Reflux help

[Grimmfebruary]

Ds was diagnosed as having reflux by the hospital at 10 days old (we took him down after he stopped breathing before being sick - was terrifying). They just observed him and sent us home with very little help, just get on with it. He is gaining weight so is obviously keeping some milk down.

However he’s now throwing up after nearly every feed and it’s projectile style. He’s unsettled and seems to be constantly hungry. When he does bring milk back up it’s always silently and there’s no pattern to when.

Any tips for dealing with reflux? Already trying to prop his Moses basket mattress with little effect. Trying to wind him loads, keep him upright after feeding... nothing seems to help.

Is he on medication?

No they told me just to persevere with him. Feeding little and often etc.

How old is he?

He’s 3 weeks. I know everyone says give them 6 weeks to settle in but when he was unable to take a breath and choking it needed addressing. It’s getting worse if anything.

With Reflux they sometimes don't treat at first, it often it takes you going back to the GP and pushing - is he gaining weight?

Are there other symptoms that could point to cows milk allergy or similar?

Also although quite rare something to be aware of is Pyloric Stenosis -

The below is cut & paste from http://www.gosh.nhs.uk/medical-information/pyloric-stenosis]

What are the symptoms of pyloric stenosis?
In most cases, a baby with pyloric stenosis will begin bringing up small amounts of milk after feeding. Over a few days this will become worse until the baby can no longer keep any milk down. This vomiting may become so forceful that the milk may be projected for several feet out of the baby’s mouth. This is called projectile vomiting.

As the milk is lying in the acid in the stomach, it can curdle and become yellow in colour. This also reduces the amount of faeces (poo) passed, as little or no food is reaching the bowel.

If the condition is not treated, the baby will become dehydrated and not gain weight. Signs of dehydration include lethargy, wet nappies less frequently than normal and the soft spot (fontanel) on the top of the head may be sunken.

What causes pyloric stenosis and how common is it?
Pyloric stenosis is a fairly common reason for babies needing an operation and usually develops around six weeks after birth. We do not know exactly why pyloric stenosis develops, but it tends to affect more boys than girls, and seems to run in families too.

How is pyloric stenosis diagnosed?
The thickened pyloric muscle can be felt, especially during feeding, as a small, hard lump on the right side of the baby’s stomach. The muscles around the stomach can sometimes be seen straining, moving from left to right as they try to push milk through the pylorus.

Your child’s doctor will ask you lots of questions and may want to examine your baby during a feed to observe any vomiting.

Sometimes the doctors may want to confirm the diagnosis using tests and scans. These can include an ultrasound scan, like the ones used in pregnancy, to get a picture of the thickened muscle.

He is gaining weight and no other symptoms other than bringing up milk after feeds. It’s just frustrating as there’s no warning when he’s going to be sick so sometimes I’ve akresdy put him down and I don’t realise until he starts choking on it.

It's best to keep him upright for 20mins after a feed. It's less likely that he will throw up when put down then.

He’s a bit young for pyloric stenosis to show itself. I had to really push to get my DS medication, ended up with ranitidine which was great. Some GPs seem to think that as long as they’re putting on weight they don’t have to treat it. Never mind the screaming uncomfortable baby. . My DS ended up being diagnosed with a cow’s milk protein allergy.

Our youngest suffered with this. Raise the mattress ( head end) in cot/ Moses basket, whatever you use. There were special cushions for this, not sure they are still advisable.
We kept our baby upright for an hour after each feed, or he threw up, even through his nose ( breast fed and later bottle fed)
We considered using our spare car seat to keep him more upright at night in his cot, but it never came to this.
And the thing that saved us was a new milk ( at the time) for babies, which we found in Boots. ( I breast fed, but his reflux was horrific) so we combined and then ultimately bottle fed.
It’s now called anti reflux milk, it wasn’t at the time, and there is a whole new method of making it, in effect it’s much thicker, so when bottle feeding you need to make the hole in the teat bigger ( I just used a pin) and start steam sterilising bottles. I used the tomme tippee steam steriliser. Easy enough to use.
Hope this helps. Doctor also gave baby gaviscon, but I preferred to sue the milk, as it was less like medicine, but that was my choice.

He manages to be sick out his nose too, it’s awful to watch. I’ve been trying to raise his Moses basket mattress with a towel under the mattress so it’s on more of a tilt?
He gets the most horrific hiccups as well which usually mean he’ll be sick.

Defnetly raise it up, I had a wedge cushion I’d bought with my round breast feeding cushion. Failing that use small towel to raise the small mattress in the Moses basket.
Definitely keep upright in excess of 30mins after each feed ( we had to for an hour ) .
I bought Infacol, and used this too, and it was the only child I had to use it with. ( I have four) and this child was the only one with reflux, and I breastfed, but used the breast pump and then combined fed. Then ultimately bottle fed on the reflux formula.
I think I used infacol after every feed. I tried gripe water, but it wasn’t effective. ( check the infacol dosage, as it was nearly five years ago )

I did try infacol as it said suitable from birth but it just seemed to make him more sick?! He’s been bottle fed from day 1 as well, was a very lazy feeder and was difficult to get milk into. He takes a bottle well now, demolishes what he’s given but will be sick at least once during a feed. We had a run of 3 feeds with no sick and I was over the moon but it soon returned.

