Baby won't take carobel - help!

[WhatTiggersDoBest]

Ok so Friday we had a pretty solid plan about his severe reflux. Today, however, he's upset that he can't feed off the breast and he won't take the carobel (powder made into paste to help with reflux) before or after breastfeeding with a syringe and my HV's got no advice.
I just want to be able to put him on the breast, feed him, and the feed stay down.
I've tried it warm, cold, with breastmilk and with water and he just pushes it back out of his mouth with his tongue.
I tried smearing it on my nipple or in his mouth with a finger before latching him but it made a big mess and I can't get enough of it into him that way as he only swallows when there's a flow of milk!
I called the national BF helpline, the lady was lovely but she didn't know what to do either.
How do you get stuff like this into the baby? Any ideas? When he had his first vaccines, he was like this with Calpol too, BTW.

Have you tried syringing a small bit in then quickly putting the dummy in so they will suck and swallow? That works for me!

Hi,
I’m having similar issues with my EBF 5month old who’s been prescribed gaviscon for reflux. Tried all sorts too and it’s a bit hit and miss.... here some ideas I’ve had limited success with;
The dummy trick PP suggested sometimes works
Making it up a bit thicker so there is less to get in so what little that does get swallowed counts for more.
Syringe and then stroking his throat
Doing it before a feed when he’s hungrier (sometimes massively backfires as then he gets too stressed to feed)
I’ve been looking on amazon at medication pacifiers - that might be my next try....
I’m hoping that as it becomes part of his feeding routine he’ll start to accept it a bit better. Over there last two weeks I’ve had a couple of occasions where he’s happily taken it from syringe as if he knew what was expected just hoping that increases with time.

Good luck OP and let me know if you find the magic solution l!

The paste recommendation didn't work for us at all. We found that syringing a little mixed with breast milk into the mouth but carefully along the inside of the cheek first, then allowing him to feed worked. If he takes a break or slows down so he unlatches try to syringe some more in them.
As others have said it can be hit or miss and you need to explore options and find info that works for you
We found keeping them upright for 20/30 mins after a feed worked wonders!!!! Not ideal in the middle of the night though.

Thank you for the advice, everyone!
@Sparkey47 he's a bit hit and miss at taking his dummy (he doesn't always like it) but I've tried that this evening based on your suggestion. We got a bit of the stuff into him (about 3 ml out of 15ml) which was a good success, but not enough to keep his milk in his tummy. It's like his mouth and tongue seem to freeze up whenever I syringe anything into his mouth.
@Pipanchew2 a medication pacifier might be what we need, so we could maybe give it to him after feeds. I didn't know such a thing existed! The new doctor gave us Gaviscon to try, too, but I don't know if DH mixed it up wrong but it was just watery and didn't make a difference to DS's reflux. We should probably try it again.
@MrHaroldFry we did have a bit more success mixing it with breastmilk than water, but he seems to be instantly suspicious of it so very little gets in. I wonder if the delivery method is the issue since we're using a syringe. We had to fight really hard to get the carobel/gaviscon prescribed and it took 5 weeks despite the HV being on our side, so it's really frustrating that the baby is refusing it.

Pop it into the back of the mouth sort of between the guns and the cheek, keep mouth closed and slightly tip the chin up, only enough to stop it leaking out not all the way back (you don’t want to choke them!) and gently stroke throat with fingers to make them swallow. Worked with both my two.

Oh bugger sorry misread, that’s what I did for calpol, no idea if it’ll work for other medicines but hope it helps?!

@DartmoorDoughnut thank you, it's worth a try! I'm actually using the Calpol syringe for all these things (and getting him to take Calpol before his next vax in 10 days would be something) so that's really relevant.

I don't know, but just wanted to say my DS3 had very sicky reflux, and the dietician said we could get Carobel but really don't worry if he doesn't like it and not to stress about it or force it as the evidence for it working isn't huge, and just ride it out, he should outgrow it. He did eventually.

As an update, I tried the Gaviscon again tonight and we had familiar little waterfalls of sick preceded by quiet splashing sounds again, so the Carobel is definitely the only thing that works for him (it works in a full bottle of expressed milk really well, but it takes me an hour to express one bottle for him, by which point he's hungry again).
For a longer term answer, I'm looking into a medication dummy, if he'll take it. Any more suggestions definitely welcome though! I keep thinking it has to be my technique.

They said breastmilk is absorbed very quickly. So even when his weight gain was an issue temporarily, he wasn't starving, and feeding as much as possible at the breast rather than trying to thicken feeds was best.

