A 'solution' for my DS's reflux?

[ToTheMoonAndStars]

Ok. My DS has reflux. He vomits after almost every feed. He is EBF. I'd say about 1.5oz of milk comes up between each feeds on a bad day. He will never not vomit between/after a feed.

We have been to the doctors several times. They don't seem to care much. He is on gaviscon and ranitidine. The gaviscon does nothing! The ranitidine helps in that he isn't in pain when he vomits, so that's good. I have been dairy free for 2.5 months as we suspected a cows milk allergy. I'm not convinced as it didn't change much. Scared to have dairy again now though.

He was between the 50th and 75th percentiles when he was born. He's now 16 weeks and has dropped to below the 25th :-( the doc and health visitor don't seem bothered as it's not quite 2 percentiles he's dropped, so according to them he's fine. I feel sure that if he didn't vomit as much then he wouldn't have slipped.

When he feeds he has started groaning and crying. He latches on and off, nibbles away and often cries when he comes off. It's not pleasant for either of us.

I'm not really willing to just keep going the way we are and wait for him to drop the full 2 percentiles, it seems unfair on him. So I am considering a few options to try and would love some feedback if anyone has gone through this before.

1. Try him on a regular anti reflux formula.

1. Persuade the doctor to prescribe a hypoallergenic formula.

1. Begin giving him small ammounts of baby rice to help him keep his milk down. (Would this even work??)

It could be that none of these options would work, but I'm at the end of my tether. I want to bf him but neither of us enjoy it and it's so upsetting to seem him vomit so much after each feed :-(

Any words of wisdom grateful received. I'm desperate!

And I meant to add ( I know it's an essay already!!!) that it's not just a laundry problem as helpful people keep telling me .

He can't do tummy time because he ends up with a faceful of sick and sitting down also makes him vomit, his bumbo, swing etc. All he wants to do is stand up and stretch out his tum. It can't be good for him to find these things so uncomfortable.

I'm so sorry you are going through this, have had children with reflux and haven't found a magic fix for any of them although have seen some improvement on ranitidine with one. Sympathise with having to hold baby up and nobody interested unless 2 centiles....the work you are having to do just to keep the weight as it is! Has anyone suggested you try carobel? Can be mixed with ebm and given on a spoon, holds stuff down but doesn't cause constipation like gaviscon. Also just check the ranitidine dosage is right for baby's current weight. Would steer clear of the antireflux formulas as they aren't dairy free and also can be quite constipating. Dairy free formulas can be very thin and come back up quite easily. No formula IME is any use for reflux unless there are multiple allergies or you are needing a break.

One thing that did help me was to stop looking for the magic key, batten down the hatches and look after myself a bit - that did mean one bottle per day, getting milk into baby whenever possible (lots of sneaky feeds at the end of a nap, forgetting any sort of schedule and putting less pressure on myself re extending their sleep during the night), getting breaks from the baby. Four months has been the peak of reflux with each of my children (and I think this is supported by research). It is onwards and upwards from here I promise. The vast vast majority improve with sitting up and solids.

Thank you for your reply :-) it's interesting to hear it peaks at 4 months, it really feels like it has!

We are lucky that in himself he isn't unhappy. He gets uncomfortable with it but no more so than any other baby does with wind etc. It's just not very nice, and he isn't putting on the weight he should be. He only gained 5oz in 2 weeks :-(

Carobel sounds interesting. Can you give it easily enough when breastfeeding? How does it work?

I think for my own sanity and his weight we will give a bottle a day, just get the calories into him to make up for what he vomits up. Did you give expressed milk or formula?

We don't follow a routine for feeding at all so that's ok. He feeds every 2/3 hours and still feeds frequently at night.

There is definitely a part of me that sees sense in your 'batten down the hatches' mentality. Looking for the 'cure' is taking its toll on us all!

