?possible silent reflux- but also on comfort milk for constipation- plus irregular bowel movements - im confused what to do.

[Tiredemma]

DD is 5 weeks old. Really irregular bowel movements from birth and was extremely constipated (was on Aptamil 1). Gp prescribed lactulose- initial poo would remain hard like (plasticine consistency) but would then come through quite loose. I could however hear the milk literally 'hitting' her stomach and she would be constantly writhing around in pain.

HV suggested trying with Comfort Milk - initially this was all very good-

Now however I am concerned about the following-
DD remains irregular with bowel movements (every two / three days) and appears to be really straining to poo, however when she does poo its quite liquidy in consistency and tends to come through as an 'explosive fart' if you understand.

She is really 'windy" (very farty)

on occasion she will bring up an entire feed - this strangely tends to be her 7pm feed. I dont know why.

she hiccups a lot,

she spits a lot - especially after waking up.

Ive looked up silent reflux on the internet and she seems to have a fair amount of symptoms.

My quandry is now not knowing what milk is best for her. I dont want to take her off the comfort milk and put her onto anti-regurgitation/reflux milk in case I re-introduce the constipation?

My other concern is obviously her minimal bowel movements and then the explosive farts- I suppose im concerned about a greater underlying concern? (but I dont know what this is?)

I have my 6 week check next monday so will discuss this with HV and GP then, however just curious as to whether anyone else has had any similar experience and if they had any advice.

I haven't had a similar experience but didnt want you to go unanswered.

one thought that occurs is possible cows milk protein allergy. what do the nappies look like? any green? is dd in distress or happy? if you think it could be this, you could try buying a tin of nutrimagen formula and switch dd for a week and see if it helps. if so, you can get it on prescription.

Another possibility is simply that she is taking in a lot of air when feeding. I don't know much about ff but have you tried burping her regularly during a feed (every few oz) and also holding her upright during and after a feed to let her burp. anti colic bottles might also help...?

hopefully more knowledgeable people will be along soon!

Thanks for replying. Nappies are very runny and a mustard/ green colour. She is very windy.

I've just read a bit about cows milk allergy and interestingly, just over the past two days she has started to get dryish skin over her face/head.
She sleeps well but on reflection when she is awake she is pretty miserable.

I burp her each oz that she takes and have raised her bed 45 degrees.

Have direct experience of this as my dd was hospitalised with it.

Keep her on the constipation milk, however you could do with seeing a dr for some infant gaviscon.

If that doesn't work you need to be asking for ranitidine, reflux presents symptoms of intolerance and allergy.

Suppositories went a very very long way in helping to solve the issues with the reflux, being windy and backed up made things much worse

Feeds need to be little and often, not huge feeds every 4hours as it is to heavy.

Ps. The best bottles we found are mam ones, the teat seems the best out there and we literally tried them all. For about 6 weeks she would only drink from hospital teats..

Thanks for this, I have started 'breaking up' her feeds instead of giving it to her all at once.

Hi,

That sounds almost exactly like my DD was. She was diagnosed with reflux (the messy type) and was on Domperidone and Ranitidine, however that never really made the tummy any better.

Finally we discovered several food intolerances that really affected it, the main one being wheat, although others included bananas and broccoli and one mystery one that still remains that causes severe rash like nappy rash even though she is potty trained.

In the early days Osteopathy gave her, and me, some relief, as did very gentle massage ( as long as it wasn't near her sore tummy) and keeping her upright (I used a wrap type sling thing) I bf so cannot help with the bottles, although I have heard Dr. Browns are the best for colic and windy ness relief.

Hope she feels more comfortable soon.

Has the GP mentioned the possibility of Hirschprung's disease? It's a condition affecting the nerve endings in the bowel causing constipation from birth.

I would want to get a paed referral to rule it out, personally. My DD has issues with constipation that weren't as severe as your baby's, and she was investigated for it (but didn't get to the stage of needing a bowel biopsy, thankfully). It just seems wrong of the GP to blithely prescribe Lactulose to a newborn without investigating further. A newborn shouldn't need laxatives.

If it was hirchsprungs she would have solid hard poo all the time. My dd had bowel biopsy for it, and botox injected into the sphincter.

Alot of reflux issues are worsened by the lack of consistent emptying of the bowel.

Oh is that right? I must say, the surgeon we saw was very interested in the frequency (or indeed lack of frequency) of bowel movements in the days and weeks following birth, rather than the consistency of the stool.

Sorry I was rush typing. Definitely frequency or lack is a huge factor, dd is diagnosed with symptoms of however noone can put a finger on exact name.

Reasons for our investigation was / is because dd is unable to push poo out by herself regardless of 'texture'

Ive just got a GP apt for tomorrow morning.

She was very uncomfortable in the night- once she goes off to sleep she is ok, but prior to that is loads of 'straining'. I cant work out if her straining is trying to cause a bowel movement or if its trying to force wind up.

Very distressing to see.

tiny- are your DD's movemnets any better now?

She has ridiculous amounts of lactoluse every day, suppositories on occasion. She is very late to weaning as she has alot of other issues aswel and we think she has allergies.

You may be advised to offer her cool boiled water, I would strongly advise against it if she is diagnosed with reflux, water made my dd even worse.

I have noticed that if I try her with some water, she literally recoils and gags and then I worry that she will vomit.

Silent reflux is like heart burn, for some reason water makes it worse. I had it terribly when pregnant and it would make me gag

I would ask for a trial of aptamil pepti. Symptoms sound very similar to how dd 2 was. The milk solved it pretty instantly tbh although vowel movements took a couple of weeks to completely sort themselves out. Dr sis mention diligent reflux but tbh i would rather try a milk than shove medication down her neck just to make it tolerable. Beg if you have to. I told dr that if it didn't work I'd not ask again but please just let me try.

Changing milks regularly cause more harm than medication which is proven to actually help.

Do you know, the more I read about Cows Milk allergy the more I am convinced she has delayed symptoms of it. She looks like she has excema over her eye sockets and forehead today.

and really gassy/windy. Straining for ages and then just breaking wind.

is peptil really £24 a tub???? (just seen on internet)

Obviously I am not a dr and can only go on the experience I had with dd.

She was given a milk called nurtimigen and then another called neocate.

It could help your dd but what you describe is reflux imo

Dry skin at 5 weeks is very normal, dd1 had it all over extra virgin olive oil helps.

Thanks for your help.

Will see what GP says tomorrow.

My dd is 9 weeks today and was exactly the same I would say scrap the comfort milk and get gaviscon with normal milk and give a little boiled water between feeds to help her poo

Does she have black eyes? Like she's been punched in the face?

no black eyes, no.