6wk old & reflux bf baby - any other thing I can do?

[Wishiwasanheiress]

Hi, dd2 is 6wks. She vomits after feeds (bf), if moved, if changed angle, if seemingly after anything.

We have been prescribed ranitidine at 0.06ml x 3-4 times a day. It worked at 0.05ml for a few days then stopped. Apart from taking it as suits in a day I've no other info, GP rather clueless it appears. Is there a trick to it I'm not doing? (You try measuring this out in a syringe! Not easy!!!)

We have angled wedges in cot & Moses. Is there anything else I can do?

When will this stop? It's extremely disheartening. She makes a straining noise alot which sounds like pain, I'm sure it's her tum. Feel so sorry for her. Im combining it with infacol which has helped wind. Dunno what else to try.

Any ideas gratefully received.

Afraid I don't have miracle cure but wanted to answer as I know how hard it can be. My first DD had reflux. I spent a very long time in the early weeks blaming myself, also bf, and being convinced she'd be better off on bottle as She was so uncomfortable after feeds and forever throwing up....serious projectile! She refused a bottle thoug so was stuck with me!

You are already raising bed etc which should help. Other tips;

• don't plan to rush anywhere after a feed (it's not worth it!)...keep her upright for as long as possible.
• she may prefer outdoor naps in a upright carrier, like a Bjorn, than a pram.
• don't be too attached to your soft furnishings...there's only so much projectile vomit they can take!
• don't go out without ample supply of muslin clothes for occasions when it spills out of her

-we were advised to give our DD a dummy to help ease the trapped wind. Unfortunately she refused to take on but it may help you

• get used to other people not really understanding that it's different to normal possetting. They are in pain as acid reflux burns on the way back up.
• try to feed in as upright a position as you can manage

I can't really remember when it got better! It was such a struggle with us, being our first. I think we got better at dealing with it quicker than it actually improved itself. I do know that I was very glad when she could sit up and eat proper meals. She is now 3 and certainly has no food issues ( eats like a pig!)....but does have a sensitive gag reflex!

Sorry can't be of more help. Good luck.

My lo reflux has started to improve-19 weeks. The sphincter in tummy is not mature enough thus allowing food contents to reflux. Seemingly once they are able to sit upright it improves. Baby massage can help too if tummy is tense

Hi!

Sorry your going through this too.

We are (fingers crossed) staying out of hospital this week. My dd2 has severe acid silent reflux. Same as normal but shes not sick.

You need the following to get any kind of diffrrence in your baby...

Omoprozole 10mg (if over 8lbs in weight)
Gaviscon sachets to help keep milk down, they can be used in breastfeeding.
Domperidone - helps clear the stomach quicker thus leaving less to be sick with.

Dont mess about waiting, seriously.

We have got this far and dd has been hospitalised twice, last week was in for 5 days!

If all of the above still leaves severe symptoms of reflux you need to go to a paediatric consultant and discuss a potentional cows milk protein or lactose intolerance, most reflux is a symptom of another problem i.e intolerance.

It turns out my dd is all of the above on a very severe scale, I would not wish on anyone! lac

Hello there wishiwas, just to echo what's already been posted that it sounds like you're already doing a great job with all the positioning stuff so... Time to get more drugs on board!

Domperidone was life changing for us, my DD was a "happy chucker" in that she was never whingey/uncomfortable but could make an amazing vomit fountain. Domperidone stopped all that over the space of a week, she still has a v sensitive gag reflex and if she gets a cold the attendant gunge tends to mean pukesville again. But by and large she's fine now and steadied out onto the 25th centile rather than the 9th

Our HV said most babies grow out of it by 6 months and it does improve a lot when baby is sitting/standing more - this phase won't last forever and you won't always have to do this much washing...!

Your ranitidine dose sounds homeopathic. What does she weigh? Dose is 1-3 mg/ kg 3x a day of a 15mg/ml solution, so for a 5kg baby would be 0.3-1ml per dose. Ranitidine suppresses acid so should help with pain but will not limit the amount of reflux.
Highly recommend a book called Colic Solved by gastro paed Brian Vartebedian.

My sons have both suffered from reflux, the eldest was on domperidone and ranitidine for about 10 months which helped and the youngest is currently just on ranitidine although we may have to introduce domperidone soon.

I just wanted to say that 0.06ml is a very small dose - do you mean 0.6ml?

Also Ranitidine (and Domperidone for that matter) is weight based so you need to get your baby weighed fairly frequently and the dose needs to be adjusted as their weight increases, otherwise it will become ineffective.

Did you try infant Gaviscon first? Bit of a faff if BF but might actually limit the vomiting.

Yes get the book its brilliant, by the 3rd page we knew it was about our dd

Yeah I'd say mines a happy chucker too. She's gaining weight so GP not that worried. He doesn't have to listen to the pain though....

Thanks for this. Will investigate.

It's under 1 on in the syringe. Unsure.

Shes 5.03 kilo, about 11lb just over...

Weighed yesterday at our 6 wk check up. Thanks guys really appreciate the help here....

Ranitidine is a dosage of 1mg-3mg per kg up to 3 times a day. So for your daughter, a minimum dose of 5mg and maximum dose of 15mg. The medicine itself is in a concentration of 150mg/10ml (you should be able to check that on the bottle), so to work out the dose per ml you need to divide by 15.

So your daughter could be on a dose of between 0.33ml up to 1ml, three times a day. Obviously check this with your dr though - I tend to work out the dose each time my son's weight changes and then ring the dr's to get them to verify it. He's 13lb at the moment and currently on 1ml, three times a day.

We found the timing quite important too - Ranitidine seemed to be most effesctive if we give it about 20 minutes before a feed.

With my eldest son, domperidone did make him a lot happier though as the poster above describes so you might want to discuss that too with your dr.

It is a nightmare, as we're finding again with baby number 2, but it does improve all the time as they get older. That's what I remember from last time, this is probably the worst period for it.

Realised after I'd posted this that BakingTins had already calculated it for you. At least I know my maths is ok now though!