Reflux

[Smellybears]

Four week old baby has reflux. Doctor put him on gaviscon which reduced his sickness but didn’t help with anything else at all. Midwife advised stop the gaviscon and try colief. I thought that was the answer, baby has been great for a few days, I even posted on here about the colief! Anyway, colief now seems to have stopped working. My little one has spent the last couple of nights screaming, being sick, waking himself up clearing his throat, being sick in his sleep, arching his back, as soon as I put him in his basket he’s sick etc.
what I want to know is does this sound like silent reflux? The doctor the other day seemed reluctant to diagnose it as reflux (she really rushed us and I could tell she just wanted to get the next patient in) and I have an appointment this morning. I’m tempted to try anti reflux milk? He’s on Hipp Organic which has reduced the symptoms a little when he first went on it. He used to struggle getting wind up when on cow and gate, that’s not as much of a problem now.
It’s so disheartening seeing him in so much pain. It’s been another night of only a couple hours sleep for me as I’m worried he’s going to choke on his sick. He’s got a wedge hog in his Moses basket which has helped a little.
During the day he manages to get a bit of sleep on me but obviously I’m missing out on sleep and he has to sleep in his basket at night.
Any advise really will be appreciated

Have you used the gaviscon alongside colief? Colief breaks down lactose so would only help if the issue is with lactose.

Midwife said she wasn’t sure if that was allowed so she advised me to only do one or the other.
The thing that puts me off gaviscon is that it says only 6 doses per 24 hours, what must that be doing to his tiny insides if he’s only allowed 6?! It sounds like it’s going to be quite harsh on him?

I forgot to add that I’m keeping him upright after his feed for at least an hour.

How much and how often does he feed op? Refluxy babies offen take more than they need as that soothes the reflux but then makes it worse because their tummy’s are overfull. I would make sure you are not feeding him too much before trying the anti reflux formula. You can’t use gaviscon with the anti reflux formula either

I don't see why they couldn't be used together as they do different jobs.

He’s having either six or seven bottles a day, between 3 and 4 ounces. He was low weight when born and trying to get him to put weight on. He is gaining weight which is good.

I’ve just got a feeling that the doctor is going to try fob me off. When he’s sick in the night he doesn’t make much of a sound so I’m panicking that I’m not going to hear him and he’s going to choke which is why I’ve not been able to sleep. He spends ages clearing his throat and I don’t know how I can help him, he then wakes himself up. I’m a first time mum and just want his pain to stop for him

My doctor told us that anti reflux milk basically does the same job as gaviscon, so you use one or the other.

How much gaviscon are you using? It worked wonders for us however I know it's not always the answer.

Hi OP, no advice on the medication but my son was a little reflux-y at that age (hated lying flat), and we had one of those bouncy chairs with a vibration setting. It really helped him to settle down and also got wind up that I didn't always manage! The one we had could fully recline too so he napped in it. Could be worth getting one of those and if it does help him to nap you could get some sleep too?

Go back and say you're concerned about silent reflux. Take video of episodes of pain so you can show them.

If it is SR push for ranitidine or omeprazole as well as gaviscon.

Tilt the cot / Moses basket
Consider a cot wedge
Keep upright after feeds

We’ve got a Moses basket wedge, I’m keeping him upright after feeds too.
He was on the maximum dosage of gaviscon, six in 24 hours. Like I said, it reduced his sickness a little, he was projectile vomiting, but hasn’t done much else.

He’s got a vibrating bouncer, I’ll try him in that a bit more then, thank you!

Can I ask please, what’s the difference between reflux and silent reflux?

Saw the doctor. He’s said to carry on with the gaviscon and colief but use it together. To be honest he wasn’t that great, he was lovely but wasn’t keen on giving me anything as ‘he’s small, babies cry and arch their backs and be sick, it’s what they do’.

To be fair op, the GP is right to be cautious. All medications have side effects and ranitidine should be reserved for severe reflux. A watch and wait approach isn’t a bad idea. If using both together for a week or so doesn’t help then go back.

I am usually a MN lurker but you only posted this yesterday and as a fellow first time Mum with a LO who had really bad silent reflux I couldn’t just read and run as I know how much you much be fretting right now.

My boy is now 2.5 by the way.