Hello so glad to hear he is not unhappy with it. Does he have any other symptoms of dairy intolerance? Usually babies with allergies are a bit miserable, one of mine was dairy intolerant so he was EBF with me dairy free and the last feed of the day was a bottle of expressed milk. Another of my children was mix fed with comfort formula and I did not go dairy free, not sure why but he seemed to take the comfort milk better than other formula. I think it is because it came out of the teat slower. I don't know if you have tried bottle feeding him before but if you do make sure you go for the slowest teat as the faster it goes in the more it seems to bounce out, I certainly notice a lot more vomiting if there has been a lengthy gap between feeds and my letdown is fast.

There is no guarantee that he will not bring back the formula or EBM, and if there is a dairy intolerance then he will be a lot worse on formula. For me the bottle was a break, allowing me to go to bed early and get a bit of rest from the constant holding upright, it had no benefit to the baby except an ever so slightly less exhausted mother.

I don't know if your baby is still on gaviscon but I stopped it when starting ranitidine, as I found it constipated my babies thus making reflux worse. Carobel is given in the same way as gaviscon for breastfed babies, mix with a little expressed milk on a spoon before a feed. Does upset some babies stomachs though. It sounds like the only other thing you haven't tried is omeprazole, again this did nothing for mine and has some full on side effects. I don't think its really worth it if your little one is not unhappy.

I have done a lot of research into this including reading medical papers and there is no good evidence that thickening milks, ranitidine, omeprazole or any of the stuff works well. I think one study showed inclining cots and putting babies on their stomachs (!) worked in 30% of cases, but gaviscon made no difference from the placebo group. This helped me to stop looking for answers and just take things day by day. As you know some feeds are awful and they bring a lot back and you feel tearful because you're going to have to feed again really soon. When that happens I try to think - the next feed will be different or tomorrow he will probably be a bit better rather than getting worried about weight gain etc.

My daughter had reflux although it doesn't sound as if she was as bad as your DS. I also found formula made it worse though we have later discovered a dairy intolerance which is probably why. If you can express, that may be the best idea - we used to give an expressed bottle as last feed of the day too. Quite often took a break during feeds to burp and give tummy a chance to settle.

I found the gaviscon did help to keep the vomit down a bit but she still seemed very uncomfortable and didn't like lying flat. She improved almost as soon as we started weaning - which was maybe a week before 6m. We also struggled with her weight in the first few months but now she's a chunky little toddler so there was no lasting damage.

I hope you find something to help as it's not a nice thing to go through.

You could try buying a tin of aptimil pepti formula and trying that for a week. It's not totally hyper-allergenic though.

BTW 50% of babies with a dairy allergy will also have a soya allergy so if you are dairy free but still having soya try cutting out soya.

OP my dd is 18 weeks and EXACTLY the same as your ds - ebf and projectile vomming ALL the time (she's up to 60-70 times per day). I've also heard the 'laundry problem' line and it drives me mad because, like you say, it can really limit their quality of life. It's also soul destroying being on puke-watch 24/7. My dd's weight and growth stalled from about 13/14 weeks, and we'd tried meds, holding upright, blah blah blah, and two weeks ago the GP suggested we try and get her to go longer between feeds. She said they can get into a cycle of feeding, getting the reflux/pain/vomiting, then feeding again soon to try and soothe the initial pain, but causing more reflux, pain and vomiting as a result.

I didn't really think it would work but we've been leaving a minimum of 3 hours between feeds (unless she's clearly thrown up absolutely everything she's taken in) and overall she's been less sicky and has very quickly put on weight. The GP said to try a dummy as well when she's got reflux pain and we did the first few days, which really helped. As well as being less sicky now, she's definitely getting a lot less pain throughout the day. I was dead against dummies, but having tried one alongside spacing the feeds a bit more, I'm really happy with how much it's helped dd. Hope things improve for you

I really sympathise as Dd had silent reflux really bad for what seemed like a lifetime. She would fuss and cry 90% of the day and feeding was a nightmare. Doctors and Hv didn't show much concern either, I think they don't know enough about reflux to make decisions on what might help baby I basically got told by up that I was just an anxious gym. She is now 6 months and doing great. Things improved after gradually switching to formula I know breastfeeding is best for baby but when it's stressful for you both its no good. I also started weaning early on porridge ( rice made her constipated) at 16 weeks. I hope you find something that works for you but I think the main thing is time baby will develop and grow out of it and all you can do is try everything you can to help them through it

JoJo when did you switch to formula and why do you think it helped the reflux? I'm asking as I wonder if switching would help dd but keep being told 'breast is best' instantly, like nobody will even consider the possibility it could help. Makes me wonder

when did you switch to formula and why do you think it helped the reflux?

