8 week old - silent reflux. Started on infant gaviscon

[purpleviolet1]

Ds will be 8 weeks tomorrow and is a good weight of over 10lbs now. He was born at 37+5.

He is formula fed - cow and gait comfort (since 4 weeks) as we initially thought he had colic. He has had the following symptoms:

• distressed during feeding
• approx 1-1.5 hours after feeding he cries and cries. Very rigid body and very difficult to settle.
• gulping noises up until next feed followed by shrieking
• wheezing, clearing throat, grunting noises during sleep
• waking up mid nap clearly in discomfort. Not able to settle for more than 15-20 mins at a time
• sometimes bringing up milk , other times we have seen it in his mouth and then he has swallowed it
• burps regularly and passes LOTS of wind
• lots of hiccups
• congested nose (all the symptoms listed seemed to have started/ got worse after he had a cold)

On a side note he has very good head control and is very alert. Numerous people and HCP have commented on this since birth.

It appears to be more silent reflux than normal reflux. GP prescribed infant gaviscon yesterday and said to see how we get on.

So far the crying episodes are very slightly less. Don't think this medication is going to cut it but I understand it can take time so will give it until Monday unless there is further change. Only way he is settling is on his front on my chest if I'm lying down. He doesn't appear to be getting into a deep sleep at all.

If your LO had silent reflux do the above symptoms sound similar? What medications worked and how long until you saw an improvement? Any other tips?

We have got the wedge to raise mattress and keeping him upright after feeds (he is mostly in my arms now constantly anyway).

Lactose intolerance is v rare in babies, and completely different. It means they don't have the lactase enzyme to digest the lactose (a sugar) in milk; obv rare because we're evolved to drink our mothers' milk (which is why lactose intolerance becomes more common in adults, as many populations aren't that evolved to have milk as adults).

CMPA is a quite common allergic response to the proteins in animal milk (cow, and usually goat, sheep etc too). It's a (non IgE) allergic reaction by the body, rather than a lack of enzyme.

Lactose free foods have the lactose removed, but still retain the proteins, so they're of zero help for someone with CMPA.

A reflux expert here... From bitter experience! We are 2.5 years in of dealing with severe Gastro Oesophageal Reflux Disease and CMPA. Firstly, I just want to say that reflux can be such a distressing experience as it csn be very debilitating and really impact what should be a lovely time in your lives. Secondly many GP's and HV's don't understand the condition or take it as seriously as they should. On that basis, be prepared to fight for the support you and your LO needs.

No child should suffer frm reflux. it can be well managed with meds, dietary changes, milk changes or a combination of all. If you are experiencing symptoms this is an indicator that the conditon is not well managed so insist on something else and/or a referral to a paediatrian who specialies in this area

Some pointers that I think are worth mentioning... Reflux can cause apnoea as the axis flowing into the oesophagus can get into the lungs (thisnfa why a symptom of reflux is a cough or wheezing)!and cause choking. I don't want to scare anyone but if you are experiencing choking/breath holding then you should push for a paediatrician referral as soon as you can and if this happens again consdier calling 111.

As another poster mentioned, lactose allergy and CMPA allergy are very different. The latter is very common. If your LOnhas CMPA then removng dairy fr your diet if you are BF or switching to a prescribed non-hydrolysed formula are the only ways to treat this. All reflux milks on the market are still based on cows milk and won't help if there is a dairy allergy. This is why some babies don't respond to the reflux or stay down forumlas.

Meds... Ranitidine works well but is weight based. You need to weigh your child registry and have the dose adjusted accordingly and of course it needs to be the right dose in the first place.

I could go on and on... Ill end by saying you have my every sympathy dealing with this. It soils your experience and can be utterly isolating and overwhelming.

Wishing you all the very best and remember that you are the parent... Trust your instinct and don't be fobbed off. Good luck!!

And apologies for the typos! iPhone and toddler jumping on me!

