Help with possible reflux for 7wo dd

[HopelesslyHopeful87]

DD is 7 weeks old.

We've had a nightmare of a time in these first early weeks. I have posted before and got good advice at the time but now we think she has reflux and I'd like some further help.

She started on aptamil first milk. By age 6 days she was constipated and having pains and was generally unhappy. We persevered but by 2 weeks old the hv advised comfort milk. The comfort milk made her ten times worse and she was screaming in pain every time she passed wind. She was prescribed lactulose.

Hv then advised moving to cow and gate. We did and used first milk. This had no improvement. Gp prescribed colief. This helped her symptoms but she had an allergic reaction to it and we were advised to stop it. Hv then advised cow and gate comfort. Initially this helped for about three days but then she was back to screaming all day and all night and in pain.

Then she developed a new symptom and started vomiting clear fluid. It would fountain out of her effortlessly. She was coughing a lot, grunting, squirming, thrashing around.

I then found out that aptamil and cow and gate are exactly the same and we'd essentially done the same thing twice with the milks. After advice here I moved her to hipp organic.

Gp prescribed gaviscon as the new symptoms sounded like reflux. Gaviscon instantly stopped the vomiting and she's generally more settled. She was prescribed 2 sachets per feed as she's over 10lb but this made her very constipated and this was an issue already so we use just one sachet in most feeds but two at the bedtime bottle. However, she is still grunting and writhing around.

Is there anything else I can do? Do I need to be asking for ranitidine? Or should I carry on with the hipp organic, gaviscon and lactulose?

I feel so sad because I'm wishing her to be older so we get past this but I should be enjoying this stage. The cuddles and snuggles and first smile and giggle. Instead I'm just miserable. She is my last dc and I don't want a bitter taste in my mouth when I look back on her first weeks. I feel like I've failed by changing so much in her life in such a short space of time.

We did the same with my dd and had even tried lactose free milk in that time.

Minus the constipation your dd and mine sound very similar.

We first added ranitidine to our regime, and on top dose that does help a bit. But the absolute saviour was anti reflux c&g milk. Every feed she was breaking away screaming in pain from acid, and the minute we tried the anti reflux milk she emptied the bottle in 5 minutes, clearly relieved to be able to feed pain free!

I don’t have any real advice, all babies are different, it’s so hard trying to get it right, but just wanted to say that eventually you will find the right combo for your dd xx

Oly5 I agree if baby had wind/Colic than yes that's normal. Silent reflux is not normal and can damage a baby's esophaghus. Ds had that and didn't spit up (he couldn't) because the acid just used to make him cough and burn his throat. He would scream in pain, the ranitidine helped almost immediately.

Oh I breastfed as well so it wasn't an issue with formula type etc. Silent reflux is very painful for babies but even normal reflux needs treated as it causes discomfort.

HopelesslyHopeful87 I know how you feel. Ds is my first and I've had nothing but problem from day one: 2 weeks over due induced at 42 weeks, complicated high alert labour, discharged with well baby, emergency admission at 1 days old with seriously ill baby, silent reflux, catnapper. It's not surprising I'm hesitant about whether I want a second one! Ds is now 10 months old and I'm still exhausted. Love him more than life itself though.

problems

www.nice.org.uk/guidance/ng1/chapter/1-Recommendations#initial-management-of-gor-and-gord

I look at her now, asleep on my shoulder, in her grobag ready for an attempt at going in her basket and I just feel so much love. I just want her to be pain free.

Oddly enough I've just been reading the NICE guidelines on infant reflux and it does actually state not to offer the meds. First line of defence is the thickened feeds as PP mentioned.

I'm loathe to change her milk again. I feel like I've made things worse for her by changing so much. The hipp organic seems gentle on her tummy and her bowel and her poo is good on it but as it is thin it has made the reflux more prevalent. Win/lose situ.

If I did go for a thickened formula I.e. adding carobel or a reflux formula then I run the risk of irritating the bowel again.