I am not jojo, but I sometimes think that the excessive crying that is put down to 'silent reflux' in babies, is actually often crying due to hunger and/or overtiredness. So formula helps because it is easier to give extra formula feeds so that baby isn't hungry (easier than it is to increase supply when breastfeeding).

I believe it isn't that formula solves the reflux. More that hunger was being mistaken for the pain of reflux.

I am a Mum of four who should know better and I look DC4 to the doctors aged around 3 weeks because of excessive crying. Doc gave me baby gavison and an 'answer' to the crying in the form of a reflux diagnosis.

It was only because I have the benefit of experience that my sensible head kicked in and I realised the crying was down to hunger. I fed DD though it - breastfeeding all the time to increase supply. It worked, 'silent reflux' was not more.

Nine weeks later (when DD was 12 weeks) the excessive crying and poor sleep returned. I could easily have just put up with the baby's upset and put it down to a reoccurrence of the reflux (since I did have a diagnosis). But again I knew it was down to hunger. This time rather than breastfeeding through it I started mix feeding.

Oh hi FATE waves from Sept postnatal thread

That's interesting about crying and hunger. I'm pretty sure in our case dd isn't hungry. Her reflux doesn't manifest as excessive crying, but constant vomiting and pain after feeding. She cries if she's hungry but that's a different thing from the reflux...

I haven't read the full thread but my DS had this and it was definitely related to his dairy intolerance. I didn't have dairy in my diet but he had top ups from standard formula (I couldn't fully BF for a number of reasons). Within 24 hours of swapping to Neutramigen for top ups the reflux stopped, it was extraordinary. I had an amazing GP who prescribed the Neutramigen straight away which made all the difference.

My baby suffered from terrible silent reflux/dairy intolerance so I sympathise massively - but it does get better. Reflux can either be stand alone (which can then be exacerbated by various things like teething, certain foods, vaccinations) or a symptom of an underlying intolerance, such as to dairy. Unfortunately, it really is a matter of trial and error, and it therefore sensible to try and make only one change at once, so you can work out what is going on. Have you tried eliminating soya from your diet? Quite a lot of babies who react to dairy also react to soya so that could still be triggering a reaction.

For us, the best option solution was switching from breast feeding to Neocate at 6 months and the screaming stopped within 24 hours and she started to put on weight again (having dropped to below the second centile). The advantage of Neocate for us was that it is totally hypoallergenic and doesn't contain any traces of cows milk protein so is a totally neutral base, whereas it was really hard to gauge what she was reacting to whilst I was feeding. Neocate is expensive though, so most GPs like to prescribe a formula called Nuetramigen first as it is cheaper as the cows milk proteins are only partially broken down. Some babies still react to it though (like mine).

The other avenue to pursue is whether there is any medication which would help. My baby went onto omeprazole (an anti acid drug) which really helped her.

Good luck!

I hate to say it but in my experience there's no solution for reflux except time...it will get better.

My experience is similar to yours, my now 18 month was 9lb when he was born but gradually dropped down the growth charts and was an extremely poor feeder. I found raniditine helped him settle more but it didn't solve the underlying problem. He was bottle fed from a few days old but he took two or three sucks of a bottle, arched his back and pulled away.

Your little one is 16 weeks, I was advised to wean my little one at 17 weeks by the hospital and things definately improved then. He still vomits quite easily, for example, if he has a cough he'll be sick so there must still be a weakness there.