Thanks for all that...I know this isn't my post but I'm so glad purpleviolet raised this...I've just fed Etti again and had to stop after 4oz she was in such a state... clearly bringing up and swallowing back down whilst drinking...then screams...then repeat until I gave up and she passed out

How about the anti reflux milks??? Anyone else tried these?? I'm just worried about the constipation people say that causes... I don't want to rid one issue for another.... she had bad constipation on first milk hence the change to comfort ....it sorted it but not all the other issues ....

P.s I'm not putting off taking her to the gp it's more what can I do before I go so they can't fob me off ...I had it all with my son (reflux I'd say over silent as he was bringing up whole bottles right up til the next one was due) and was fobbed off and made to feel so stupid for being upset over what one gp advised - "he's just posetting it's normal...all babies do it" ...had to even ask what posetting was! So never went back after that...

I've the HV over Tue anyway so will talk to her but she seemed useless last time and as mentioned in a previous post...said she's probably just over hungry at night if the nights feeds are worse than the day... not enough support when you know things aren't right with your baby

That's so informative hellomoon, thanks so much. We have our follow up on Friday wth GP so I'll see how we get on until then. I think LO is slightly more settled but still having frequent episodes of crying hysterically. He is constantly making gulping noises from 1 feed to another (even if he isn't distressed the whole time).

Really appreciate all the advice, it's giving me confidence to push the HCP.

For those of you experienced/ diagnosed with CMPA, is it necessary to have skin issues? I think if LO does have CMPA it'll be a mild version..

From what I understand wriggled, anti reflux formula is thicker than comfort and the gravity of it is meant to help keep it down. I don't think it'll help the acid issue and is probably better for what your son had, reflux where they bring whole bottles is. It's worth a try though but trying all the various things is so time consuming and in the meantime we suffer.

My plan is to see how we get on this week and then take it from there. If the ranitidine doesn't help im going to push for the non hydrolysed milk - if the issue still remains then we'll know it's just silent reflux and we can keep going with the meds.

Hi there. No, doesn't necerssarily follow that with CPMA you have skin issues. My LO didn't.

Unfortunately this whole issue gets muddied by GP's who dismiss the condition as 'what babies do' or don't have a great deal of knowledge in the area.

And of course, sorting out CPMA doesn't automatically mean that the reflux will go...whisly they are seen together they can exist independently of one another.

The back arching/gulping/screaming/agitation is the acid flowing into the oesophagus and causing pain. If you've ever had heartburn you'll know how awful that is. Normal posseting does not cause the distress, it comes up with no issues. So... If every time you feed you are experiencing these symptoms it is highly likely to be acid. For that you need an acid suppressor until such a time that your LO grows out of it. (By that I mean that with growth and gravity that comes with sitting up, the intental mechanism responsible for keeping acid from flowing up into the oesophagus, strengthens) or you have the condition medically managed through other means.

If you can't wait to see a paediatrician (and let's face it...evey feed feels like a battle with reflux) then consider calling your HV directly who can contact the paediatric team of your local hospital and get a fast track teferral.. This is want happened in my case and we were seen on the same day and then seen by that team, bypassing the GP. If you are very cornered then go to a&e. You are not wasting time or resources and they can get you onto some decent meds and refer you onto paediatric care.

Gaviscon is the de facto starting point for reflux but doesn't work for many and in my case was pointless and just wasted time if it's not working within a few days then it's probably not going to.

It's awful. And whislt it might be common, it's not normal. So push and do not be fobbed off. Insist on a referral. with the right meds, your LO will thrive.

Hi all, my baby also had silent reflux. Initially we were given carobel which didn't help. Then gaviscon and ranitidine which took a few weeks to really see a difference. I also changed his milk a few times finally buying neocate myself in desperation. When I went to a private paediatrician he said to stop changing the milk that cows milk allergy was highly unlikely and really I needed to take one step at a time giving the medication time to work. I told him I was desperate he suggested I ask for more support and stop trying to be an armchair medic. In the end the neocate which was very expensive didn't help at all. He told me a huge list of things that would be seen in a baby with an allergy and in the end I think we was probably right. Things did improve immensely at 5 months and now he is a wonderful 2 year old.

Ranitidine helped and a battery operated baby swing. That saved our sanity.

