Incredibly sicky baby. Is this normal?

[MelvinThePenguin]

DD2 is 4 months old. She has had a reflux issue since birth and has an infant gaviscon prescription. She's also CMPI and on Nutramigen. However, her sickness is getting ridiculous now. She's been off her milk too.

Every feed during the day results in her vomiting so much that she needs to be changed. A muslin is totally ineffectual. I often have to change too.

She sleeps really well (on her front) but really struggles to get to sleep. She's really not a terribly happy baby at the moment and just wants to be held all the time. That's simply not possible with a toddler too, so she cries quite a lot and I feel awful.

Her weight has dropped from between 75th and 91st centile to the 75th centile line. Nothing dramatic and the HV isn't worried.

I'm very nervous about taking her to the doctor as they've been so patronising and unhelpful. I got a lecture and had to put up a fight for the gaviscon.

Is this normal for some babies or should I be stamping my feet with the health professionals? I'm at the end of my tether, so not really sure I can put up the fight. I'd probably just cry!

Have they not tried ranitidine or omeprazole? We found it much more effective than gaviscon as it only made DS constipated. Have you tilted her mattress so she's not lying flat and keeping her upright for 20 minutes after a feed.

You need to go back to the GP and
ask for something stronger. DS2 has been on ranitidine since birth as he had surgery that can cause reflux. It's great stuff.

DS1 had terrible reflux and gaviscon did nothing. He did grow out of it eventually but we should have pushed for better medication.

No you need need need to get back to the GP and stress how bad it is. You need prescribed medication if the vomiting is that frequent

Definitely go back to your doctor. My ds had severe reflux it was tough and I had to really fight to get help for him. He couldn't help himself so I had to really go out of my comfort zone and create a fuss.

This website is fab for advice and help with doctor appointments, it's Australian but better than the UK site reflux

Ask about carobel, my DD was sicky after bottles of nutramigen but not to the extent you are describing and I was told that carobel would work as it thickens the milk and makes it easier for them to handle, I was very sceptical at first but she’s been brilliant ever since she’s been on it

YY to Carobel if you are formula feeding. It needs a Y-shaped teat for the bottles though.

Carobel is the thing that made the difference for us. We tried everything before that and he was on Milk for CMPi and Omeperazole. Omeperazole helped with pain but did nothing for the sick. I remember bursting into tears in Drs reception because referral to Paedaetrician had not been done & boy had been sick what seemed like hundreds of times that day.
In the end I gave up on Drs / Hospital and bought the Carobel myself. It must have reduced sick by about 90% & was life changing.

The weight seems oK. My girl was a happy spitter and dropped from 91st to 50th quite quickly and they weren't at all concerned. My boy went from 91st to 9th and he got referred when he dropped 3 percentiles.

Milk allergy?

Have you tried asking for neocate? DS is CMPA and nutramigen still made him sick as it still contains the cows milk protein albeit broken down.

Neocate is completely df and we saw a massive improvement in reflux. As others have also said investigate about omeprazole and carobel as well, both can help.

When he was small I used to burp him every couple of oz and also sit him upright for at least 20 mins after his milk which helped

YY to carobel. Also speak to HV / GP about potential for early weaning which is sometimes advised to help reflux / weight loss (although obviously 6 months is the standard recommendation)

my DD was an incredibly sicky baby. nobody ever believed me until they spent more than 2 hours with her. we must have gone through about 20 muslins a day. we put a pillow under her mattress so she was slightly at an angle which helped with sleep.
docs wouldn't help my DD the bastards. went back and forth more times than I can remember and always had "she'll grow out of it/colic"
she did grow out if it. 9 months later after a probably very uncomfortable start in life.
sorry I can't be much help. it's horrid watching your baby sick up constantly. the pillow thing did help with sleep though as before that she was grunting all night.

