Is this silent reflux? Something else? Please help!

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DD is six weeks old and very unsettled during the day. She's always been a bit like this but it seems to be getting much worse and I'm tearing my hair out now. Her symptoms are:

• screaming and arching her back during and after a feed. She's fine when she's sucking on the breast/bottle (it's usually expressed milk in the bottle) but literally as soon as she stops she howls. It makes it very difficult to end a feed as she always seems to want more. The only way I can end the feed is by giving a dummy which does often calm her down a bit, although she never properly 'settles'.
• this is then followed by endless bouncing and holding her upright in an attempt to calm her down, with varying degrees of success.
• she doesn't bring very much of the feed back up, particularly if held upright. She does have a lot of hiccups and spit bubbles around mouth though.
• She doesn't nap during the day no matter what I try, although she sleeps brilliantly at night for a six week old, usually following an overtired meltdown in the evening.

I went to the GP who quite clearly thought I was a hysterical first time mother and said it didn't sound like reflux as it usually happens some time after a feed not during. And because her weight gain is good. I said I'd read that large weight gain can actually be a sign of silent reflux due to comfort feeding (she's gained 400g this past week) and he gave a face...

Probably to get rid of me, he prescribed infant gaviscon which is really difficult to combine with breastfeeding and doesn't seem to have made any difference (GP said it would be instant relief if it is reflux).

Help me please! Should I go back and ask for something else or does the fact the gaviscon doesn't work prove it's not reflux? Is this just normal baby behaviour and I'm overreacting? Could it be something else?

Can anyone help?

Sorry can't advise on whether this is silent reflux but my dd is just the same and 6 weeks old today. Am shattered as she only sleeps for 2-3 hours at night, and only after 180ml of bottle after a good 2 hr bf.

Sounds rough. My 6 week old is similar but having been through it before my sympathetic GP let us go straight to ranitidine which helped DS1. Gaviscon is a huge pain with bf and did nothing for us last time except make him constipated.
Does she burl/fart easily? We started with infacol which helped that bit but bubbles, not lying down well and swallowing sick noises continued. Helped that he screamed through 6 week check when laid down!
I'd go back and push to try ranitidine- we have a month trial - if it doesn't help I'll stop it! It's a tough time anyway as mega growth spurt and fussiness. Hang on in there - it does get easier - keep having to remind myself of that too. This bit is relentless

gubbinsy yes we've been through all the wind remedies but I'm fairly confident that's not what it is, as she does seem to pass wind fairly easily. Infacol and gripe water have made no difference.

I think part of the problem is that GPs aren't very sympathetic to first mothers who walk in and say "my baby keeps crying..." Or at least this one isn't! But I just can't help feel that this isn't normal baby crying, it's a reaction to the milk and it's a pained screaming cry not an "I'm hungry/windy/need my nappy changing" cry...

Wow topsy that's a lot of eating! Is she unsettled throughout the feed? Is this a new thing? Maybe six week growth spurt?

We have a slightly different issue in that DD actually sleeps brilliantly at night - often up to 5 or 6 hours (don't hate me!) but she doesn't sleep AT ALL in the day even in the pram/sling/.car. Maybe the odd five minutes here and there if I'm very lucky. So at night I think she's basically passing out from exhaustion...

She might not be hungry hence arching and pulling, is it possible that she's tired and the cues for hunger look the same as cues for sleep? Babies often "ask" to be fed when they are exhausted as it calms them. If she's overstimulated this might aggravate her?

Sorry, I know you know this, but your baby needs to sleep during the day. She's too tiny to go all day on 5 minute catnaps.

My 5 week old will only sleep spells of 2/3 hours day and night.

It does sound like it could be silent reflux, or an allergy to cows milk protein. Sometimes an allergy actually causes reflux. Try cutting dairy (milk, yoghurt, cheese) from your diet for a couple of weeks and see if it makes a difference. Don't replace with soya though as the protein structure is similar.

Could you try to express a little breast milk and combine this with the gaviscon in a bottle at the start of each feed? Perhaps you could keep a supply of expressed BM in the fridge..?

ice yes definitely - I'm sure that a lot of the time when she looks like she's asking for food she's not really hungry, it's for comfort (which is one of the symptoms that pointed me to reflux as apparently babies with reflux often like to suck as the milk/saliva helps to soothe the pain - and this might also explain why the dummy works...)

There are no feeds where she doesn't scream and arch her back - even when she IS quite clearly hungry. Although she is slightly better at the middle of the night feed.

The napping thing is a big issue I know but there is literally nothing I can do to get her to nap in the day. I can't feed her to sleep as she cries at every feed without fail. Whereas a couple of weeks ago she could sleep in the sling or if I bounced her enough, this no longer works. I've tried white noise, long drives in the car, shhhing in her ear, lying her on top of me...everything I can think of. Its so hard.

