Has anyone saved BF in a quite refluxy situation?

[WhatTiggersDoBest]

My baby is BF and we've so far dealt with tongue tie which led to a cut/bleeding nipple, then I got a stomach ulcer and couldn't keep fluids down which messed with how much milk I made, then in week 3 we both got diagnosed with yeast after my nipples had been feeling like there was shards of glass in them and his mouth was white and sore. We got through all that, but in the meantime, another problem has crept up on us. His reflux has gotten so bad we can't lie him down anymore, even an hour after his last feed he'll still throw up. He does it on the changing table every. Single. Time. I'm sick of him crying from wind no matter how much I burp him and I'm sick of him not being able to finish a feed because he pulls off the nipple when his digestion does strange things.

HV said two weeks ago it was reflux and that I should burp him for 40 mins each time he feeds (during the day he feeds every 2 hours or sometimes closer together so we are literally going feed-wind-change-feed-wind-change over and over).
I've tried raising where he sleeps as well and that hasn't helped avert the reflux, he always seems to have sick dribbling out of his mouth.
We also tried pulling him off the breast every 10 mins, burping him and putting him back on again. That slowed it down a bit but we're still getting reflux, just delayed.

HV came again today and said that I should phase out breastfeeding and get him on some special formula with thickeners. My baby is only six weeks old today. He is on the 50th percentile for weight and height. This feeding issue has taken over our lives but I don't want to abandon BF. Is there anything I can do to salvage it at this point? I actually hate BF but I know it's good for the baby so I don't want to completely give it up. If we switch to thicker formula, can't we get something to mix into breastmilk? I wouldn't mind exclusively pumping if I had to, or combination feeding, but the HV seems to think I need to totally stop BF. I just want to be sure he gets as many antibodies etc as I can give him, at least until he starts on his vaccines. I don't even know if I'm making sense any more but if anyone has salvaged BF with a REALLY refluxy baby please weigh in! Sorry this was long I'm so tired.

Sorry I meant if we can switch to thicker formula, can't we get something to mix into breastmilk instead?

You can give Gaviscon Infant sachets to a breastfed baby to help keep the milk down - you need to speak to a healthcare professional to get them I think. Well done for persevering OP - reflux can be really miserable

Thanks, I had no idea there was a Gaviscon for babies. I will ask the GP if we can try that before thinking about stopping breastfeeding.

Yes, you can get something to give when you breastfeed. Look up Carobel (it's usually used as a thickener for formula, but can be given on it's own when you breastfeed). You'll have to order it via a pharmacy (but you won't need a prescription). My GP recommended it as a less medicated alternative to infant Gaviscon which also thickens.

On a possibly controversial note, remember that health visitors are not necessarily always right! I've found that health visitors in the same clinic often contradict each other. I'm quite surprised that you've been actively advised to stop breastfeeding when there are products like Carobel/Gaviscon available (however I note that you've said you don't enjoy breastfeeding, so if your HV is aware then perhaps that's why she's so actively pro-stopping? Your happiness/mental health is important). Don't be afraid to seek out a second opinion from a GP/HV clinic.

Wow! You have done so well with all you have had to contend with. As others have said, you can try Carobel which is a thickener...you can mix some with a tiny bit of expressed milk and give it with a syringe...it's before or after a breast feed (I can't remember which). There is also infant gaviscon but please note that this can make them constipated. Finally there is medications like Ranitidine or Omeprazole that you can have prescribed. Omeprazole turned our situation around in 48 hours...now have a very content baby.

I have had two refluxy babies. First, I had to top-up and combi feed and I only managed to keep the combi-feeding up for 12 weeks. Breast, followed by bottle, followed by pumping combined with reflux and all the holding upright after feeds was a nightmare. However, it turned out that my DD had CMPI that was contributing to the reflux and needed a special formula so by the time DC2 arrived I wanted to try and stick to breast-feeding as I thought it would be easier to go dairy-free myself if necessary than try to get more formula on prescription.

Little and often is the key to feeding reflux babies. With DC2, who had silent reflux, co-sleeping worked well for us. I was always too nervous to do it with DC1. Strangely enough, the lying on her side facing me seemed to cause her less reflux than when she was feeding upright during the day. Maybe it's because she was feeding a little bit on and off all night and only gently. Anyway, I managed to feed her for 18 months.

