Really worried - 5 wk old vomits, grunts and only sleeps 45 min stretches...

[user59457812]

My 5 wk old DD has been posseting a lot after every feed for the last ten days. Sometimes it looks like the entire feed - we both end up soaked! She is EBF but has become v v fussy at the breast, writhing and crying often.

She hardly sleeps at night and writhes and grunts constantly when laid down, not crying but in very restless sleep. The max peaceful sleep she gets is 30-45 mins before hours of grunting during which she looks v unhappy. She'll only sleep in the sling or on someone in the day.

I've seen a GP and on-call paed, both who said it's immature digestion and we just have to tough it out for six months! I may go psychotic from lack of sleep before then...

She's gaining weight ok but is getting more fractious by the day. My instinct tells me something's wrong but I don't know what to do.

Does this sound familiar???? Esp the grunting - I can't find anything on it.

TIA!!

Hi Hotpink, I posted yesterday on another thread (mixed signals while feeding) which was also set up by someone with a 5 wk old. Seems to be a time for babies to grunt/ posset and be uncomfy feeding! No real advice sorry - am first time mum equally bewildered by it all- but just wanted to say yes to the grunting. My DS does it, along with a range of other weird sounds. Can be quite alarming while feeding! I don't know if it indicates reflux or if he's just a bit mucuousy.
I share your pain at thought of weeks of broken nights. I don't mind waking at night to feed but when he takes ages to settle each time or just doesn't sleep long (like yours) it's tough.. Very.
I'm mixed feeding so had been worried that I'd 'broken' my poor baby's digestive system but it does appear at least to occur in EBF babies too. Not much comfort to you I know.. But suspect your Dr etc were right and they're growing into their digestive systems. It'll get better.. Eventually! Sob.
Will watch thread with interest.
And congrats!

Have you checked out Kellymom?

The writhing and grunting sounds indicative of wind to me. It could be the start of reflux and the posseting would go along with this, along with the fact that it is getting worse and that it is something new.

It can't hurt to try a dairy free diet to start off with. Analytical Armadillo also has lots of information.

Not sure there is much else I can say, as if its reflux only time will tell.

This sounds very typical of reflux to me. Last year there were a couple of threads in feeding that listed all the strategies to try. I think posieparker started it - you could do a search. There are several medicines to try and we found a cocktail that helped my dc. I had to go and ask my gp for them, so don't be fobbed off. If the first one doesn't work, go back again. Look at www.cryinggoverspiltmilk.nz for advice about the medicines. Medics don't take reflux very seriously because most babies grow out of it between 6-12 months, but I think its impact on family life is greatly underestimated. It will get easier. You will have good and bad days but you will get through it. Feel free to PM me if I can be of any help. Be kind to yourself and good luck.

Was at work earlier when posting, bu felt I could add a bit more to you and the lady who responded above...

I think it is important to differentiate between posseting and vomiting -the vomiting you describe is not the same as a baby posseting (as your washing piles will testify, no doubt!!) Have you tried a hand towel or terry towelling nappy square rather than a muslin? It took me months to work out (in desperation) that it was possible to limit the flow of the vomit, thus saving washing of clothes and carpets!! (and do take a spare top for you out, as well as multiple sets of changes for the baby!)

My DC were breast fed so mixed or EBF doesn't cause it. Reflux seems to be incredibly common sadly. I found it was better not to compare nights with mums of other babies the same age who are not dealing with reflux. I'm afraid bad nights seem to be part of the deal with a refluxer. We have never really solved reflux nights and ended up doing alternate nights so as to stay sane. In the early days of night feeds, I did both because I was feeding, but DH always did one of the 90minute sit up sessions with the DC afterwards. Not quite sure how I'd have survived otherwise. I think what I'm saying is that we may not be able to solve the reflux (although the medicine makes a huge difference to some babies), but we can help you find ways round the sleep deprivation. I'd also say, if anyone offers to help you practically - whether in terms of housework, minding the baby for an hour, cooking a meal etc... - do accept, as caring for a refluxer is all consuming. (And by the way, you will get over it - I've had two, so I couldn't have been that put off by reflux, although it would now stop me having a third!!)

