Sudden frequent sick at 4 months & poor weight gain

[JacqueslePeacock]

My DS was diagnosed with silent reflux at 6 weeks. He was quite unhappy with it, especially at night, when he would gurgle, cough and choke then cry a lot. However I started a dairy- and soy-free diet at 8 weeks and his reflux disappeared within 48 hours. He became a very content baby with excellent weight gain.

The problem now is that since 14 weeks he has started spitting up frequently - 30-40 times a day. He doesn't seem to mind so I wasn't worrying about it, until I had him weighed this week. He is now nearly 19 weeks and has gained only half a pound since 13 weeks when I last had him weighed. He's dropped from above the 50th centile to below the 25th.

I haven't changed my diet and with the silent reflux he wasn't sick at all anyway, so this is completely new. The HV has just told me to keep an eye on his weight, but I can't help worrying because of the sick. Does anyone have any ideas what might be causing this? Or if there's anything I could do? Thank you!

Baby's don't often stay on one centile line and a drop from the 50th to the 25th is only a one centile drop. They don't normaly worry unless they drop at lest 2 or more.

I don't think you have anything to worry about and unless his being sick is making him upset it's not a problem really. This often stop's when baby's start solids.

Thanks for your reply- that does make me feel a bit better. I guess I'm concerned because previously he'd been gaining half a pound a week, and now it's half a pound in over 5 weeks! He was a chubby baby and now looks long and thin.

The fact that the much slower weight gain came at exactly the same time as the sick makes me think that it must be connected. It's good to hear it may stop when he starts solids.

Does a drop from between 50th & 75th to between 9th & 25th not count as 2 centiles though?

I guess you are keeping him upright after feeds, slinging him in an upright position, the mattress he sleeps on raised slightly at the head end, time in a bouncer/swing?

Could some dairy/soy have crept back into your diet (perhaps a 'new and improved' version of a previously safe food?)?

Has regular reflux been ruled out? Or is he already on meds for that/silent reflux?

I don't think 'posseting' 30-40 times a day is 'normal' and perhaps a visit to the GP/Paed (if you are under one) might be worth while to see if there is anything to counteract the vomiting.

My eldest DD had reflux from a few days old as she was put on a 2oz per 2 hour regime for her jaundice and it took 8 weeks to get back to ebf (would feed for up to 1 3/4 hours every 2 hours!! Just to fuel the puking I reckon ). Even after the regime was ended she couldn't stop being sick.

She went from 50th to 2nd centile (you could see all her ribs clearly she was so thin) and actually started losing weight before anything was done as prior to that I got told posseting was normal - it wasn't posset it was like pouring milk out of the carton when she was sick.

She got put on gaviscon which just stopped her pooing not puking, domperidone was what worked and she started gaining really well. She didn't get any better with solids (just puked food and milk instead of milk ) but did get amazingly better at 12m and gained weight hand over fist. She's a tall, slim girl now but doesn't seem to have any harm from the copious vomiting of her baby days! We just let her grow out of the dose (it's weight based) as she got older and she was ok when it stopped.

If you are not happy with what your hv has advised you could make an appointment with your gp.

I am pretty sure your gp will be happy to prescribe gaviscon and other medication if need be. Also to rule out anything more serious and put your mind at ease. My ds had reflux so you have my sympathy as it is hard work!

Thanks so much for the replies.

Truthsweet, I am doing all the upright-y things, yes. Oddly though (and unlike with the previous silent reflux) it doesn't seem to happen much when he's lying down at night - more when he's rolling, on his tummy or especially when he's being held. :( The bouncy chair seems to be best for reducing sick.

Definitely no dairy/soy in my diet - I am a scrupulous packet-checker.

He isn't on any meds. Gaviscon didn't help the silent reflux (just caused constipation), so we were about to start ranitidine, but didn't because the dairy/soy-free diet worked so brilliantly. Is it possible to have silent reflux because of a food intolerance AND physiological reflux AS WELL??? And if so, is it possible for reflux just to start at 3 months+??

He doesn't sound as bad as your DD - it's more like copious posset and less like rivers of sick (thank goodness - your poor DD!). I'm EBF and am trying to feed little and often but am not seeing much improvement.

everybodyfreeze good idea to try the GP. I will go if his weight is still poor next Wed. Am not at all keen to go back dwn the Gaviscon route though... Thank you for the sympathy!

I should add that the possetting is not just after a feed. It can be an hour or more later and bring up really digested looking milk. I have gaviscon left from the initial silent reflux and suppose I could try it, but am reluctant because of the constipation. Although at the moment DS is having frequent green nappies so perhaps that's not a problem.