Thanks all.. day 3 of ranitidine, think it is helping a little although still having frequent crying in distress episodes

It was a few years ago but DD2 had this. It was tested with a radioactive drink and numerous x-rays; something like one every 10 mins for 2 hours. When it was confirmed, we were given omeprazole and it was incredible. I think there were 3 doses a day. By the second does i..e mid afternoon, she was like a different child. They were weaned off it around 2 years old, IIRC.

Just wanted to update as health visitor came today for last visit (seriously delayed visits due to this new area change to which HV team you get!)

Spoke to her about Etti's symptoms and she admitted when she visited 3 weeks ago she had a feeling she had silent reflux but felt it too early to tell. After explaining all that had been going on and my attempts to help the situ she has advised me to raise this at Etti's 8 week check next week and also an issue she has with her tongue...(Etti has always struggled with her tongue sticking up since being born...can be known as peanut butter tongue where it sits at the roof of her mouth...just a natural reflex she should grow out of apparently!) as this could be an issue too...it's no where near as severe as it was when born and is getting better but it does take about 4 of 5 attempts to get get to latch on to her bottles making sure her tongue goes under the teat...if not the bottle goes under her tongue and then she just chokes and can't drink!...

I've changed her milk at the weekend just gone to HIPP Organic which has made quote a big difference to us...her feeds are no where near as difficult and she seemed generally less irritated on this.... today I have also had carobel arrive and she's had a bottle with this in 3 hours ago and I was actually able to change her nappy 10 mins after the feed with little spit up..what did come up also didn't seem to upset her quite like it did on the aptamil.

Basically I've advised the HV that I've literally done all I can now to improve things before going to the GP and should the carobel help I intend to ask for this to be prescribed going forward as online it's cost me £11 for a box that's actually only £3/4 ....(not that there's a price on making my baby well and happy! But it would help and as other parents can and are getting his ok prescription according to the HV - it seems only appropriate to ask for this myself)

Lastly I did mention the choking problems I've had 4 times now and the stress /anxiety this as caused me even down to just changing her nappy or putting her to bed for the night - the HV gave me some good advice that has made me feel a lot better around how to deal with this...she asked me to describe exactly what had happened on said 4 occasions and for how long I felt Ettiene had stopped breathing for....in all fairness this was probably only 3-5 seconds...she has told me that anything up to 12 seconds is quite normal and babies natural response to things coming up in to their throats such as acid reflux is to hold their breath... (she did agree that 12 seconds is a very long time when you think about it but perfectly safe?!) She told me to never panick as hard as it is at the time as baby will read from my face that things are not ok- she has even said I should try not to worry every time I change her nappy as babies can pick up on anxiety. She also explained quite a bit about the anatomy with regards to the wind pipe and food pipe and how this works to prevent chocking on liquid plus what a babies response is to deal with any liquid that ever did enter the wind pipe.. that said she has advised that if small amounts of liquid do enter the lungs frequently- infections can start to occur and that's the main worry hence the importance for me to get her treated.....it was all quite reassuring re my concerns about choking recently... and I'm feeling a little less stressed today.

I just wanted to share as I found a lot of this advice very helpful - plus my change in milk was worth a mention as Etti is deffinitly much much better on HIPP....(bowls and wind have also massively improved!) Xx

Thanks for sharing wriggley I'm so glad you managed to speak to someone! And great news on the improvement too. It's day 5 on ranitidine todayand I'm afraid although it's helped slightly , things are still dire. We had 8 week jags today and spoke to the health visitor at length who said keep pushing and being proactive until things improve. She said her 3rd had it and was on both ranitidine and omeprazole together and it did help quite a bit although her daughter did continue to vomit here and there. She wasn't distressed though which was main thing.

Got the follow up with GP on Friday and I'm counting the hours.

How quickly did you notice an improvement from the milk? I did ask HV today if it's worth a try and she said she wouldn't recommend changing too many things just yet.

