him. Try using a sling for some naps (some of the behaviour will be because he wants to sleep and is so overtired he can't relax on boob and goes mad) and in the day after a feed so he gets your closeness that way. Really persevere with a dummy. No trousers or tight waistbands.

It will pass I promise. 4 months was a real low for me but suddenly by 5 months DS was sitting, rolling etc and life got easier.

Thanks Iggly!

I will persevere with dummies, have tried before and they get spat out, but will give it another go.

Deep breath...

ds had suspected reflux and used to scream for hours, arch back etc. Sling was a lifesaver, also feeding when he'd woken from a nap in a dark room so he just latched on, not thrash around.

A good sling won't hurt your back and will save your arms.

Also co-sleeping was a lifesaver as sometimes he was waking every 20 minutes! Dh on the sofa and it doesn't have to be forever, just to get you through.

Yes we had the same re dummies but worth trying when he's happier? And different shapes.
Also make sure you get regular breaks - even 20 mins to have a bath etc works magic

Any recommendations for slings? We have the baby bjorn and DS likes it but it can press on his tummy when facing outwards. Tried the moby wrap but too much of a faff to put on/off!

I didn't bother facing outwards - too overstimulating for DS (had a bjorn). I used the pushchair once he got to 4 months as too heavy! The close baby carrier is good (soft ring sling) and I've bought a manduca for DD who's 1 month but it doesn't face out (does let you hip carry though). It's bulkier than a bjorn but much more comfy!

Wrap is brill for a newborn (thing is to put it on in the morning and just keep it on all day, popping the baby in and out) but for an older baby you might be better with something more sturdy. Ergo or Beco are really comfy and will carry a toddler so are worth the price - loads of fakes on ebay so steer clear of anything too cheap. Do you have a sling meet nearby so that you can try out different options?

Some people don't approve of facing outwards as its thought to not be good for their hips, especially in a carrier like a bjorn where the weight is carried on their crotch, as well as being overstimulating - there is nowhere to turn in to if gets too much.

Been there, finally done that, and can reassure you that it will get better. DS had silent reflux up until two weeks ago (he's 4.5-months-old). Now he's a "happy spitter", as they say, but from eight weeks to four months he fussed/arched at every feeding, screamed like a cat if placed flat on his back and woke at least five times a night with a sudden screech. He's now without medication and a totally different baby. If your baby is putting on weight well and reaching milestones, chances are this is developmental reflux and not GERD.

We went through slings like nobody's business (reflux babies often hate them because of the pressure on the stomach) but we had most success with the Beco Gemini, which is the only ergonomic carrier to face in, face out, plus allow hip and back carries, and it's so darn comfortable.

Thanks all- have used the bjorn facing in and worked better last night, after DS screeched for 3 hours straight, he fell asleep in it! (though we were up again at 90 min intervals after that..). Will also check out the other slings you've all mentioned.
GP has agreed to a pediatrician referral if no change in a week, thank god.

I feel so much for you, i've been there and 4 months was definitely the low point. We had all the meds too, and the only time DS would feed when he was at his worst, was when he was asleep. To prevent being admitted into hospital with dehydration I used to drive him to sleep and then pull over in a layby and feed him with a bottle!! The dummy was a also a saviour and once he had relaxed and been sucking on one for a while, I used to subtly and quickly swap the dummy for a bottle which was a good trick!
The real turning point was when the paed told us to wean at 4 months. I didn't want to do it so early, but under his instruction we tried and whether it was coincidence or not, it made a dramatic difference. It was far far more effective than any of the meds.
I hope you start to see an improvement soon, it's so hard and people who have easy non reflux babies just can't understand what you're going through. I'll keep everything crossed for you!!

Sorry to say we had nine months of hell. Ask for rereferal back to paediatrician. Omeprazole helped DD, but in all honesty she never slept through till put back on ranitidine as well at 12m.
Have you tried cutting dairy out of your diet?

Sleep wise at night we got no more than 20m until we got a sleep wedge with positioner. Also had the Close carrier, a godsend.

Probably a basic question but is his ranitidine being increased regularly as he gains weight? Its very sensitive to weight and should be reviewed every couple of weeks or so. Also, they can have a lot more than the basic dose but the GP would probably not prescribe this (a paed can). The maximum dose for babies is 3 mg/kg three times a day.

We went straight onto omeprazole (at four months) and it was really good, you could ask for a trial of this if nothing improves.

If it did it all again with my reflux baby, I would have paid for a private paediatrican rather than waiting three months for an NHS one (!) and used an Angelcare monitor and slept him on his tummy.

Am in process of cutting dairy, I wondered about it but he's never had diahorrea, which I thought was a key symptom? He only has a bowel movement every 2-3 days, though the past 2 weeks it's been once in 5 days :(

Have had the night from hell with DS sleeping 45 mins at a time, then two hours of screaming, followed by a couple of 2- 3 hour stints. Spent from 5am this morning pulling his legs up and grunting, tossing head from side to side. Feeding has become more erratic with either v small feeds with lots of crying, or a big feed followed by a bit of vomiting.

I feel so helpless watching him struggle :(

The ranitidine only just started two weeks ago and we are on 1 ml 3x day- I do think this is still on the low side and he is a big baby, just over 7 kg now.

I will find out about wait times for a pediatrician and consider just paying for private care if its a long wait.

ah, poor wee thing, and poor you having to deal with it and see him in pain. You probably know this already but the small feeds will be him trying to soothe his sore throat.

It can't hurt to cut out dairy (unless you are finding it very difficult). Although problems with diahorrea, skin problems etc are common and it doesn't sound like he has those.

Reflux IS awful but it can be managed really well with the right medication for your LO, its just getting onto that right medication which is hard.

In the meantime the thing that made the most difference for me was winding often, as soon as I saw wind symptoms, the more burps the better. Keeping him upright for half an hour or whatever never worked for me - it seemed to get the wind stuck there and impossible to get out. Do you know the winding position where you just face them outwards and sit there?