Thanks so much everyone

You have given me a LOT more ideas as to what we can try. We have an appointment with a dietician on Monday, so I'm going to research everything you've said and go in looking like I know what I'm talking about. That's always my strategy when I'm anxious about something at work, I just didn't know where to start with this.

If talking to the dietician doesn't get us anywhere, I'll go to the GP. There is one nice one (who diagnosed the CMPI) but because she actually listens and is p/t it's really hard to get to see her.

We do have her mattress tilted, but bizarrely she's much better at night. We put her down on her back but she rolls straight over to sleep and is now fairly reliably sleeping 9-10 hours at night. I've given up flipping her on to her back again because she just rolls every time. She's been rolling since 8 weeks and I wonder whether that's partly because she was so uncomfortable she was just desperate.

Oh and upright after a feed doesn't seem to help much . It's always while she's against my shoulder or sat in a fairly upright bouncer that she vomits the most.

Add to that a toddler who demands that I "put the baby down"! It's pretty tough!

Our DS was projectile vomiting after feeding for 18 months. He is now 9 years old and healthy, but i felt very alone during that time; the doctors weren't much use. I used to feed him in the gardens of friends' houses as he would have ruined their sofas/ walls/ carpets! He was allergy tested and found to have a dairy intolerance so we switched formula and diet. He slept upright in his car seat when he was having particularly bad days.
Now, he still doesn't have dairy, but is otherwise a normal sporty, cheeky and typical boy..no lasting effects thankfully. It will improve, i promise!

Absolutely agree with Pps that she needs medication, and a trial of a completely dairy-free formula. SMA Alfamino is like Neocate, in that it is completely dairy-free, but is (allegedly) more palatable. It is also a bit cheaper than Neocate, though just as good, so GP may be happier to prescribe.

The hierarchy of meds prescribing is Gaviscon (with lactulose for the inevitable resulting constipation), then addition of Ranitidine, then, if necessary, swapping the Ranitidine for a PPI like omeprazole or lansoprazole.

You may need to fight for it, as it sounds like you have an ignoramous for a GP (a fairly large proportion of them seem to be rather clueless on this topic, unfortunately).

for you and DD. Hope you get some actual helpful help soon.

I've had 3 super sickers. They all grew out of it eventually around 9/10 months. But I guess the difference is mine were all happy pukers. We tried gaviscon with the 1st but trying to get it in to a BF baby was a nightmare so we stopped. The 1st didn't gain weight brilliantly, we saw a paediatrician and a dietician but she could only help after weaning and baby was only about 4 months old at the time so was a bit useless.
WIth no. 2 and 3 we didn't do anything, just put up with the sickness knowing it would eventually get better. I ended up just nodding and smiling at people who said, keep them upright after a feed. OK, but what about when they are still being sick 2/3/4 hours after a feed? Upright made no difference whatsoever.

So I can't really help with the medication side of things but some of my puky baby top tips:

They never had nice clothes on, lived in baby grows and not changed at every bit of sick. My trousers/tops were constantly sicky as well, we just lived with it unless I needed to be particularly presentable.

Leather sofa is much more forgiving than fabric!
Wore double bibs and a muslin 24/7, Usually a plastic backed bib underneath, with a tommee tippee cushioned neck bib on top for max absorbancy and clothing protection. Muslin to catch the stuff that shotts off the end of the bibs.
No-one wanted to hold them, or if they did it was at arms length! They were all rolling by 14 weeks so I used to take a tesco value double duvet cover everywhere we went and let them roll about on that to protect other peoples carpets. Big, easy to wash and only about £3.
When weaning, the sick becomes green and orange, sorry. If going out visiting, make sure breakfast/lunch is beige colour. Less staining if it goes on other people stuff.
Banana sick does NOT come out of things, ever ever. No vanish ultra, no full sunshine, nothing can ever get banana out. So again, time banana for when your going to be home for a few hours.