Could also possibly be a lactose intolerance. Is it worse after u have eaten alot of dairy? Breastmilk does contain lactose so reducing your dairy intake may not solve it completely. My dd was formula fed but symptoms were very similar . Grunting writhing bloating, and the most stinking nappies and what appeared to be constipation yet when she went it wasn't hard or dry. All this went went away after being placed on a pepti formula . If u think it could be possible maybe start a food diary of what u eat and severity if symptoms :( hope u figure it out it's horrible to see them so distressed x

Lactose intolerance is very rare. However cows milk protein intolerance is more common - which gets into your BM after eating dairy. Also soya does something similar. You could try reducing your dairy/soya intake but when they're this young, it's hard to know what's causing what.

Practical suggestions like winding during and after a feed can help as well as holding upright after a feed for 20 mins.

Also consider whether you have an overactive letdown which can make baby take down a lot of air so ends up with wind in her tummy. Does she choke or splutter when feeding?

Another option is to check your latch - is there a perfect seal? If not, will let wind in and cause problems again!

Finally check for tongue tie - again (theme here) can mean they take down a lot of wind. Nipple pain is not necessarily an indicator. DD had a tongue tie with an estimate 80% restriction of movement and my nipples were fine! She put on weight fine too but had reflux type symptoms and fed very frequently night and day

Surely if its TT, latch, overactive letdown or CMPI they would have caused problems before now? The fact that it started about 3-4 weeks and is getting worse to me points to reflux.

I've had both a baby with reflux and then a baby with TT (which was undiagnosed until three months) so have been through every possible cause for wind/feeding problems until I finally found the answer!

If it is reflux then medications should be able to sort it out and if they're not, then you're either on the wrong meds or the wrong dose. Crying over spilt milk mentioned earlier is a great resource on reflux.

That's why I asked about symptoms. Not necessarily though - especially CMPI which can go hand in hand with reflux. And over active letdown can become more of a problem in first 6-12 weeks before supply settles.

Both my dc's have reflux (eldest, 2.6 years had acid coming out of his nose at 7 months despite meds!), both have CMPI, I have an over active letdown and dd had TT. Drove myself crazy trying to work it all out - however I wanted to rule everything out before going for medication (with dd, my second, it didn't take me as long).

I agree, sounds like reflux to me - my DS was similar and it really seemed to kick off around the 4/5 week mark. I blamed mixed feeding at the time (as I never managed to get EBF properly established) but I think it's just a developmental stage as I've met a couple of mothers since who had similar experiences.

A sling saved my life in those days when he just wouldn't sleep, also thoroughly winding him after feeding because otherwise he'd just wake up shortly after going to sleep and posset half the feed and / or cry. What about always putting your DD in the sling after a feed to help get wind up and only putting her down to sleep afterwards? I also found co-sleeping with DS in the sling on my chest (one of those slings that holds him in place so he couldn't slump off my chest or suffocate) worked well.

Also, I may get shot for this but now that you have established BF you could use a dummy. The sucking motion used to soothe DS when he was in pain.

If it's any consolation, the reflux with us kicked in about 4 weeks and peaked at 10 weeks and then started to ease off slowly. He's great now (6 mths), just burps after a feed no problem and sleeps through.

Thanks so much for your replies. It does seem to be getting worse - last night we had five hours of screaming only interrupted when she'd drop asleep exhausted for a short while or go on the boob (only to scream as soon as she came off it)

I'm really unsure about the protein allergy as she was fine for the first three weeks - can this set in later? How is it diagnosed??

Did any of you get a referral to a paed or did you have to do it all through your GP?

We keep her upright for 2o mins after a feed, spend a lot of time with her in the sling and tryto wind during feeds' although she's often so restless it can be hard to do.

It's so upsetting as - as well as the worry and concern for her pain - it's ruling our lives. Hard to go anywhere social due to the sick and fussiness, and I can't imagine going on holiday with her lack of sleep. She is generally quite 'sensitive' and won't sit or lie happily when she's awake more than a few mins. She also wakes and cries instantly - no happy cooing. Her behaviour is v different to her peers of the same age. Is it part of the reflux picture??

Yes it sounds like reflux to me. I spotted it quite quickly with dd (dc2) as knew what to expect.

The cows milk protein can be an intolerance which builds up. You could try cutting dairy and soya (I also have to avoid chocolate and spicy food despite there being no evidence, DD still gets atrocious wind if I weaken and she's nearly 5 months). Soya is similar to cows milk wrt proteins.

