Reflux hell - Can anyone help? (V. long sorry)

[whittywan]

I have posted a couple of times before and finally have some sort of an answer from the GP.

Background: My 8 week old DS is ebf and has become progressively more unsettled since 5 weeks. Initially nobody would take me seriously as he has really grown beautifully - almost 4 pounds gained since birth. Finally last week the GP prescribed Gaviscon after I suggested a diagnosis of silent reflux. This however has not made much of a difference as I'm finding it very difficult for him to take the Gaviscon and I'm not sure it is making enough of a difference to warrant the huge effort.

Currently the major problems are:

Feeds - During the day he will latch on, feed for about 2 minutes and then come off and cry (often inconsolably). He is clearly still hungry but won't feed further until I have settled him by rocking and pacing often taking about half-an-hour. I have had a lactation consultant look at his latch, have tried feeding him upright, while walking, while lying on his left side and in his sleep, feeding expressed breast milk from a cup and bottle. Nothing seems to help and he only seems to be getting worse. This afternoon I have spent from 15H30 til 17H30 trying to feed him (last feed at 12H30) to almost no avail. This has left me not only responsible and like I am failing my son but also rejected.

Sleeping - With all this disruption in his feeds he is obviously not sleeping well and will only nap for about 20min in the sling during the day and at night for an hour in his moses basket (head-raised). The rest of the night we co-sleep but he is very unsettled.

I am exhausted, a virtual prisoner at home (attempting to feed in public leads to disaster) and at my wits end. And this after we got of to such a wonderful breast feeding start.

Any advice or encouragement will be greatly appreciated.

go back to your gp and ask to try a stronger medication.

Best way to get gaviscon in is to put the powder and water in a very small lidded container, shake very hard and then syringe in. TBH I ended up bottle feeding my screaming miserable baby but she was 6 months old by the time they accepted there was something wrong and it wasn't "a touch of colic"

Sounds v. difficult

Did the bf person suggest over-supply?

He ticks a lot of the boxes....

Sympathy-I am going through something similar with dd2 who is now 4 months. She actually vomits though but the problems feeding and little sleep are the same. I am waiting for the gp to come back to me after consulting the paediatrician. Probably resulting in more medication. So I can't offer advice other than persevere with your doctor, there are other medications than gaviscon.

Tiktok - I'm interested, what do you mean by oversupply, how could that fit this scenario? (I am aware you are the MN bf guru so v interested in your suggestion!).

Tiktok - I have wondered about over-supply. What are the signs and what can I try

I could have written this exact same post a few months ago! DD was 3 months premature, spent 9 weeks in SCBU and was fine. When she came home she moved from a beautiful 4-hourly routine in SCBU to 1-1.5 hourly. Then, around her due date, began behaving exactly the same way as you have described. (It built up gradually - to start with day time feeds were grim but night time ones were fine, but gradually they were all awful)

I wasn't sure whether it was silent reflux or oversupply (hadn't discovered MN at that point). Got some Gaviscon from GP and administered the same way as PP. It sort of helped. For about 2 weeks. Then I went back to GP who arranged for her to see Paediatrician (she was seeing one anyway due to prematurity, but we were moved forward to see them sooner). He prescribed Domperidone and Ranitidine. One reduces the acid in the stomach, the other increases the speed the milk moves through the digestive tract. He was more than happy to presribe them as there are few side effects and the definitive test for reflux is pretty grim and not always accurate.

Around the same time I changed DD's breastfeeding position. We also saw a cranial osteopath.

Something worked - it wasn't an immediate solution, but gradually she got less fussy. Maybe as she grew older she was able to cope with more powerful letdown. Maybe new positioning helped. Maybe it was reflux and the drugs helped. Maybe the osteopathy worked. I'll never know, but what I do know is that after a few weeks it sorted and she became a wonderful feeder again.

We are now mixed feeding, with bottles in the day and bf overnight, and it is a joy (except when she wakes over and over again, but that's a different story!)

I hope this mammoth epic post has helped. There really is light at the end of the tunnel. I FELT an absolute failure - not only could I not look after her in pregnancy, I then couldn't feed her! However, I wasn't a failure and she was ebf for about 7 months.

Feel free to ask me for more (!) info if you want it!

Oh, and DD put on loads of weight to start with too - 1kg in 4 weeks at one point.

However, that has now tailed off and they are querying failure to thrive! Bah!

Sorry - no time at the moment to go into over-supply, but there is a lot in the archives about this. Babies who are unsettled, gain weight fast, splutter and show signs of being hungry and upset despite frequent feeding should always be thought of, at first, as being normal, healthy babies coping with a generous milk supply, IMO, rather than being thought of as being ill with reflux and then getting dosed with meds.

I have never, ever heard of a doctor considering this, though

And over supply is so easy to deal with, without meds and without distress.

Thank you so much two and tiktok. I am feeling alot better now that I am considering over-supply. (Despite hardly any sleep)

I do have quite a forceful let-down (especially on the right)and the link to kellymom sounds exactly like my little one.

My spirits are definitely lifted.

If it does turn out to be reflux (which my DD has / had) - may I ask how you're trying to get the Gaviscon into him? Have you tried a dosing syringe?

I have tried mixing with both cooled boiled water and ebm and giving in a bottle; from a spoon and with a dosing syringe. Have had best results with dosing syringe and mixed with ebm.

I had exactly the same problem with DD2 ( now 5 mo). From 3 wk old she became difficult to feed, pulling away from the breast after a few minutes, crying, gassy, unsettled at night and during the day, never comfort fed etc. I took her to the GP who referred me to a paediatrician who diagnosed silent reflux. She started taking Gaviscon and ranitidine, but I didn't really see any big improvements. I always felt that the problem was more linked to my forceful letdown and oversupply, but when I mentioned it to the paediatrician, he told me that she had all the symptoms of a baby with reflux. Anyway, before Xmas, I decided to get a private appointment with lactation consultant, who immediately told me what I thought, that my fast letdown was the problem. She showed me different ways of feeding my DD2 and I must say that now things are much better. We still have a few problems, but I have learned how to deal with it and DD2 has as well, the kellymom website has lots of very good suggestions. Oversupply and forceful letdown should normally settle around 3 months, but I must say this hasn't happened to me!

As an update - I have stopped attempting to give DS any Gaviscon and although he isn't any better yet he certainly is not worse. And I feel a lot more relaxed now that I'm not struggling to feed AND trying to get the meds in him.

I am going to the bf support group tomorrow and will see if I can get any help there - if not will prob book to see the lactation consultant again.

A doctor friend recommended Baby On Board to me - she was given it by her obstetrician in Australia.

Now - the premise behind this is going to annoy a lot of people (as the mother of a refluxy baby, it unsettled me). It suggests that almost all babies don't have reflux and are instead overstimulated.

Now - I thought very deeply about this and concluded that since the Gaviscon stopped her symptoms overnight in quite a dramatic fashion, it must be correcting something.

But - if Gaviscon isn't working - is there any possibility it could be overstimulation? The author suggests sitting with the baby in a dark room and boring them to sleep.

Tiktok - thank you for giving me the confidence to consider oversupply as being the real problem. Having practised some of the techniques here PFB is much more settled and feedings have become alot easier. They are not perfect yet but I am very hopeful