I thought these two were separate issues but once I started looking them up I realised they could both be signs of silent reflux.

mum yes I was worried someone might suggest that! I've seen that come up on old threads. My diet is quite dairy heavy so this would be a challenge. Worth it if it works though Is it something you tried?

This sounds exactly how my DS was, and he has silent reflux. Except the sleeping well at night bit - as he would wake every hour at least and basically had to feed all night long as he slept almost! No one believed me that he didn't nap during the day. I knew it wasn't normal for a 4 week old to be awake for 12 hour stretches at once, but as soon as I put him on his back he would start screaming. Even a sling didn't help much at all.

I also had my GP saying it couldn't be reflux as DS was putting on tons of weight. Well of course he was, he was feeding almost 24 hours a day to soothe the pain! You need to keep going back and saying this isn't right, I need to try different medication to see if it helps. Gaviscon was useless for DS, as was ranitidine. Omeprazole worked well though but he was about 8 months old by then and I was physically and mentally ruined from lack of sleep and stress.

It could be an allergy, does your DD have any formula at all? It's worth trying to cut out all dairy from your diet (tricky as it's in so many things) to see if that helps too.

The sleeping well at night fits with silent reflux as they can often just be exhausted from not sleeping all day. Sounds like a visit back and get pushy but it can be hard! Think I've been lucky with GPs - HV can help if they can see a feed (others useless) and at least you can say to GP that HV suggested too. Shouldn't make a difference as you know your child but it might!

Thanks roomba. I don't envy you having to go through all this AND unsettled nights!! And yes as soon as I told the GP how much weight she is putting on he looked at me like I was mad. I've heard a lot of GPs don't believe in silent reflux so maybe he is one of those.

I was giving some formula (aptamil) as initially I thought the crying was because she wasn't getting enough milk from me and was still hungry. I found it made her vomit much more though, and still didn't help her to settle, so have tried to cut it out. I do express fairly frequently and her last feed of the day is usually expressed milk in a bottle.

Agree with you and gubbins, think I need to go back to the GP. Sounds like ranitidine is the next step, and works for some but not others?

Will try cutting out dairy too, this could be a challenge!

I sympathise - my son (now 9mo) had it but has grown out of it now (I say this to show there can be light at the end of the tunnel if it is silent reflux). I second what most of the posters above have said but would also add that it's a good idea to just try one thing at a time. So leave dairy in your diet for a bit if you're starting ranitidine and vice versa, so you can see what's really made the difference. Cutting out dairy is a significant undertaking as it means no milk protein, whey, goat cheese etc etc and it's amazing how many foods have dairy in some form in them. But it's obviously worth doing if an allergy/intolerance to milk protein is what's causing the reflux.

On the daytime sleep point - all daytime naps here were in pushchair after (often lengthy!) pushing over a bumpy surface (ie doormat!) and with white noise blasting. Still only resulted in one sleep cycle's worth of 35 mins or so but would try several times a day. Like you, nighttime resulted in the longest chunk of sleep and best/calmest feeds of the day.

Ranitidine really helped us and, later on, omeprazole did too.

Good luck x

In my experience reflux would affect night time sleep too? So if your baby settles well at night then maybe it is something else? Have you tried a sling for daytime naps? Ds2 had all his naps in a sling for months as he couldn't tolerate lying down.

sleep that's a good point, I will try different medication first then look at other options if that doesn't work. Do you remember how long it took for the ranitidine to take effect? And what was it that made you switch to omeprazole?

cakes yes, tried a sling. Sometimes I feel like I've read every single "how to get baby to sleep" article on the Internet. You name it I've tried it!!

Fwiw I needed to push my DS miles to get him to sleep. It took about 20 minutes before he'd look sleepy then he'd slowly nod off, asleep by 30/40 minute mark then maybe he'd sleep a cycle or two depending how much further I pushed. Bloody knackering twice a day but I was lucky that car worked too. That said, I hated driving aimlessly around when I was so tired myself. I agree that reflux would probably affect night sleep too but what you and other poster describe certainly points towards it. If only they could talk... Good luck OP.

Ok, went to GP this morning, was pushy (and maybe cried a little bit...) and got a prescription for ranitidine...I really hope it makes a difference, I'm starting to find this very hard!

Good luck with meds. I've heard it can take up to a week to kick in and see improvement. I hope your little one is more settled soon and you get rested too.

Thanks ice. At least it's the weekend so my OH is here and has been able to help out in keeping her upright most of the day - hopefully that will make a difference too.