I went through my GP and asked for medication straight away with dd - made a list of symptoms so I would forget. With ds it took longer to convince them.

Do try a dummy. I was (and still am) a bit anti dummy but they really really help. A dummy and a sling plus make sure she gets regular naps - not awake for more than 45 mins if you can help it because over tiredness makes it worse and extreme overtiredness can even be mistaken for reflux.

Also I would keep pressure off her tummy - no trousers, leggings or tights and don't tighten nappies too much. Keep her in the sling all day if you can - it's claustrophobic at times but you only need to do it for the first 10-12 weeks of her life then she'll be happier sitting in a bouncy chair.

I also lay dd on her left hand side because ds nearly choked on acid coming back up his nose when he was 12 weeks old.

I found changing my diet helped the most with ranitidine (medication to neutralise the acid) for dd. the GP will most likely prescribe gaviscon first which is pants and faffy. You may as well book another appointment straight away if they do - but they need to go through their protocol I guess.

Reflux is very tough to deal with, which is why I asked about other possibilities too because if you can fix it without medication, that's great.

Oh and most little babies don't like to lie happily for too long anyway - not until they're closer to 3 months so it will get easier. If you need to put her down, try a vibrating swing chair thingy (I just held out until 12 weeks as I knew from experience with refluxy ds he'd be happier as he got older).

Thanks iggly I hope it is something else as I hate the idea of medicating her. She's rarely awake more than 45 mins as she cries so quickly when not being fed - she only sleeps on us or in the sling. She hates being in the car seat or oram though and will scream if I try to take her out awake in it.

My antenatal group must have a very placid lot as their babes all sit and kick happily in their prams or on laps for ages! Mine's the only one that cries, bless her.

Glad to hear it does improve with time. I just want her to be happy and healthy.

Oh and iggly when do you give the dummy? She won't take it and not sure I'm timing it right (or using the right technique) xx

R there any other symptoms ? Is her skin dry or flakey is she sniffly constantly? These can also sometimes go hand in hand with cmpi. What r the nappies like? If u could persuade ur doctor to have a brief trial of pepti milk such as neocate, aptimil pepti, cow and gate pepti junior then a bottle or two of that would give a fairly quick improvement. Or elimination of dairy an soya in ur diet would take a week or two to clear from ur system x

She didn't want a dummy until she was older - say around 3 months? Although I gave up after trying in the early days then tried again so she might have taken it sooner. I'd give it after a feed. Sometimes I'd have to tap the end very very gently to keep it in her mouth. Usually while she was in the sling.
I had to experiment with makes of dummy. Some people have success with the old fashioned cherry ones (your chemist will sell them usually), dd liked the MAM ones as they have a wider teat. Now at nearly 5 months she takes any one though!

Yep car seat would mean screaming here too. A lot of the time it was because she would have wind as they put pressure on her tummy so I had to wind her first. Or sometimes it was because she was hungry and tired and couldn't switch off. As soon as she could stay awake for longer and once I took out the foam insert as she got taller (kept the head hugger though), she is much happier and has even fallen asleep

Get through the next few weeks, see the GP anyway. You can ask to try gaviscon - it's really a pain to give but if you see an improvement then you will know its reflux although if she's reacting to your diet you won't see much. Then you can think about how best to proceed. Do you eat a lot of dairy? Chocolate? Take away food with soya in?

In response to what someone wrote about the wrong meds or wrong dose, I think I got the wrong baby second time round, as he didn't respond to any of them very well! My lounge carpet is ruined from 20 lots of vomit a day (though luckily he was a very happy baby, screaming only during feeding).

Don't be put off if you don't see an improvement with the first medicine. I assumed with DC1 that it meant it wasn't reflux, but it was just an ineffective medicine.

Swing seats are supposed to really help. We went down the dummy route. It took a little while to persuade them to take it but both were on them by 4 days! It stopped the night coughing too, which can go hand in hand with reflux.

Do consider keeping her upright for longer if she can't lie flat comfortably after 20 mins. As I said before, mine both needed 90 mins, but then slept comfortably until the next feed (which at 9 weeks became from midnight until 6am, although it got worse again at a later stage). We watched a lot of tv in the night in those first few weeks!!

Keep posting. We all sympathise tremendously.