If reflux is bothering your LO, it does need to be managed by a doctor. Gaviscon is not particularly helpful IME and a real pain to administer to breastfed babies as you can't mix it with a bottle, you have to mix it with water and feed through a syringe. If the reflux is painful, ranitidine is usually very effective. It doesn't stop the sicking though, but prevents it from causing pain. Carobel was brilliant for my bottle-fed baby but would again be difficult to administer for breastfed babies.

Speak to a GP would be my advice. If you can, ask around the baby clinic etc for recommendations. Some GPs are still stuck in the dark ages regarding reflux while others are really on the ball.

Usually reflux is a symptom of something else like CMPA or intolerance to dairy. So I'd start with giving up dairy.

As others have said you can get thickeners to add to milk if you wanted to express. But personally, I'd try with the cutting out dairy first.

I'm breastfeeding and currently my lo is on ranitidine as gaviscon was a pain!

I had a very refluxy baby which stopped as soon as I cut out dairy - this was at 4 months so I'd already tried various things including carobel and infant gaviscon. They worked a bit but made her v v v constipated which was awful, so yes I'd google cmpa and but dairy out as it's easy to try and will rule it in / out. Reflux is so hard, I really hope you find a way of helping your little one x

I had a very refluxy baby and breast fed. We supplemented one bottle a day of Enfamil AR (special formula with rice thickener) and continued to breastfeed until 11 months. Started solids at 6 months.

Definitely speak to the GP. I've had two reflux-y babies, and have had a number of different medications for them. Infant Gaviscon is a pain as it's difficult to mix and feed to baby if you're not using bottles; I syringed it in. With my youngest I requested to try Ranitidine first; it's just a 3 times a day liquid medicine, so much easier and great if it works!

Remember different medicines work for different babies, so keep going back to your GP if necessary. Switching to formula is not necessary! Good luck

A HV shouldn't be advising you switch to formula if you want to bf. They should be supportive of you breastfeeding and help you to carry on. You've done so well to get through a you have!

Reflux is a symptom not a disease, has anyone spoken to you about the possibility of cow milk allergy? It can cause reflux symptoms, rash, bad nappies etc. Not all symptoms have to be there, only way to know is to eliminate from your diet and see if it makes a difference. My DD is allergic to dairy and soya. Within 3 days of eliminating milk from my diet her reflux and wind symptoms were gone and I had a happy baby who doesn't mind being on her back.

Thanks everyone, I really appreciate all this advice. It's great to see so many ideas for ways we can manage this without losing breastfeeding so early.

I know quite a few people have mentioned cow milk allergy and I actually can't tolerate cow milk protein at all, so I am already dairy-free and have been for years (so he might well have CMPA but he's definitely not getting any cow milk from my breastmilk, so I don't think that's the cause of our current issues). It's definitely something I'm worried about with the prospect giving him formula though.

I'm seeing the GP this afternoon because I have my 6 week check, I'll ask them about carobel and gaviscon, and see what they recommend. The carobel sounds like it might be easier to give to a younger baby, so that sounds better to me, but if they think something else is more appropriate I'll try that.

I think the HV was trying to be supportive of the fact I am not really enjoying BF at all, but I don't think that's a good reason to completely stop in and of itself, and I'd probably hate BF a lot less if LO wasn't having these problems and crying so much. I'll update later this afternoon.

Also I'm currently taking omeprazole for stomach ulcer (caused by diclofenac after C-section...) so would he already be getting some of that through my milk?

Does he seem in pain / uncomfortable or is he just sick alot? My DS was a super sicky baby. He'd spit up after every single feed. But he gained weight really well. He was just a happy spitter. He grew out of it around 4.5 months. Now at 6month he's never sick. Could that be the same for you?

Update: Went to doctors. Got literally nowhere. She said breastmilk is designed to be the perfect thickness, then said reflux is over-diagnosed. Arrgh. She also said if I wanted to change him to formula I should just use the normal stuff. And then she said we were overfeeding him, and that infant-led feeding doesn't work and we shouldn't be doing it. I said current advice is you can't overfeed a breastfed baby but she said that wasn't true.
We are seriously not overfeeding him but she wouldn't listen. She then said he should be having 6 oz which I had to look up, that's almost 180ml per feed!!! When we use expressed milk with a bottle, he's barely taking 90ml without chucking up and he's definitely not on my breast long enough to have anything close to 180ml!

