Does this sound like silent reflux?

[QueenOfWeeds]

…or just a normal, slightly unpredictable baby?

DD is 7 weeks, born with a tongue tie which was snipped at 6 days. We are combi-feeding due to slow weight gain (with the tongue tie I was told wasn’t a problem!). She dropped a lot of weight initially but has now settled onto her centile and has been tracking on that for the last 3 or 4 weeks (I take her to the health visitor clinics).

When feeding, she feeds fairly happily on the boob but it’s hard to burp her at this point. She then has 120-150ml of formula. We pace feed and try to wind after every fluid ounce. Despite all this, she

• is really uncomfy at night. We have been assuming trapped wind but now I’m not sure
• flails arms and legs when on her back in her crib (more than the normal startle/squirming)
• arches her back
• howls if you take the bottle away to burp her
• has had a blocked nose for a while (we thought this, plus wind, could explain her bad sleep)
• hiccups frequently, but not quite daily and definitely not multiple times a day
• possets after burping frequently but has vomited rarely, although twice it has come from her nose too

We only really see this when she is lying down at night. During the day she will sleep in the bassinet of her pram, or occasionally the Moses basket (prefers contact naps in her sling) and will happily lie on her back smiling and engaging with sensory toys (as much as you can expect a 7 week old to do!).

Predictably this is the week I can’t make the health visitor clinic to ask but I assume if it continues to next week it’s likely to be silent reflux. Her different attitude during the day is throwing me off.

All of what you describe certainly sounds like silent reflux. Mine used to be happy as a clam in the daytime, but night time was a totally different ball game, and she was really upset and uncomfortable. The things we did were keeping her upright and burping for at least 30 mins after a feed, raising the head of her cot by using books under the legs, smaller feeds but more often, using a thicker formula (hungry baby I believe) that isn't so easy to bring back up. We were given omeprazole at first, which didn't do much, and then we gave baby gaviscon, which worked wonders (but did cause constipation). Silent reflux tends to rear its head around the 6 week point and will eventually die down once the baby's oesophagus has fully developed. I'd speak to the GP instead of the health visitor to see what they can do to help if baby is in a lot of distress at night time - but it will pass!

Ok, that’s helpful- thanks!

Could be silent reflux, most will probably suggest that. But I'd honestly suggest it's wind and she needs a thorough burping. More likely an issue at night because they are more tired and less likely to push them out, they just want to go back to sleep. Still having this issue with my 8 month old.
Try looking at more burping techniques and consider gripe water or infacol.

We started infant gaviscon at this point and it made a massive difference, similar symptoms to your little one. We gave approx three sachets a day, but in half doses spread out over six feeds, and she was so much more settled after that, it didn't cause constipation thankfully

Yes sounds like it. Have you tried a dummy? The sucking motion (and possibly saliva) used to calm dd in between feeds. Also try and keep them upright at all times (I used a sling) I used to spend a lot of time holding the dummy in at first, she wanted it but would let it fall and then cry.

No dummy - was advised not to due to tongue tie.

She has pretty much all her naps on me in a sling - I thought she was just a Velcro baby but now wondering if it’s the upright-ness helping her. She’s just gone through the whole howling, arching rigmarole during a day feed, which is new 😥but I had a phone consultation with our fantastic GP and got a prescription for infant Gaviscon to collect this afternoon. Will see how we go.

so last night DD managed the first three hours or so in her crib before getting uncomfortable. Tonight I’m still waiting for that to happen…just given her some more Gaviscon in her night feed, so will see if that helps to settle her.

I’m currently running on about 3 hours of sleep in the evening before DH brings her up and she gets upset, and the odd snatched 5-10 minutes when I put her down. There must be a better way than this! All I can think of is that I go to bed as soon as DH gets in - I’ll get a decent sleep, but it means DH and I won’t really see each other at all during the week and that makes me sad.

When she is in her crib, initially she is grizzling and upset but still has her eyes closed. I’ve been picking her up to cuddle and soothe because this has always turned into awake and upset, but should I be leaving her? We haven’t nailed self-soothing yet (but I think at 7 weeks that’s ok? She has done it occasionally but more from fluke than anything else).

Seconding this - how long are you keeping her upright after a feed? It's quite similar to my daughter now - hiccups, arching back etc, but also gagging and coughing. We have to keep her upright for at least 20 minutes after each feed, even at night, or she will stir in her crib and cry and then be sick

They should be referring the infant feeding team before giving meds - gaviscon can then cause constipation which is another issue in itself.
Who did the tongue tie release? I would be going back to check latch - make sure they aren’t taking in too much air again if it’s reattached or latch has slipped. Then I would look at a hypoallergenic formula from the GP as it might be CMPA or (cutting out if you want). Generally there’s a reason for reflux and it’s usually latch or allergy related!

Thanks, that’s useful. My sister suggested cutting out dairy but I read that you shouldn’t do it without a doctor if you’re trying to rule out allergies? We have a GP appointment next week so will check then.

Her tongue tie was done privately, but I’ve had her latch checked weekly since then at a follow up feeding clinic, so it shouldn’t be latch related.