Aptamil Pepti & reflux in 5mo who is constantly hungry...

[tethersend]

I'm not sure where to start with DD's feeding, but it's very much Not Right and there seems to be so many issues involved I am getting really confused.

Up until 3 weeks ago, she was a dream baby who slept from 8-6 and was happy and relaxed. Now she wakes every 3 hours for a feed and is generally cross, although she doesn't really cry, she prefers screeching at the top of her voice. I know about the 4month sleep regression, so am taking it with a pinch of salt, but also concerned that something's not right.

She is on Aptamil Pepti 1, has been since about 5 weeks when GP diagnosed CMP allergy/intolerance. She has two sachets of gaviscon in each bottle (7oz) for reflux and uses Tommee Tippee bottles. She is fed on demand.

The problems are:

1. She is hungry ALL the time. She never seems full and only stops feeding if she's in discomfort or falls asleep. The rest of the time is spent screeching at top volume until she's fed.

1. She is sick/possets quite frequently

1. She is very windy, and it's increasingly difficult to get her to burp. She cries in pain with trapped wind.

1. She takes upwards of an hour to drink a bottle. She will typically take two hours to drink 4-5oz, and frequently feeds all day.

She is putting on weight, and is going through the centiles almost quickly enough to be worried that she's putting on too much weight. The HV thinks that she is overfeeding and advises putting her on hungry baby formula- I am sceptical as this would mean switching her back to CMP formula and risking more stomach upset. The GP said to start her on baby rice- this resulted in constipation so have stopped giving it to her(over 2 weeks ago) and the problems above remain.

So, I just want her to feel happy and full. What can I do? Start weaning and risk constipation? Try hungry baby milk and risk vomitorama? Or should I try the new anti-reflux formula? How about moving on to Pepti 2?

Gah. Please help!

Anyone?

Tongue tie is usually the concern of the BFers, but it can affect bottle feeders too and some of the symptoms you describe are consistent. Has she been checked for this?

Reflux, wind, vomitting, slow feeding, allergy/intolerance would all suggest to me that tongue tie could perhaps be the reason for this as Elphaba says.

have a read of this

Did you try to breastfeed? If so, what happened? Not asking for judgey reason, more that the breastfeeding story also gives clues about tongue tie.

article here from Dr Kotlow who is a leading expert on tt.

I'm glad you brought that up, elphaba- both the GP and the HV gave her tongue a cursory glance when I mentioned it and said that as she can get her tongue past her lips, she doesn't have a tongue tie. She can extend her tongue, but it looks slightly heart shaped to me. However, I was told it was fine.

She also drinks very noisily, and I wondered if she had a poor 'latch' as it were...

Thanks mawbroon- no, she was bottle fed from birth.

I had seen the first link but not the second, very interesting.

Do you think the GP and HV could be wrong? If so how do I go about getting it properly assessed?

every chance they could be wrong!!

some info here

I would suggest you contact Milk matters who I linked to, They offer a virtual service to help identify tongue tie.

Bloody hell mawbroon- this excerpt from your 2nd link describes DD to a tee!

The mother described the infant?s following feeding scenario.
Her infant experienced prolonged feeding, during which
time the infant clicked (released or lost suction). This was
followed by gagging, crying, and reflux. She was unable to
hold a pacifier in her mouth, and had been placed on a milksubstitute formula because the pediatrician felt her crying
and gas were due to formula allergy. The infant had been
prescribed Prevacid (lansoprazole) -for us it was domperezone (sp). However, the mother had
not begun using it at this time

Alternatively, your local hospital with a maternity ward may have an infant feeding specialist who may have the training to check in real life (I say 'may'...). Your HV can refer you - show her the symptom list mawbroon linked to and tell her you need a second opinion. It sounds pretty text book to me.

I bloody LOVE you two.

DD was born at UCH, so in theory I could ask about a referral to somebody there... I am going back to the HV and I'm going to go MENTAL. In a good way.

This has been going on for months; MN at its finest.

THANK YOU

Most welcome!

ds1 is 7 and we went through the mill with undiagnosed tongue tie.

I would suggest that if you possibly can, you should go private to one of the two dentists in the UK who trained with Dr Kotlow (who I linked to earlier)

ds1 had his done at the beginning of this year and it wasn't done properly (common!) and we had it redone last month. The incomplete revision cost a fortune as it was done under GA (now know that this is not neccessary) and the second one cost £250 and was done under local.

There is a really good tt support group on facebook if you want to read of people's experiences

and you're welcome, glad to help

Have you tried going up a teat size? Your dd may need a faster flow and be getting frustrated which may be why a feed is taking a long time and she's hungry quickly after

Right, I will go and see HV again on Monday, armed with the list. I can't afford to go private unfortunately. If no luck there, I will go and see GP again.

She's on the largest teats already, Eagle- I did think that might be the problem though.

Since you're in London there must be somewhere NHS-wise that can get things sorted. If you don't get anywhere with the GP, I wonder if it might be worth contacting The Breastfeeding Network or La Leche League to see if they know of any decent NHS practitioners or even if they have any volunteers locally who are hot on tongue tie (many are) who might be able to help.

Thanks again