I know it's too early for you to tell but I would also say that my little one has, and I think always will be a small eater, so don't be suprised if that happens to be the case for you too.

It is extremely stressful but with time i have learned not to fret. As long as your child is meeting the developmental milestones, try not to get wrapped up in growth charts. One other bit of advice I got from a book called, my child won't eat, was that genetics have a role to play. My husband had reflux as a baby and was always the smallest in his class till he hit puberty, now he's a sizeable 6 footer.

You have my sympathies, just keep hold of the fact that this will get better.

My dt2 had silent reflux and screamed in almost constant pain throughout the day. It is tough.

As others say it does get better. Once they sit up it gets so much better.

In her case it is a milk protein intolerance which was bad on BF but got worse on mixed feeding. So you could try cutting out dairy- but only do so for a short time, if it doesn't work, go back.
We also got omeparazole prescribed by a consultant who said to start weaning at 17 weeks and Nutramigen for bottle feeds which made a massive difference over normal formula (switching between the two made it obvious what the problem was).

she had a dummy- this also helped a lot.
and a gap of 3 hours between feeds- as otherwise she was just overloaded and in pain all the time. she was not hungry but would 'comfort feed' and made it all worse. so the dummy helped with that.

I also got a breast feeding tea from the herbalist, which helped a bit.

also the usual- slant the mattress, try to keep them upright as much as possible- she liked being in a car seat although some babies do not as they slump. its trial and error. she often had to be left to cry herself to sleep as that was relatively quick compared to rocking which made matters worse and just prolonged it

If it is a dairy problem they usually grow out of it although mine has not.

Omeprazole (Losec) helped my son too. He's still on it at primary age. The gastro says it has a very good safety record for long term use in children. He went on it at 7 months, but only because he only started to be properly investigated at that time.

DS fed more calmly from a bottle than breastfeeding, but perhaps as much for controlling flow reasons than for the content of what he was drinking. We tried a load, and in the end he went onto Neocate for about a year, although it was never fully concluded whether or not he had a milk allergy. (His gastro thought not.)

We also used 'Thick and Easy' from around 5 months. I think this is corn-starch based thickener. It was under the direction of a paediatrician / dietician anyway, so obviously ok at that time for that age.

Ds was much calmer when he learned to suck his fingers at around 4 months. Agree that otherwise a dummy could help, if it's not too late to introduce one.

My son was unusual in that he liked lying down, so can't help with tips on that. Would say though that for him, Losec was/is something of a wonder drug.

My DS has gord. Sorry I haven't read the whole thread but things that helped us are omeprazole when ranitidine wasn't working well enough he's been in a lot less pain since starting omeprazole, dairy and soya free diet for me when bf but now we're on neocate formula. Weaning absolutely doesn't help at all, he chucks just as much with solids as milk so I wouldn't bother with baby rice. When he reached 6 months or started sitting hasn't helped either. Now i'm hearing it'll be better when he turns 12 months. He has never tolerated a bumbo seat but the babysitter balance has been fantastic and now he's older the jumperoo he loves and keeps him upright without his belly being squashed. antidepressants for me it's been unbearable and you have my empathy. Gaviscon does absolutely nothing but we have to use it because if we don't when it's bad the dr's just say oh yes gaviscon that'll help

Has your GP suggested domperidone? We used that for DS alongside ranitidine and it seemed to help. I believe it encourages the stomach to empty faster so less likely to vomit.

Id forget the gaviscon, all it did for DS was make him constipated and he still vomited!

We also had Aptamil Pepti prescribed from around 7 weeks due to suspected dairy allergy. BF didn't work out for us for various reasons but DS had expressed BM from birth to 6 weeks old, gradually replaced with increasing amounts of regular formula as my supply dwindled and the reflux seemed to get worse as the regular formula increased. The prescription milk seemed to relieve it though although at 16 months he was tested for allergies and doesn't have any (although the paediatrician did say he could have grown out of an allergy by this point) and we are now introducing dairy.

