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.

Both my 2 were reflux-y babies, if I lay down my son on his back it was like a volcano and he’d be sick until it turned yellow. Gp prescribed ranitidine for both mine and it helped loads and I could tell when the dose need adjusting due to gaining weight.

When making the appointment ask if they have a paediatric specialist who you could see.

I breastfed both mine, neither would take a bottle. Both self weaned around 3.5 years old. We also co slept as the puked lesson their sides.

Good luck, and try and find a breastfeeding group they are fountains of knowledge x

Based on my experience breastfeeding, I think you're right to raise your eyebrow at the GP suggesting a) that you're overfeeding and b) to aim for 180 ml every four hours!

I suspect that 180 ml is a guideline based on formula, not breastfeeding... Even at 6 months old, my breastfed DS took no more than 125 ml of my expressed milk in a bottle and he was usually satisfied by about 100 ml. I'm constantly amazed by how much milk his bottle fed peers drink! He did sometimes vomit if the milk was given too fast (bottles being easier to feed from), but if we paced the feed he was usually fine. Also, DS fed much more often than every four hours, as breastfed babies usually do when they're tiny (you'll probably be glad to know it settles down and becomes much less frequent as they get older...). On demand feeding is standard when breastfeeding.

I feel that you're being horribly let down by both your GP and HV. Please don't be afraid to trust your instincts and seek second opinions. Try a different GP. The professionals often lack training when it comes to supporting breastfeeding (bitter experience speaking).

Are there any breastfeeding groups that you.could access in your area? Sometimes you can find midwife run groups (my local hospital ran one based at a childrens centre) or you could try La Leche League. They could probably advise you about reflux in a more breastfeeding specific manner (although they won't be able to prescribe anything, knowledge = power and confidence which will help when you speak to people like the GP again).

You might find this article helpful (this website is a fantastic resource recommended by an IBCLC midwife who advised me in my early BF days):

kellymom.com/hot-topics/reflux/

You poor thing, that's tough going. My (second) baby is one now, but I could have written your post except for the sick - he generally didn't puke, but was very unhappy, screamy, and in pain with wind at and after every single feed. Short feeds, constantly unsettled, feeding very frequently. I tried a few bottles of formula, but it made no difference at all - same behaviour, so just kept feeding. I remember well the feeling that BF is taking over your life - it's awful. So here's my thoughts, having come through it recently:

1. Push your GP for reflux medication, if it's something you want to try. Mine came out with the same line ("reflux is the latest trend"), but I kept going back till she gave me a prescription. We had some improvement with ranitidine, but not a huge improvement, but I others have had success with one or other of them. Try them all.

1. Everyone will suggest CMPA. You are already dairy-free, as you say, but people will say there could be other allergies or hidden dairy or whatever. I wasn't able to do the elimination thing - it was just too much on top of everything. Luckily, DS started to improve on his own accord before I reached the end of the line. And he has dairy now without issue, so it wasn't CMPA. I also spent a lot of money on sessions with an osteopath. Also didn't make any difference.

1. What's your let-down/supply like? I had a VERY forceful let-down reflex (jets of milk that could travel five feet! and painful), and several let downs per feed. I did try to unlatch him and catch the initial jet in a muslin, but honestly, I just had a fast flow and he had a sensitive system - not a great combination. This was definitely the root of a lot of our problems.

1. I'm REALLY sorry to say this, but the only thing that helped resolve it was time. The whole feeding process got a bit easier around ten weeks, but he was still a very screamy baby and needed very frequent feeding, especially at night. Big improvements with wind came as he learned to sit up himself, and then crawling. But I know how frustrating that 'time' thing is, when you are in it.

I also raise my eyebrows a bit at the 'space out feeds' thing, but...I will say that the frequent short feeds combined with my fast flow didn't really help matters. This is just my own gut feeling, and I know it goes against the advice for breastfeeding. He was in pain, he sought out comfort at the breast, more milk came quickly, he gulped it down, he got more pain. Honestly, things got better when he started naturally spacing out his own feeds. But he did that himself, on his own schedule, and it could have been a coincidence, of course - maybe his gut just started maturing, my flow settled down etc.

