Silent Reflux

[jojomama1507]

anyone had any experience of silent reflux? My DD is now 10 weeks old and we have been having feeding problems since she was about 3-4 weeks old. I initially thought it was just colic and may pass by around this age, but this week her symptoms seem to be getting worse. She grunts and cry and draws her legs up in her sleep and when I feed her she feeds for a few minutes then pulls away arches her back and crys, she gets hicups all the time and will suddenly start crying in pain throughout the day usually after a feed or half an hour after. I have looked all over the internet as all Health professionals have not really understood me and suggest she may be hungry or just a phase of colic. She is bf and FF (has a top up as last feed) she prefers to sleep upright and hates being put in her cot to sleep. I am going to see the GP tonight but worried he may not see any problem as she is a healthy baby and gaining plenty of weight probably due to all the comfort feeding ! any advice or people in a similar situation ??

Sorry I don't have much to offer but I'm interested in what anyone else has to say because I think my DD (3.5 weeks) might have silent reflux too. In fact, we went to a cranial osteopath yesterday and she suggested it as a possible issue. I ended up having to feed DD in the osteopath's office so she saw first hand what feeding was like and suggested it then. So obviously i came home and googled silent reflux symptoms and it describes DD2 to a tee. Does your DD go stiff when you are feeding her? It's a nightmare at night because every evening it takes an hour and a half to settle her all the while she is crying and screaming, then when she wakes in the night, it's not just a quiet night feed, it's an ordeal for an hour at least. It's made even more difficult by the fact that the crying is waking up DD1 as well so we were up twice in the night with her last night too. So if anyone has any magic tips, I'd love to hear them and I feel your pain OP.

Yes, DD1 had silent reflux. I would recommend filming a feed on your phone to show the GP and HV. We found that was most effective. The GP was quite shocked at how bad things were. She started screaming after just 1oz of formula. We were never able to get her to take more than 6oz regardless of how old she got. 4oz was as much as she would tolerate even on medication.

If the GP agrees it is silent reflux, you will likely be offered Gaviscon. We had to see 6 GPs over 8 consecutive days to get medication. Do not give up! Gaviscon is a PITA and am seems to constipate babies without helping the silent reflux. It may be useful for reflux. You are likely to then be offered Lactulose to help the constipation. Try to avoid all of that by asking for Ranitidine. It works. However, it is not licensed for babies and some GP are twitchy about prescribing it. The dosage is based on weight so your LO will need weighed once a month. There seem to be 3 dosing levels too. If it doesn't work after a week, ask to try a higher dose. You may need a referral to paediatrics.

Keep your baby upright as much as possible - a sling like a stretchy wrap is great in the early days. We used a Kari-Me then an Ergo when she got heavier. Prop up the end of the cot/crib. Join the littlerefluxers.co.uk forum - you'll get lots of great advice there.

Consider it may be something else - CMPI or TT?

Hugs, OP. It's such a hard road. You will get there though.

I second the ranitidine recommendation. Baby gaviscon is a nightmare for bf babies. Ranitidine is a much smaller dose and works to neutralise the acid in the stomach as I understand it, rather than just thickening the contents to stop it coming up which is what gaviscon does. I had to tell my GP it was silent reflux and tell him to prescribe it. Luckily he was amenable but as PP says, some won't.

Thanks for the advice guys its really helpful to know there are others that understand. Feel like I'm going mad when I take her to the GP and he says there absolutely nothing wrong with her. He did however prescribe gaviscon which we have started taking last night. It was a nightmare and has made no change in her yet I was hoping for the ranitidine but will probably have to ask for it. Worried about using the Gaviscon as she rarely has bm and doc previously prescribed lactulose which i got rid of as I thought it did more harm than good.

Hi Jojo, we got some gaviscon from the GP with instructions not to use it unless desperate as DD is already a bit constipated but I got desperate yesterday afternoon! Anyway we started using it and I have noticed a slight difference. Not masses, she is still in pain but it has made the feeds slightly less traumatic. However it has made her more constipated though!! So I'm going to see how it goes and if it gets worse, I'll head back to the GP and ask for something else!

FailedActress we used the Gaviscon Friday Saturday after having a terrible week. I stopped using it however as was worried she was constipated and could not see a difference, I have decided to just keep going as I was before without giving her anything and see how things go for a week or so before I head back to the GP !! good luck to you and your LO hope things get better soon

Thanks jojomama. I've just been back to the GP today and he has just suggested I up the dosage of the Gaviscon to a sachet and a half. I'm going to give it till DD's six week check up and then go back again if there is no improvement and ask for some other medication. Good luck to you too!

I took my DS to A&E who then did an urgent referral to pediatrician. Pediatrician gave lansoparazole and 2 weeks later, we had a different baby

At 7 months he was off meds and fine.

What worked for us was Ranitidine administered with a syringe and Carobel in DD's feeds. It's a powder thickener and it had miraculous results.