All 3 are much bigger now and rarely ill so it's certainly not done them any long term harm. Apparently there are several pukey babies in DH family so I blame him!

The 2/3/4 hours later thing sounds very familiar xyz!

The duvet cover is a good idea, especially as we have new carpets everywhere.

I think we'll just live in the kitchen diner when we start weaning. There's a conservatory directly off it which the toddler's toys can go in. Then I can just shut the door on the rest of the house. Might save on heating too!

DD had reflux and as previous posters Gavison didn't help..

We were then given another medicine to mix with formula (can't remember the name) but that didn't work either.

I kept going to the doctor until they gave Enfamil AR formula and that worked.

Her reflux got better when I started weaning her. She was fine with the change to cows milk.

Hope it gets better, keep going to the dietician & doctor.

Thought I'd post a quick update.

The dietician thinks DD's cow's milk intolerance is on the more severe end of the spectrum and has prescribed a new formula which has been 'nowhere near a cow'.

No fight required at all. She noticed DD still has a bit of a rash and was very sympathetic about the vomiting.

I feel much better now

Great news!! Hope she (and you!) gr some relief soon.

Excellent. If you still have problems though get yourself to the gp and demand ranitidine and/or omeperazole. My 16 month old is on both and we only got it right at 8 months after finally getting to see the right gp, all the rest had told me to give it time (was on nutramigen and just the ranitidine then) but I feel so guilty for not being more forceful before then, as the addition of omeperazole made such a difference!

Just wanted to say that you can buy carobel over the counter without a script, fingers crossed the new milk is having a positive effect anyway OP :)

Dd was really really sick. Frightening projectile vomiting!
Like others it was more about getting prepared with washable thick stuff round like thick towels cut to size. Muslins had no chance. Disposable mats and wipeable stuff under her when playing. Got better sitting and then crawling. She wasn't bothered though and put on weight.

The new milk is going well...except it seems the GP got a bit confused by the dietician's instructions and gave us a prescription for the old stuff (Nutamigen) rather than the new (Puramino) so now we've run out. It feels horrible giving her milk I know is making her poorly, but it should be sorted tomorrow.

Oddly, her rash exploded when she went on the new milk, but is now abating. Puramino contains no known allergens, so I'm not sure why this would happen, but I've read anecdotal evidence that it can.

The sickness has got much, much better! I really confused another Mum who told me DD had been sick this morning by declaring 'oh, that's not sick!' at the minimal puddle on her dress.

Feel for you, had the same and you need a paediatrician referral ideally. My daughter has had ranitidine (gaviscon of no use) and then moved onto omeprazole (which caused horrific diarrhoea) and then onto lansoprazole which she is still on. Reflux fairly common (1 in 5) in under 1's and so more tests don't generally start until then which is what happened with my daughter and they also diagnosed a hiatus hernia which was adding to the reflux problem. She tried multiple diets in the early days and in recent years (she's 12 now!) did develop a dairy and egg white intolerance but that has settled a little now. She has had multiple endoscopies to look at the condition of her oesophogus which they monitor with reflux and when they do these they take samples to check for allergies which is a more definitive way of checking than trial and error. Having said that if it is dairy or lactose the results are fairly clear within a week of changing the diet but you shouldn't use soy especially for girls (something to do with hormones) but my daughter adapted to rice milk and almond milk well and you can buy them with added calcium. If she is settled at night maybe it is allergy rather than reflux as that usually causes problems when lying down. I would get her started straight away on ranitidine and then trial some diet changes. Good luck and hope she grows out of it. Whilst my daughter didn't she is so much better now than she was as a baby. I still travel with changes of clothes mind....old habits! Oh and I used a baby bouncer or baby walker to keep her propped up if I couldn't carry her (also had a toddler at the same time!) and propped the mattress up in her Pram as well as cot and put something at the bottom so she wouldn't slide down (just remember rules for safe sleeping though with what you put where!). Hope it helps and that you get the help you need.