@user1573334 unfortunately, he's sicking so much he's losing weight because he can't keep his feeds down, he's going through 7 or 8 outfits in a day, screaming constantly in pain, not sleeping for more than 30 mins at a time, and we're basically housebound for another 3 months if we can't crack this somehow. I'm supposed to be working full time and literally just feeding him and handing him back to DH during the day, but that's not possible right now. I had to fight really hard to get the carobel and gaviscon prescription as the first doctor was really dismissive of how badly this is affecting all our lives where the one I saw last week actually took this seriously. The first bottle we gave him of expressed milk and carobel on Friday made such a difference, all his symptoms were gone and he slept for 3 hours straight, but now he keeps spitting out his bottle and rooting. I'm not ready to abandon the idea of carobel and direct breastfeeding until I've tried everything to coax him to take it, because when this (hopefully) passes at 6 or 12 months, I want to have some milk supply to give him!

Can you cup feed? Express a little and thicken it with the carobel (perhaps a tiny bit to start with rather than full dose)

I honestly didn't realise they'd prescribe carobel for BF babies (and to me that seems a bit crazy, friend's DTs need it with their neocate but that's simpler to deal with)

oh and look at Human Milk for Human Babies to consider getting a supply for bottles. A friend does as she can't express enough for the bottle her DS2 has at DS1 bedtime and I just dropped a whopping 15L off to a family as a courier (I definitely didn't have a stash like that, ever)

I couldn't get gaviscon into my breastfed baby so the doctor prescribed renutadine. You only have to get 1ml in so it's much easier to make sure they get it. Is that an option or have you already tried it?

It sounds like you need more than Gaviscon and Carobel. Have you talked to the doctor about things like ranitidine?

Interestingly @Celehelly, friend's DTs no longer need ranitidine now they're on neocate with carobel

@WhatTiggersDoBest has CMPA been discussed?

@Harrysmummy246 thanks we might try a cup. We've managed to have some success making a slightly thinner paste and putting it in a bottle with a fast flow teat, but he's being sick before we finish breastfeeding so it's not solving the problem completely. Expressing wise, I just got a new Medela pump today (I have the Tommy Tippee electric which I've been trying to use), so I'm hoping I can get a better milk yield as I'm pumping about half a litre a day right now. I read yesterday in reviews on Amazon that a lot of people were struggling to express with my Tommy Tippee pump, so hopefully the Medela will be better! He just really misses the closeness of a direct latch. :(

They haven't brought up CMPA but I'm milk protein intolerant (so milk free, even the "hidden" milk, I have to be very careful) so they think it's unlikely, although I don't know. He's free of 99% of his symptoms when I give him either Cow and Gate Anti Reflux Milk (he gets 1 bottle a day) or expressed milk with enough carobel, but I have wondered if the amount of soya in my diet is causing some of his symptoms.

@Hollywhiskey @Celehelly the doctor mentioned ranitidine as a next step, but said we should try Gaviscon and Carobel first. I think we will have to go back for it. Does ranitidine help with the little waves of sick that pour out? The doctor said it would make it less acidic but not necessarily stop it happening.

I wanted to clarify, they think it's unlikely DS's symptoms are caused by CMPA due to the fact I have no milk in my diet, however, there's been no mention of the fact I have milk protein intolerance and hubby's family all had CMPA as babies which is why I'm not ruling CMPA out completely.

Our boots has medication dummy’s.. and they’re a pain in the arse, small chamber and not the best for thicker fluids.
I didn’t even think carobel would be given for bf’ing, I know it’s a bottle but ds doesn’t need the full dose to keep his feeds down. Might be easier if you could do 5ml latch 5ml switch 5ml.. that’s just a theory but if it lets him calm n feed rather than a fight with a syringe it might help.

Ranitidine seems like a better solution. I’d call the gp and ask if he can try it.

Syringe it in mixed with a little breastmilk.

CMPA babies are often soya intolerant too. You poor thing, it sounds awful. I'm assuming it's important to you to keep breastfeeding but just in case you needed someone to say it: it's okay to stop if it's impacting your (and his) quality of life too much, you've done amazingly well and given him so much goodness already.

@Lunafortheloveogod yeah I looked at the medication dummies on Amazon and in the end I decided we'd be better just putting a tiny amount of milk mixed with carobel in a normal bottle. That was working perfectly for the past few days, and then today he's randomly started refusing his bottle and insisting on getting his milk straight from the source. He's crying every time I try and give him the bottle.

@GrumpyHoonMain that's what we tried in the very first place as it seemed like the most sensible solution but he just pushed the mixture out of his mouth with his tongue. I tried getting my breast in there straight after getting a bit of carobel/breastmilk paste in, and I just ended up covered in it.

@peachgreen I was hoping to step it down to formula feeding him as the anti reflux milk is amazing (or at least combi feeding him), but now he's refusing bottles on top of everything. I was thinking I could pump until 6 months then we could try again without thickeners when it's time to start weaning as I'd heard it often resolves by 6 months. But IDK if I'm being overly optimistic.