Reflux, Nexium/Esomeprazole and constipation help!

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5 month old DD has been on Nexium (esomeprazole) for the last 2 months for reflux (ranitidine before that). She is increasingly constipated and straining/grumpy before managing to pass a stool. It's always thick and stuck to her.

Looking to mumsnet for help. I have tried giving her water but she is not keen at all and it hasn't helped. She is mainly BF with one formula feed per day.

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Sorry I can’t be much use on this one OP. Usually if baby is BF and constipated the advice is to add extra feeds in, if you can so it might be worth trying to add at least one in, if you can.

Have you ever managed to find out what causes the reflux? Has CMPA and tongue tie both been ruled out?

Excuse my ignorance what is CMPA? My LO has had reflux diagnosed since 5 weeks so I am surprised the doctor hasn't really covered why it has happened. The only answer I have been given for it is along the lines of 'lots of babies have reflux and yours is probably just worse because they were prem'.

I am offering breastmilk every 2 hrs as it is as weight was dropping so I would struggle to add another feed in anywhere. I was considering putting water in one formula feed but that's not really what I want to do when LO's weight has been dropping. Not sure what to do. Considering lowering the nexium dose v slowly.

Paediatrician wasn't much help with reflux either. I asked some questions and he didn't know the answer to one of them 🤨

Oh and the HV said they don't see a tongue tie.

Oh and the HV said they don't see a tongue tie unfortunately HVs aren’t trained in tongue tie. Have a read of this from Milk Matters and if you think she may have it, get in touch with Milk Matters or a Tongue Tie Practioner. Your local BFing Support Group might be able to help you too if you think she has the symptoms.

Sorry for using abbreviations. CMPA is Cow’s Milk Protein Allergy which I think affects about 4% of the population. The symptoms of this can be similar to tongue tie (tt). Kellymom has produced sone useful information on Dairy here.

Are you getting any support with you LOs weight too? Is it actually dropping or is she just plateauing? Have a read of How might I increase my baby’s weight gain?

Hey OP.

I had a GORD baby who was on liquid Omeprazole from 6 weeks.

Question; the weight loss, is it drastic? Is there any follow up about it, or is it something you have just noticed during weigh ins? The 2 could be related, or, a coincidence. Or, the reflux could actually be something else which is causing the weight loss.

Why have they diagnosed reflux? What symptoms is your LO having? The medication you are on shouldn't cause constipation, which is what is making me wonder if you have something else at play here.

The medication your LO is on is a pump prohibitor, so it's stops the production of the acid back into the stomach which then travels up causing the reflux.
If I had to hazard a guess, I would say the constipation is coming from the combi feeding and the milk is upsetting your babies tummy (which will be sensitive because of the medication)
So, if you need to up weight and want to use formula (mine was FF) I would look at which one you are using.

Oh wow @JiltedJohnsJulie I read that milk matters list and there are so many that apply to my LO!! I'm now unsure what to do because I think the NHS waitlist for tongue tie referrals is very long and as my LO is almost 6 months I don't even know if they would see us. Not sure we can afford private or if it's worth it at this stage? I really don't know what to do.

Yes my LO had actually lost weight not just dropped percentiles so is now under care of a paediatrician. Routine checks have been done, no blood tests yet though.

@fruitshot it was the GP who said reflux although I know they are far from an expert so who knows!? Symptoms at the beginning were thrashing on the breast, coughing, choking, vomitting after feeding, crying and in distress after feeding, etc.

We only introduced one formula feed a few weeks ago and LO was constipated before that. I am concerned it could be something else though. I have no idea what? I mentioned to the paediatrician that LO was constipated and thought it was medication and he didn't disagree with me. I will push on that at the next appointment as I see you are right the side effects of the meds actually say diarrhoea not constipation.

@fruitshot weight loss was a 14oz drop (from c14.5lbs). I don't know what counts as drastic?

Unless Baby was weighed on the same scales, at the same time of day, by the same person and the scales have been calibrated, I wouldn’t worry too much. Is she bright and alert at times? Is she meeting her milestones?

As for the tt, yes, I’d say it’s defintely wortg gwtt8g done. Our DS’ wasn’t diagnosed until he was much older. We had years of trouble with his sleeping, wouldn’t eat solids and had speech therapy. Wish I’d had a pound for every HCP who told me it was reflux and not tt. Have a look to see if there’s is an NHS Tt practioner in your area here. You might be able to call them directly.

I'll definitely call the NHS practitioner tomorrow, see what they say. If it is a tt then it sounds like it would definitely be worth paying to go private if we can't be seen soon from what you've said. Thanks so much.

@JiltedJohnsJulie seeing a private practitioner next week as the waitlist for NHS is months. I am concerned about how distressing the procedure might be considering my LO is older. How was it for you? Was your DS out of sorts afterwards? How quickly did you notice the benefit?