Apparently feeding him 180ml every four hours and letting him cry will fix all our problems. Then my car broke down in the car park of the doctor's.

I don't even know where to begin with solving this now but he's screaming again after feeding and I want to cry. I hate seeing him like this.

@lookingatthings He's definitely uncomfortable and very fussy with it. If it wasn't affecting him I wouldn't worry at all.

Not read the full thread, but would second you cutting out dairy (and onions!)

Oh my goodness you poor thing. What a horrible situation. We've had some fantastic support from medical professionals and I'm very grateful but sometimes you do get these ridiculous responses from people who clearly have no recent direct experience of trying to nourish a baby who is constantly ill and beside themselves with discomfort. Noone can fully understand what it is like trying to feed your baby, especially from your own body, and have them recoiling in pain away from you unless you have experienced it, I can't stand this dismissive attitude towards reflux. It is awful and it deserves to be taken seriously. Unfortunately we had similar but just kept going back and refused to be put off - eventually we got lucky with a lovely locum and got Gaviscon and later Ranitidine, which made ALL the difference. If I were you I would ask for another appointment with a different doctor; it is awful feeling like you need to 'make a nuisance of yourself' on top of everything else you are dealing with but honestly if I were you I could not accept this advice. You are absolutely right to feed on demand and of course you can't leave a breastfed baby to cry for 4 hours between feeds - mine never managed more than 2! You are being a brilliant mum trying to help your baby who needs you, just remember that and don't let anyone tell you anything different.

You can get enfamil AR over the counter. Try it and if it works, then go back and ask for a prescription.

Also meant to say I agree with previous posters that feeding little and often is key, so the advice to give loads every 4 hours is crazy and I highly suspect coming from someone whose only experience is of formula, which is much heavier. In answer to your original question, yes I exclusively breastfed my baby for the first 4.5 months and then combi fed for another month- I only stopped because I was going back to work and didn't want to express (plus if I'm honest formula did help my baby sleep better!) but there was certainly no feeling of needing to stop bfing because of the reflux. I found it helpful to ask my hv for advice and then tell the doctor that I had exhausted all methods advised by the hv, at which point the hv had told me the only avenue remaining was medication. I told them which medication my hv had said could help. Saying that another health professional (with more specialist experience than a GP) had conceded that we had already done everything possible and that we should try meds seemed to help reassure the doc that we were legitimate (although you really shouldn't need to prove yourself to that extent!). After my first awful experience with the GP I called back my hv and they advised me to go straight back and told me exactly what to say, they were great. Might be worth having another chat with them? Really hope you get sorted.

I'm really surprised by your GP. I'd ask to see another, or just go to a different surgery. HV's can prescribe infant gaviscon too.

I had two reflux babies. We were all covered in milky vom, most of the time. It is miserable and you have my sympathy.

Gaviscon, and for DC2, Nexium solved all our problems. DC2 did have a CMPA/sensitivity but luckily outgrew it. Sounds like that can't be your problem though.

Good luck.

Arghh. Well gaviscon made a world of a difference for my breastfed baby. I premade it and kept it in little sterile tubs/cups for overnight and when out and about.

I suggest you try again with GP and explain you are close to giving up BF but want to give everything a try first.

It is also worth letting the HV know the sort of advise the GP is giving out!

Two of my DC had reflux. It's a pain in the arse OP, you have my sympathy.
We had Gavisvon perscribed, tried Infacol, gripe water, reflux cot wedges, specialised formula, you name it, we tried it but none of it really made any difference.
It magically stopped with all of them when they started weaning.
I just wanted to reply to say it sounds like you're committed to breastfeeding, don't give up on the basis formula will help, because it in my opinion the chances are it probably won't.

Maybe go back and try another doctor? I know it's so frustrating, my little one had reflux and the doctors kept trying to fob me off, ranitidine solved everything, he's like a different baby now! So much happier! They tried to give me gaviscon but it just didn't work for us. The breastfeeding support team local to me don't recommend it with breastfeeding as it's really tough going having to mix bottles and breastfeed.
It sounds like you've been through the wringer! Go easy on yourself, you're doing your best ❤️