Ok couple of things:
Your LO is only 4 weeks old right now and his little body is learning to eat/drink/digest/wee/poo etc. It takes time for everything to happen at this age, nothing happens over night.
Swapping and changing milks can upset his tummy, it is very delicate at the moment. You need to pick one milk and stick with it. I moved from cow and gate to aptamil and then to aptamil comfort milk and he stayed on that till I weaned him.
Gaviscon is not an immediate fix like a rennie is for an adult, it is a gradual build up, so you need to stick with it. Are you mixing it in with milk? It basically acts as a milk thickener, which is what the comfort/reflux milks are too. I would give it to my LO after a milk feed mixed in a little cooled boiled water (the instructions for a BF baby) as mixing it into already thickened milk made it undrinkable! 6 doses a day is fine, they may not need to be after every feed, I would give it to my boy in the afternoon and evening as a run up to night time as that was when he was worse. I eventually moved to giving him gaviscon after every other feed and eventually down to once a day.
You can always ask for ranitidine from the GP which is a medicine you can give and may be more suitable for you LO but again, whatever you try you have to give it time to start to work!
Have you asked your GP/Midwife/HV if it could be an intolerance?
I didn’t get on with colief, my boy was fed on demand and i couldn’t make up bottles 30 mins in advance for the colief to work. I would give him infacol before a feed, gaviscon after and gripe water (once able to) after a feed in the evening.
Couple of things which really helped:
Keeping him as upright as possible to feed, I mean literally sat upright! Stopping feeding half way through and winding and at the end of the feed winding and keeping upright for longer (it’s called paced feeding). I got a harness/carrier which kept him upright and allowed me to get a drink/something to eat etc. Winding isn’t just one burp either, my boy would get terrible trapped wind and I would need to cycle his legs, wind him for what felt like hours!!
Baby massage is a MUST for trapped wind!
Warm baths help to move the wind.

The problem with reflux/silent reflux/colic is that they can all happen, at the same time and all have similar yet different symptoms. Silent reflux is typically symptom-less hence it being called silent. My boy would just have wet burps, spit up sick but not projectile after every feed. Reflux is a lot more pronounced. Colic is trapped wind and is arching the back in discomfort, pulling legs in up etc. But babies do that to show discomfort in reflux too.

This first few months is awful whilst you are learning and whilst your LO is learning too. You just need to keep reminding yourself that his tummy is brand new and super sensitive right now! Give everything you do time to work! Don’t be fobbed off! Trust your instincts at all cost!! And persevere...it will get better.

Cow and gate anti reflux milk absolutely changed our life 😂 the first bottle she had of it you could tell she was so relieved to be able to drink properly without that horrible reflux. We’re on ranitidine as well but I’m not sure it does anything for her (but I’m scared to stop it)

Look into lactose intolerance and cows milk protein allergy. If that doesn’t sound right, and you’re quite confident it’s ‘just’ reflux, I would firstly try anti reflux milk (if it was going to help you would see straight away) and if still unsuccessful ask for ranitidine.

Have you tried a little gripe water. I found that helped with my little one.

Colic is a symptom of reflux

My eldest daughter had reflux and the gaviscon caused constipation so switched to ranitidine and completely different little girl. Weaned at 4 mths on doctors advice and never looked back.
Just had my fifth child, a second daughter and at 5 wks I noticed she had all the signs of reflux (arching back, pain, coughing, sneezing, colic etc) except she wasn’t being sick. It would get to her chest or throat and go back down - first i’d heard about silent reflux.
She was put on gaviscon (after doctor told me no such thing as reflux!) which again never worked and just constipated her. Then put on ranitidine and worked for 4 weeks then stopped. We tried the aptamil reflux formula and oh my god, worst decision I ever made for her. She was massively constipated and so ill, she refused to drink it in the end and needed hospital treatment.
She was then diagnosed with a cows milk protein intolerance. So been on nutramigen 1 plus ranitidine for about 4/5wks now and worked a treat. Reflux stopped and colic has got massively better too.
My point is stick to your guns when advocating for your child - you know when something is not right. Maybe try ranitidine as it doesn’t cause constipation and should work unless underlying issue ie milk allergy/intolerance. Good luck, hope you find the right combo for your little one.

Thank you all for your messages and support!
I’m keeping him on the hipp organic as I’m happy and baby seems a lot better on it too. If I find the gaviscon not doing much then I’ll possibly think about putting him into reflux.
Regarding the gaviscon, I’m just going to stick with it, give it time and see how we go. I don’t want my baby on loads of medication, he’s so tiny and I don’t want to pump him with medication.
I spoke to the health visitor, midwife and doctor regarding a milk allergy and they said at this stage don’t worry about it yet. Health visitor told me about paced feeding and we’ve been doing that for nearly two weeks and found that it has helped.
I’m going to look into getting a baby carrier as it’ll make keeping him upright for as long as possible easier.
It’s a learning curve for us all-me, his dad and also for him too! Patience and time will get us through this I’m sure, also positive thinking!

I remember feeling exactly the same smellybears! Gaviscon does cause constipation but we also got movicol from the GP, I felt awful giving him loads of medication but it did make things easier. Once they are sitting up and Mobile you will see a huge improvement and again once they wean too. It was about 10 months that I could finally put it behind us.

It is a huge learning curve. I had no idea about colic, reflux or anything when my LO arrived, it knocked me for six completely I felt like I’d failed him! But looking back all we can do is our best.

Don’t let it stop you going out and about though. Just pack a few extra muslins and 2 changes of clothes (and a spare tshirt for you too!). If he’s sick so what, you’re prepared.

It will pass, it won’t be forever. Hugs

Thank you so much! This site has helped so much, you’re all so kind and full of encouragement it’s massively appreciated!