Hi purple - just a quick note to say we've been on nutramigen for 7 days now and have seen a remarkable improvement in all symptoms. Passing wind and poos improved after 2/3 days and arched back crying fits improved after about 4/5 days. When I saw the GP on Friday we were still having the arched back issues and he advised to give nutramigen a week before trying ranitidine too. Thankfully nutramigen alone seems to have done the trick and I won't be filling the ranitidine prescription.

PS - hope the injections today went ok? It's horrible!

..I'm sorry to hear the meds aren't showing better improvement purpleviolet... it's so exhausting to have all this worry..... I must say my HV also said it's not something GPS are ever so good at helping with....I asked if this was a common issue with babies as it seems GPS tend to go down the "it's normal" route and she said it's becoming more of an issue in babies now than 10 years ago (I wonder if that's because more of us may ne speaking up and saying this isn't normal?) And so GPS have been told to hold off prescribing things like baby gaviscon as a auto response to parents coming in about sicky babies... but they've kinda gone the opposite way and now won't prescribe it without a fight when it's probably very much needed by the patient...

She also said it could be a heredity thing with me as Alfie had terrible reflux...never Ettiene and my mum has always said that I bought up entire feeds for months as a baby so much so crib sheets had to be changed nightly!

Re the change in milk I found that 3 bottles in there was a difference in her...a less manic baby! And certainly by 24 hours in I knew things were better as I've been able to actually put her down for the first time in weeks without her wailing to be held again and even put her down to nap... anywhere from 20 mins to 1.5 hours... don't get me wrong I have wondered how long it will last! But 3 days in and all seems to be moving in the better direction...

By time I go for her jabs next week I'll have a good case to say I'm literally out of ideas and options that I can put in place myself...now I need support.....I'm hoping the hipp and carobel will be enough for her to be honest..... I got it (the carobel) from amazon and the reviews for it are rather incredible re silent reflux.

I hope the jabs went ok today ! Your doing so well being a first time mummy and trying so hard to find a solution to all this.... from a mummy who knows..it's does get easier and I just hope like with my first...come 6 months (if not earlier!) You find yourself and baby in a much more comfortable way! Xx

That's great HL! Thanks for sharing. Injections went as well as they could. Lots of crying today but no different to last few days so can't blame the jags...

Thanks wriggley, It really is shattering my confidence as a first time mum and without family support I don't think I would've coped at all. I don't know how people do it.

Appt on Friday can't come quick enough!

Hi OP, keep pushing as you are doing and keep raising it until you see improvements.

one thing I was advised is that the vomiting is not an issue as long as there is no distress/pain and LO is gaining weight. But it sounds like your LO is still in some distress.

If the ranitidine is not working, then there are lots of things that can be done - the dose can be inceased ( there is a 'lower' and 'upper' meds range for weight - most GP's start you off at the lowe end). As other posters have added, you can add a PPI (proton pump inhibitor - the bit that creates the excess acid) such as Omeprazone - this works differently to ranitidine, which is why they are often prescribed together.

Ask about possible CMPA - you may benefit from a switch to formula such as Neocate or Nutramagin.

Basically, you have to find the right 'mix' that will work for your LO - that can be really frustrating as you just want an overnight answer... but the good news is that there is plenty you haven't tried that can sort this out. My son's condition is very severe and even we have found a combination that works for him.

One final point - for reflux babies, the reflux is often their 'weak' spot... so when they get poorly, the reflux can flare. We have seen this frequently - cough = reflux flare. Stomach bug = reflux flare. Virus = reflux flare. That can include any ill effects from jabs too.

Good luck tomorrow, I am thinking of you. And for the record - I get that your confidence has taken a battering, but you are dealing with something that many first time mums don't have to. That makes the experience much, much harder. Give yourself a break. It's a debilitating condition that impacts everyone in the house.

Thanks so much I really appreciate all this advice it's been most helpful. Will update thread tomorrow x

Got appt with GP today. We are on day 8 of ranitidine.

Last night was the first night he slept peacefully (when he eventually got to sleep after crying episodes) - there was minimal grunting / wriggling.