I have a document from the WHO which states there's no evidence that reflux formula is beneficial. It states that as it contains the cereal thickened element it is bad for the gut (obviously why we wait til 6m to wean) and that it doesn't have to comply with regs when it comes to reconstitution I.e. it needs making up at lower temp and is therefore not ever sterilised. This concerns me.

But equally, is giving strong medication the lesser of the two evils.

Xpost andromeda. Apols, that page does say to try the meds if there is distressed behaviour. The GPs distressed and my distressed were obviously not equal.

Has anyone suggested cows milk protein intolerance?

DS had same symptoms and no amount of medication would help whilst we were still giving him milk based formula.

At 4 months he was finally diagnosed with CMPI (after paying privately to see a gastro paediatrician) and moved straight onto Neocate. I had a different baby within a week

I don't care and would offer meds if you've tried everything else and baby is screaming in pain and risk of acid damage to throat.

No other associated sx of cmpi though. No bad skin - the only rash was the colief reaction. No diarrhoea - except for the colief reaction. No froth, mucous or blood. Good growth. Good feeding. She actually feeds well. No issues with bobbing on and off the bottle. I have to wrestle it out of her mouth to wind her.

Because you're formula feeding it may be different for you. Sounds like the doctor doesn't think your baby has the kind of reflux that requires meds maybe? They need to keep helping you though and can't just leave your little one like this. Have you tried tilting crib/wedge under mattress? This made big difference for ds.

Yes moses basket is elevated. I don't have a wedge, just shoved a plump cushion under it 😁

We have one of those upright snuggle baths too so she's pretty much always upright if I can keep her that way. If she's awake on on my lap I'll have her sitting up, she'll be sitting or on shoulder for winding. I feed her with one leg higher than the other so she's practically sitting. On a cushion for nappy change. And in her bouncy chair she's elevated.

Have you tried hipp without gaviscon? I found that constipated ds and caused him new symptoms while not eliminating the reflux. Just wondering if tummy pains causing a lot of the problem and if maybe the change of formula on own may help. If not I'd tell a different doctor everything you have said to us on here and demand they help your baby.

DS had NO rash, blood or mucus.
Didn't fuss when feeding and was putting in weight.

His symptoms were vomiting incredibly acidic liquid (generally about an hour after feed),
Squirming with stomach ache, wind and diarrhoea.

GP and HV were utter shite and just made me feel paranoid.

Wasn't until I took matters into my own hands (at own cost and months of poor DS being in so much pain) that I started getting sensible advice.

I would def look into it if I were you.

You can also get formula on prescription. There's so much more they can do for you...

She wasn't on the gaviscon when we started hipp so yes she's been on it without. And she's only allowed 6 of the gaviscon a day and she feeds 3 hourly so there's a feed or two a day I have to miss it and you can Def tell the difference wrt the vomiting.

As I said earlier, I didn't get to see an actual gp earlier. Just advanced skills nurse. Takes weeks to get gp app. I have one booked for Thurs though for her 8 week check with a real life gp. So if I get no joy before then I have the bnf link and screenshot and the nice guidelines up my sleeve.

Ranitidine is not licensed for use in children under 3 years. There are doses for children under 3 years in the BNF for Children but these doses are unlicensed. Prescribers can choose to prescribe doses that are unlicensed, taking responsibility for doing so.

Constipation, wind, reflux, discomfort and irritability are all symptoms of CMPA. I would have a read Aron d it a bit more and see if it fits.

The trouble with ranitidine for babies is it's not supposed to be initiated in by GP's, ideally they should be seen by a specialist (pead, gastro etc) and the GP will continue to prescribe.

It may be worth trying a thickener with the Hipp organic if she's settled more on that milk to see if it helps but they do constipate and obviously don't give both together.

Sorry she suffering. It's really takes time fun out of having a newborn.

I don't think you'll have a problem once you get to actually see the GP hopefully.

DoItAgainBob a gp initiated DS's gaviscon and then ranitidine when the gaviscon failed. I guess it must be down to their discretion and if the symptoms are clear cut or not. Like you say though at the very least GP should refer on if not feeling can authorise.

Some gps will take responsibility more than other I suppose...it's terrible really.

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