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?

If you are in a financial position to do so, a private paediatrician will set the ball rolling and tell the gp to prescribe ranitidine.

I've had 3 refluxers (and also milk allergies) so I kind of feel I know what to do for reflux!

First one - we went through all the colic stuff, changed milk numerous times (cow and gate was the only one which didn't cause bowel issues but did give him tummy ache and vomit), good weight gain etc. Managed reflux with allergy milk and wedges, upright lots etc.

Second one - poor weight gain, screamed for the first year pretty much. He had gaviscon in allergy milk (couldn't drink without it), put on omeorazole by paediatrician at 4 months. Was still on this at 3 years old and then moved to ranitidine which was amazing!

Third one - I knew what I was doing this time. Worst milk allergy ofbthe 3, face was red raw with eczema, 20 plus dirty nappies a day, vomiting etc. Milk allergy milk by a week old, but reacted to this and needed neocate milk instead with gaviscon. This wasn't enough and the reflux was still there - he would vomit huge amounts and sit there gurgling and crying as the acid was there.

I had a private appt booked anyway as we knew it was going to be needed for milk allergy so I got him to prescribe the ranitidine, which gp then took on. Paediatrician prefer omeprazole so you may need to fight down to ranitidine first

Have you checked the milk allergy symptoms list? Reflux and cmpa are often very closely linked and many refluxers are undiagnosed cmpa.

Unfortunately no spare money for private treatment.

Worst night ever last night. Even with the gaviscon she was being sick. Not one period of sleep since 3am. Got about 2 hours prior to that.

That's tough going. Hers some info on delayed allergies from Allergy UK. DS has never had problems with his skin really apart from a bit of dryness on his legs but his reflux was very bad and he never slept. I would consider all option to discuss with the GP this week.

Do allergies run in either of your families?

https://www.allergyuk.org/information-and-advice/conditions-and-symptoms/42-childhood-food-allergy

Check the following:

1. is she over feeding? based on a weight of 10lbs she should be having a minimum of 7x90ml and a maximum of 7x 130ml feeds every 24 hours. (Total of 630ml- 910ml)
2. if shes been on first line treatment: gaviscon, thickeners, positioning and they haven't worked, she probably needs anti reflux medicines
3. If Ranitidine and omeprazole have been prescribed by your GP and they haven't worked she may also need domperidone or erythromycin. You'll need to see a paediatrician for this as GP can't prescribe them without specialist input
4. if none of the above have worked the paediatrician should consider allergies/ intolerance and again you need specialist input to ensure proper dietary advice is given and monitoring of diet and growth.

I'd push your GP and/or HV fo an urgent referral to a paediatrician, I wouldn't leave it because if feeding is painful for her now it could result in refusal to feed and subsequent feeding problems which are difficult to reverse. On a happier note reflux does usually improve with age as I found out with my own dcs

it also improves once they sit up more and start solids. Ds is much better now at 10 months old but he is still on ranitidine. I'm hoping to stop it before 1yr depending on how he is.

She's about 11lb now and takes between 4 and 5oz which is around 120ml about 6 or 7 times a day so I'd say she's average for her feeding.

I have looked at that allergy UK link. Thanks. Allergies to foods are not in the family, I don't think. I have eczema based on an allergy to soaps. Her dad has no allergies. My other two dc have none either but they have a different dad, if that bears any relevance.

I've had a lot of thinking time over the past few sleep deprived night's and I feel she's been worse and more unsettled during the night since the gaviscon has been introduced.

I'm running a gaviscon free day experiment to see how things are with just her milk. She's had 3.75ml lactulose this morning. She has pood already this morning - she seems to regularly go at about 10am now. I will not be changing her milk for the time being. Experiment underway.

Agree she isn't over feeding, I'd see how things go over next few days but get the ball rolling with paediatrician referral on Monday; you can always cancel it if you don't need it and there's always some one else who they can fit in if you give them a few days notice

HopelesslyHopeful87 Gaviscon made ds much worse because not only did he still have reflux but then tummy pains on top of it. Good luck on Thursday

You could also demand an emergency gp appt if you ring up on the day. When it's newborn's they tend to be your straight in. Hope it's the same at your surgerh anyway.

y

get you

Doesn't necessarily need to be an allergy;may be an intolerance.

You need to push for an urgent referral or could you borrow the money for an initial consultation?

Once we had the CMPI diagnosis (within 10 mins of speaking to consultant!) we then had a prescription for Neocate and continued management on the NHS.

With all due respect no amount of medication is going to help if the underlying problem is the inability to tolerate any formula with cows (or even soya) milk.