Still having frequent episodes of crying/ being very distressed , sometimes straight after a feed and sometimes about an hour after. Can go on and run into the next feed. The whole episode can last hours - 9 hours being the longest. Obviously there is an element of overtiredness in there by this point too but he does try really hard to settle and can manage to settle for 5-10 mins before it starts again.

Both during and outwith episodes he is constantly making gulping and yelling noises, bringing up clear liquid and milk (sometimes swallowing and sometimes being sick) and sounding congested (sometimes wheezy).

For the record there are no skin issues.

Will read through all the advice on the thread before attending appt and will post an update later. Appt is 15:50. All I know is that we can't carry on like this so please wish me luck!

HLbug and wriggley how are your LO's getting on?

Hlbug - did your GP prescribe the nutrimagen?

Didn't get on so great got to persevere with the ranitidine. She said it can take up to 6 weeks to work I don't know how I'm going to cope. Feeling very disheartened. Got a follow up on 2 weeks

Ah dear....not what you had been hoping for purpleviolet... 6 weeks does sound like an eternity when your stressed and exhausted with worry...I promise you and I know I keep saying it...you do get passed this... once baby starts weaning and eating solids (Alfie did bring up purees for a few weeks) it gets much better..and maybe even sooner for you either naturally or with the meds kicking in..... I for one did not miss the milk feeds with my son once they started to phase out... and now he sits talking to me about Paw Parole munching on pringles (bad mummy lol) and the worry that was his baby months is a genunily a distant memory... I'm just reliving it again in my baby girl and telling myself exactly what I'm telling you!...

Id love to say im as positive as I was a few days ago ...but she's had a god awful cold in the last 3 days... I was convinced her congestion was due to the milk thickner id bought and put in her feeds....barely thickened it to be honest ....made it similar to the comfort milks you can get but when she started sounding full of mucus I literally died and thought "omg it's my fault!! Putting rubbish in her milk!" But alas... it's a cold ....snotty nose and sneezes galore...so we've had zero sleep (as apposed to the maybe 2 hours we have been getting anyway with the reflux issues) and I did stop using the carobel 4 bottles in just in case it wasn't helping with her congestion....

I'm tempted to maybe try it again now her colds clearing up as today she actually bought up what I'd say was an entire feed....first time she's had it that bad... feels like it's getting worse not better in my opinion....only saving grace was it didn't appear to upset her quite as bad as it usually does... whether that was because it was right after her feed and not 2 or 3 hours later like usual I don't know...

I still intend on speaking to the gp about it all next week at her appointment.. here's to only 4 months off weaning time..

Also to add it can get better once baby is sitting up...or even rolling over actually...once they get more mobile and moving about it can become less of an issue... but it's all just cans and maybes and not every baby is the same...Alfie didn't get better until probably 9 months old but that doesn't mean your baby won't or my little girl won't sooner...

It's hard work it's stressful and it does make for quite a difficult first time mummy experience... if I'm not honest it's probably why I didn't go rushing straight in for my 2nd... I remember people asking me when Alfie turned 1 when the next baby was planned (love how ppl like to assume! Lol) and for a while I just said "can I get over having my first and him turning 1 before I think about another! It's just now getting a little easier and I'd quite like to enjoy this time for a bit!" ....ppl who've not had a reflux baby can't ever really understand how hard it can be...that all said when Alfie turned 2 I knew I wanted him to have a brother or sister and deep down I'd always known id go in for it all again! ....deff hoped all way through the 9 months she wouldn't have the same problems but she does...and so I've gotta do what I can this time around to help her... as difficult as it seems it is to get the support!.... I know this time next year though things will be much easier re feeding ...as it will be for you... just hang in there and know that your doing all you can!

Did the jabs go ok and was baby alright in himself? Kacking it a tad for next week... thought I'd be ok this time but nah... deff nervous all over again! And I've got my sons pre school any day now so god knows how I'll be then! I mean he actually knows what an injection is now... so there's no hiding 😂 xxx

P.s terrible spelling going on there!! I'm just making tea for me and hubby before the mini wakes up again!

P.p.s - your a super mummy by sounds of it just remind yourself of that! Everyday is a step closer to this getting better even if it's not noticeable right now xxx