It would be interesting to know whether anyone has ever been helped by Infant Gaviscon, it seems everyone has to try it to endure another couple of days of misery before discounting it.

Good luck OP, silent reflux is awful.

It is awful and nobody seems to understand they all think I'm crazy. I keep getting told to wait a few more weeks she might improve but to me it just seems like she is getting worse and the longer I wait to get proper meds the worse she is going to get. Glad theres others out there in the same situation I am finding ti so hard at the minute.

Jojo, I remember that stage, and people think you are crazy, including sometimes your own DP. I remember, no one believed me. Even the consultant gave me medication very reluctantly, but they were all proved wrong (which reminds me, I must email the consultant and give him an update, he was lovely otherwise).

Sadly you'll need to fight for it. Can you ask your GP to give you an urgent referral to the pediatrician? Take your DH with you, they will believe him (sadly true). Insist on it, be firm and you should get it.

Otherwise ask your GP for lansoparazole, it's once a day, I think it was 1/4 tablet dissolved in water.

Jojo, if its any consolation, it will pass. My LO is now 15 months and is generally a pleasure to be around.

Yeah I took DP with me last time but he i'snt really as convinced as I am that its silent reflux, so wasn't much help! he tells me to stop reading stuff online and worrying myself haha but at the moment that's my only support ! I might take my Mum with me next time we go to the GP.

Jojo, don't worry, my DH didn't believe me either and didn't come to any of the appointments. He wasn't even convinced about his allergies despite it being blindingly obvious.

Carobel is magic stuff, sorted my dd silent reflux out, less constipating than medication I found.

I hope it gets better, it's miserable for all concerned.

My DS has reflux which developed at 2 wks old. My GP prescribed gaviscon and it worked for us. My gp says it has a cumulative effect so you have to persevere for a week to 10 days before you can see if it makes much difference (this time feels like forever I know!). I exclusively BF so it is a pain stopping mid way through a feed but better than the hours of screaming we used to get!! Now he is 16 weeks old he has 2 sachets per feed.

Initially the gaviscon did make it harder for him to poo (so I felt like I swapped one problem for another) but this only lasted a few days and then his body seemed to adjust to it. I ate prunes like mad in the hope it would help him.

OP another thought -do her symptoms vary after formula vs bf? I read somewhere that formula is slower (and therefore harder) to digest than bf so that might make it worse at night? It was enough to scare me into never using formula so I don't know for sure. I was already holding DS upright for 40 'mins after each feed so I couldn't risk it.
I echo other posts though - now the reflux is under control my DS sleeps beautifully and is very happy. Each week is a week closer to them growing out of it so hang in there. It is a horrible experience for both you and your dd.

I only give her one bottle of formula at her last feed so it is hard to tell really she sleeps well for the first half of the night wakes up for a feed and then seems really unsettled for the second half so this has made me feel like the formula isn't too bad, although as you say it is probably because it takes longer for her to digest. Thanks for the advise I may persevere with the Gaviscon before returning to the GP.

Have you tried eliminating all traces of dairy and soya from your diet to see if it might be allergy related?

Yes I am doing that this week not sure if it is though as she doesn't seem worse when she has formula.

Hi jojo
both my babies had bad silent(ish) reflux. The things that helped my kids are:

1. a wedge in the cot to raise the baby up at an angle so not sleeping flat
2. sleeping on their front (plus apnoea alarm as maybe concerns re sids)
3. OMEPRAZOLE - gaviscon was crap and only made them constipated, plus a real faff when breast-feeding. Ranitidine is ok but the only thing that really helped them was omeprazole. This is a proton-pump inhibitor which reduces the stomach acid so reflux is not painful, and works better than ranitidine. You'll likely need a referral to a Paediatrican for this as the gp may not be comfortable prescribing it. Only need to give once a day but is bit tricky to give as have to dissolve tablet in water before giving (tradename losec MUPS, promise i haven't got shares in it!) My dd was on it 3 months-9months after trying everything else, my ds has been on it since 1month (now 3 months). Brilliant stuff for my kids.
4. if you choose to bottle feed formula then Enfamil AR was our formula of choice as thickens when it hit sthe stomach. We mix with aptamil as find pure enfamil too constipating for my ds.

Obviously the above is only based on my 2 babies but thought i'd share as it was a long road esp with baby number one to get there and might help. Good luck, hope it gets better soon!

ps jojo forgot to say both mine gained weight at a perfect rate along 50% centile. They actually both fed hungrily at each feed, as the milk helps ease the acid burn. But each feed pre omeprazole was as described above that miserable fight with pulling on & off, screaming, stiffening (my husband described my dd as 'banana baby' as she would arch back so the back of her head was almost touching her shoulder blades in a 'banana' shape)

Thanks bete2 great advice! My DD has defiantly been a banana baby today can't seem to go 5 mins out of her! she wants to feed but just keeps pulling away and getting upset she has been in the sling or pram most of the day bless her back to GP tomorrow