Anyway, I am still feeding him now at 14 months (only twice a day at this point), and he never really had a bottle. Whether that's 'successful' or not, I don't know. He was a very unhappy baby for the first five/six months. He wasn't a good sleeper either (linked to the feeding problems of course), so he was permanently knacked too, which didn't help. But that's partly his temperament - maybe some babies are just highly strung and sensitive.

I'm sorry that you are in this position. I remember feeling very bleak between 6 and 10 weeks. It's when you expect things to start settling down and they don't and it's very overwhelming. Good luck to you.

My now eight month old had reflux to the extent she didn’t gain weight. I am also long term dairy free but I suspect now she was soy sensitive as she still vomits after soya formula but not after breastmilk.

We survived with upright positioning in the sling, frequent feeding, occasional gaviscon and early solids (5 months) which has been the ultimate solution. I know lots of people have found other medications helpful.

I’d see a different GP. Reflux is over treated and over diagnosed possibly but that doesn’t mean it doesn’t exist! My first had reflux, the neonatal doctor acted like your GP, she stopped breathing was admitted to hospital, started gaviscon after a gastro review and problem solved.

Sorry I meant to come back and update but then we hadn't really changed anything so I wasn't sure what to say. Thanks for all the advice. We are still BF.

DP melted all the baby bottles in the steamer (and the steamer was melted too, lol) so we haven't been able to give him any pumped milk this week, it's all been coming directly from the nipple, and honestly I'm seeing a massive difference. Can babies have issues like this just from having pumped milk or drinking with bottles? We store it straight in the fridge and use within 24 hours usually. Am I getting the temperature wrong or something? I'm testing it carefully before giving it to him.

Last night we also tried putting him on his side in our bed after feeds and we had a definite reduction in problems after 2 of his feeds, plus it was easier to clean up as it was all in one direction. He still had some stomach aches after eating though.

I have the PILs visiting all this coming week but I'm going to try and get an appointment with another doctor for the week after.

Ah so pleased to hear things have been getting better that's great! Interesting points you mention- I got help from a fabulous lactation consultant in the first few days who recommended feeding in side lying while cosleeping, for my refluxy baby who just pinged awake the second I put her on her back in the Snuzpod. It worked brilliantly for us, she was much more comfortable on her side (and has chosen to sleep on her side or tummy ever since she could roll) and it was much less disturbing for both us after a feed- just unlatch and edge backwards slowly! I was then gradually able to shimmy her backwards a tiny bit after the feed without her waking and then increase the distance over time until eventually I could just plonk her straight in the Snuzpod with no bother - took a couple of weeks of my husband sleeping on the sofa but that was it. And in terms of the bottles, I never had any success with expressed milk - my daughter would gulp it like CRAZY and then scream in discomfort even though we used the newborn teats. I was expecting similar when we tried formula much later but she was completely fine with it - I think it doesn't come through so quickly because it is thicker maybe? Anyway I'm so glad you're seeing improvement for whatever reason. My motto for motherhood is 'do what works' - sounds like you're on it!

Hi everyone I just wanted to update in case anyone else has a similar issue. The carobel made everything so much better that his symptoms almost went away. I ended up pumping exclusively, and topping him up with 1 or 2 bottles of formula per day. At 6 months, his reflux got worse. He ended up in hospital last week and is now on Alimentum. He has been diagnosed with CMPA.

I just wanted to say thank you to everyone who gave me advice in the first place and all those who suggested CMPA might be the thing, you were right.

Because I didn't have milk, I didn't know where he might be getting it from, but I rely heavily on soya milk (I have over a litre a day) and didn't know that could also cause CMPA symptoms. I am prone to anxiety and thought I was being dramatic by worrying about CMPA so I kept putting it out of my mind. I didn't know his nappies weren't normal until the doctor pointed out they were mucusy and diarrhea, I just thought that was a breastfed nappy.

Carobel and prescription milk seems to be the right combination or at least has significantly improved it all. I feel awful that we missed this but we had to go back again and again to get anywhere with it. I'm just glad he is so much more settled again and we can finally get some sleep! Thanks again all.