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Infant feeding

Get advice and support with infant feeding from other users here.

14 week old sick after burping. Reflux? CMPA? Other?

5 replies

Mahonia · 26/04/2020 15:32

Hi everyone,

Apologies in advance for the super long post, I wanted to include as much information as I could.

My DD is 14 weeks old, exclusively breastfed, and for the past week has been being sick around 5 - 10 seconds after burping. This happens after nearly every burp and she seems to bring up a fair amount of milk each time. I'm trying to work out what is causing this. She's generally pretty happy most of the time although has been a little more cranky over the last couple of weeks which I think is due to tiredness when trying to get her to have a nap, although I could be wrong!

She generally seems to feed well. I think I have a fast let down as she can cough/choke when she first starts feeding, particularly during the first feed in the morning. Other than that she doesn't really fuss when being fed, only occasionally seems to get uncomfortable and usually I'll sit her up and wind her and then carry on with the feed.

At six weeks old she projectile vomited twice in two days, and produced lots of sick whilst lying down during nappy changes (think actual puddles under her head on the changing mat). Other noticeable things were mucus in poo for a couple of days, grass green specks in poo for a few days (but otherwise the poo looked 'normal' for her). No discomfort or obvious pain when she was being sick. HV suggested I cut out all dairy for two weeks. The following day DD was sick again, so I took her to the doctor. He suggested it was reflux and prescribed gaviscon. Advised against dairy avoidance as 'not an easy thing to do' and better to try gaviscon first.

Two days later we had our six week check up with a different doctor. He advised against gaviscon, due to the risk of her getting constipation and he apparently doesn't usually like to advise medication for babies so young. He suggested managing it physically - keeping her upright for 30 mins after feeding. I did this for several weeks and she was mostly better - there were fewer episodes of being sick and no projectile vomit.

Roll on a few weeks...
I did reduce my dairy intake too but didn't avoid it all together - I generally just had some milk in my tea and the occasional bit of cheese.
I also became much better at winding her, approx 80% success rate.
We had fewer episodes of being sick, so I wondered if it was actually linked to not winding her well and the bubbles in her stomach bringing up the milk. I eventually stopped worrying about the 30 min upright rule, although did find that I couldn't lie her down awake after feeding without some milk being brought up, but not in the same quantities as previously and seemed more 'normal baby' posseting to me.

Within the last week she has become much harder to burp, it's more like an 80% fail rate. I try during natural breaks in her feeding, or if she starts fussing, and then when she has finished too. When she does burp she is sick around 5 - 10 seconds later. This can be in quite large quantities although unlikely a full feed. Sometimes she gets a bit fretful afterwards but not every time. Three mornings in a row the sick after her first feed of the day was projectile (over a foot in distance). This was after sleeping around 10 - 6 without waking to feed during the night, so my boobs were quite engorged. She was then generally sick after every burp during the day, although less forceful, creamy coloured chunks and less watery.

Also, this week she has started to poo whilst sat on my lap being winded (should I sit/hold her on a potty?!), so I have to stop winding her before getting a burp out and change her nappy (as it often leaks up her back - probably because of the way she is sat as its not always large amount of poo). Once I lift her upright again onto my shoulder after nappy change she burps followed by sick 5 - 10 seconds later. Sick is mostly creamy chunks, with some more watery liquid.

She has also started to get a rash on her face - small red dots, mostly around her mouth and on her cheeks - which seems to flare up when she feeds (she looks quite spotty straight after). She is drooling a lot more which could be causing the rash potentially. It doesn't seem to affect her or cause her any discomfort though, e.g. she didn't scratch it or rub it.

The only thing I can think of that has changed in the last few weeks is that I ate more dairy than usual - I had a small amount of ice cream for dessert several nights in a row, plus cheese and yoghurt regularly too. She did have her 12 week immunisations ten days ago too.

Any thoughts/experiences on what could be causing this?

Possibilities I can think of could be:
Reflux
Dairy
Side effects of immunisations
Anything else?

Should I try giving her Infacol or similar to help with the winding as a first step? I wonder if I can get the wind out sooner then it might not bring up the sick although the sick comes after the burp not with it. She also sometimes hiccups after being sick, usually at least once or twice a day. I've tried gripe water at around eight weeks old but she absolutely hated it although the tiny amount I managed to get into her did seem to produce a burp.

Should I do a one month trial avoiding dairy (and therefore soy too)?

She's generally happy in herself although perhaps a little more cranky than usual this last week. She seems to be gaining weight and following the growth curve quite well (based on weighing her at home on the scales with me, so not completely accurate but a good indication).

Don't think I've missed anything out. Apologies again for the super long post!

Thanks for reading!

OP posts:
CaryStoppins · 26/04/2020 15:37

If she’s happy and gaining weight then being sick isn’t a problem. Lots of babies are sick, there’s nothing wrong with them it’s just their digestive system is still maturing.

Does she need winding? Breastfed babies often don’t as they aren’t swallowing air like a bottle fed baby does. I found if my babies needed to burp then just sitting them upright was usually enough and by 3 months they didn’t need any “winding”.

Mahonia · 27/04/2020 07:11

Hi @CaryStoppins

Thanks for your reply.

I know that babies being sick is quite normal and nothing to worry about generally, however this seems unusual for her and we've only been experiencing it for the past week, plus she's bringing up sick after she burps, not with the air she brings up. She has been gaining weight well so far, but as this has only started in the past week or so I don't know yet if it is affecting her weight gain. I will continue to weigh her at home and monitor her progress. As you say though, it could just be her digestive system maturing causing her to be sick after every burp.

She does seem to still need winding yes. Just sitting her upright does not usually result in a natural burp, she has always needed a little assistance and still does seem to currently.

OP posts:
CaryStoppins · 27/04/2020 09:42

They don’t always need to burp after feeding though - I wonder if trying to force a burp might cause the sick?

Mahonia · 27/04/2020 10:23

Yes I suppose that is possible. I'll try just sitting her upright on my lap after feeding without patting her back and see if it makes any difference today. Perhaps a more natural burp (if one happens) rather than a forced one will be easier on her stomach and not force any milk up afterwards. I'll see how it goes and report back. Thank you.

OP posts:
Mahonia · 06/05/2020 14:08

Hi @CaryStoppins
I tried your suggestion to not wind DD and allow her to burp naturally if needed, but had mixed results. She did manage a natural burp a few times but still then brought up milk around 10 seconds later (I could feel her stomach contracting a few times before the milk came up). Mostly though she'd sit on my lap for a minute or so then suddenly become very squirmy, stay crying and throw herself backwards. It was very hard to keep her upright and I ended up having to pat her back again to help her release the burp. Or she wouldn't burp at all but then wake up in the middle of the night uncomfortable and needing to pass wind. So for now I'm back to winding her again. The sickness has started to improve over the last couple of days so I'm still none the wiser about what could have caused it. But thanks again for your suggestion anyway.

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