I don't think there is an easy solution, its all trial and error. But its also not a constant and controlled situation and I think that even if you think something is helping, its not always the case and there might be another factor. You just have to keep trying things and trusting your instincts.

All I will say though is that I know how hard it is to have a baby who is constantly in pain/uncomfortable/clingy/screaming etc etc and I feel for you. I dread ever having to do that again

Hi hun, I am new to Mumsnet but often post about this issue on another forum. My LO is nearly 9 months and ur story reads a lot like ours. I stopped BF at 4 weeks as i was losing the plot with the constant feeding and sickness. started on Aptimal, then had the same weight loss issues and constant sickness. Tried, gaviscon, ranitidine and omeprezol, but still constant screaming,12 hours a day and reflux. At 12 weeks after feeling like i lived at the GP surgery, we got a stool sample test and referral to dietician, with suspected CMPA. LO went on Nutramigen and after a week became a different baby. Happier smiling and laughing away, started gaining weight and after 2 month got back up to his born range at 75th percentile. Reflux is still an issue but knowing he is not in pain I have learned to live with that, he is crawling and on solids so its super messy but doesn't both him it's just means a lot of washing! He is still gaining and GP said we will investigate further if it doesn't stop being sick when he starts walking. We r still under a dietitian and are still dairy free. Unfortunately it was all trial and error with us but forums like this are fab to get help and support, good luck xoxo

We put our 9 week old on aptamil anti reflux formula a couple of weeks ago, and that combined with the gaviscon and ranitidine has really helped, but not solved all the issues so we insisted on a referral to a consultant paediatrician. We saw her today and she prescribed Nutramigan which we're praying will help.

My DS had a nightmare with reflux too. When he was very small we found that baby massage helped to ease the tummy pain a little but gaviscon and similar were not effective at all.

However, he wasn't really any better until he was on full time solids. We had a prescription for hypoallergenic milk powder which we used from 6mths - 1year and then we went on goats milk - I think you can get a powdered form of this too.

We didn't feel we ever got to real grips with what the matter but it was better by the time he was 1.

Sorry to hear this - we had this and went through the list of options, going through "sleeping" propped up, gaviscon, ranitidine, lansoprazole, then anti-reflux milk, then Pepti Junior, rice powder etc. Nothing made any real difference and then he started getting eczema, asthma and was totally miserable - on all those meds, plus inhalers and covered in countless creams and steroids. Was a really tough and sleepless year so I sympathise...

The only thing that worked was putting DS on a milk, egg, wheat and soya free diet with the support of an allergist. Within 3 weeks, he was like a different child. Don't know how old your DC is, but please do consider insisting on a referral to an allergist and pursuing a dairy-free diet. Hope you're getting some sleep and things improve for you soon.

Hi Tothemoonandstars, we went through all of this and whilst it was 7 years ago, I still remember- just how hard it was. What worked for us was:
-Stopping Gaviscon (constipation issues making reflux worse)

• Omeprazole (Losec) - under advise of gastro paediatrician
• Introducing Nutramigen milk
• Propping cot up
• Putting my son to sleep on his tummy.

We did discover that he was allergic to cows milk eventually but by the time he was 18 months, his tollerance had improved and now he eats dairy every day!
From a personal point of view I would do as a poster above said and take great care of yourselves while you make the changes. It does get better but I would urge you not to wait it out. It's awful for the whole family and literally within 2 weeks of changing the milk and introducing omeprazole, we had a happy, smiling baby. Prior to this, he screamed throughout the day and night. Best of luck with it all and huge hugs xx

I'm pretty sure my DS has reflux (of the silent variety), and am really unsure what to do myself.

Does anyone know where you can get Nutrimagen from without a prescription? My GP scoffed at the idea that DS might have CMPI, so I can't get it on prescription.

Also has anyone found that the symptoms are not always consistent? We tried Gaviscon and ranitidine at around 3 months, and didn't see any improvement. However, he then improved without any medication at around 4 months, but now at 5 months seems to be back to difficulty feeding (arching back, only a couple of sucks from a bottle at a time and only taking 2-3 oz at a time).