I assume you are currently breast feeding. If bottle feeding, make sure the bottle is tilted so the baby isn’t getting too much air inneach gulp with the milk ( I know bottle feeding isn’t on trend, so if you do use it, which lots or people do, there is little advice on how to do it well )

You can buy gaviscon for babies over the counter if you'd like to try it.

My eldest is 7 and still suffers with this. Thankfully not as bad but we had years of projectile vomiting every feed to the point at 18minths he was back down to his birth weight despite 3/4 trips a week to the gp.

Reflux happens because of a loose valve in the food pipe (can't think of its long name)
So keeping him upright for as long as possible after feeds will help.
Also small feeds more frequently so less chance to come up.

There's a book on it by an American dr. If you Google reflux book America I'm sure it will come it. It's amazing with lots of tips that will help you.

Fwiw don't be fobbed off. My eldest has been tube fed for a very long time and it's all started with reflux. He does have other health problems too.

If you would like to feel free to message me.
Htg

Omeprazole from the GP was our miracle reflux cure.

We also put her on probiotics, anti-reflux formula, keeping her upright after feeds, etc

HobnobBob, pyloric stenosis showed itself in my DS at three weeks and he had surgery at four weeks. OP, I’m not saying your DS has this but it might be worth getting him checked again by your GP. It took a trip to A&E and two trips to the GP to get a referral to the children’s ward. My DS wasn’t losing weight, but had dry nappies as he wasn’t getting enough fluid. Does your DS have plenty of wet nappies?

My daughter had this at 3 weeks and was operated on for pyloric stenosis (PS) at 4 weeks. She had been gaining weight ok and had wet and dirty nappies, although in the few days before her op these changed a bit.

Doctors initially ruled it out as they said she was “too young” for PS and not dehydrated enough. And also female (is rarer in girls). Well, if they’d have waited a week she would have been “old enough” for PS (in their eyes) and also much more ill.

Hopefully the advice given above by other PPs about reflux will help but if there’s no change, please keep pyloric stenosis in mind. It’s straightforward to diagnose and straightforward to correct, so please don’t worry if it does turn out to be that.

Good luck

Keep going back. I don’t think they like to give out the medicine as it’s very expensive. We were fobbed off for ages before being referred to the hospital for something else. The peditrition there pointed out her severe silent reflux as soon as he saw her and gave us the stuff that actually worked.

plimsolls that’s exactly the same as my son. Fortunately on our last visit to the GP they listened to our concerns and referred us to hospital. They did the feeding test and felt the “olive” in his stomach which was confirmed by ultrasound. He’s now a very fit and healthy boy.

Thanks for all your advice!

He’s been bottle fed from the off, using anti colic bottles.

Will try all suggested but will phone the doctor Monday morning and see what they say, was only seen at the hospital and not given much advice so hopefully the doctor will be more helpful.

My little girl has reflux too. I would personally stop the infacol - I found it made her way more sick. But i would discuss it with your doctor first. I was extremely lucky my GP had a child with reflux so I was taken seriously straight away. Before I went to the GP the health visitor advised me to keep her upright for at least 30 minutes. I still do this now at 8 months. Wind thoroughly - I found a side to side motion best.

We eventually started carobel in her milk. Then ranitidine, which has had to be increased regularly as she gains weight. The doctor was adamant we only changed one thing at a time, which is why I advised speaking to one before you change anything you are doing.

My little one never lost weight, was always on 75th centile. No weight loss does not mean no reflux.

I gave up with the infacol after 3 goes due to the amount of sick.

I think I’ll insist on a doctors appointment Monday morning even if it’s just for advice more than anything else.

I'd like to say first of all that I am sending you a big hug - my DD (6weeks) has had silent reflux for the last 3 weeks and I know how upsetting it is.

It is trial and error though - some things may work for your LO and some won't, so there is an element of waiting with each thing sadly.

We have found anti reflux milk to be a big help. I went to the GP several times and we have tried different things - Gaviscon was horrific (awful constipation and trapped wind - hours and hours of screaming) and then the GP gave us milk for CMPA which did nothing. Propping the mattress up definitely helps, but DD still wouldn't sleep anywhere but us until we changed the milk. Be sure to prop up the pram mattress too!

I've been pushing for ranitidine but DD doesn't weigh enough yet apparently.

If you have problems with the GP giving you medication, speak to you HV. Mine have been very helpful and quite forceful, even getting us same day GP appointments after I'd been fobbed off.

Fingers crossed for you!xx

Ask for omeprazole. Failing that ranitidine.

KPBRUM My baby was prescribed ranitidine when she was about 7lbs at 4wks old m. Not sure if your baby is smaller but just thought I’d say in case it’s helpful info.

Gluetap it’s such a horrible experience isn’t it? My daughter is also pretty much fit and healthy now but I’ll never forget the stress, exhaustion and uncertainty of having a very small baby projectile vomiting all hours of the day whilst being dismissed as an anxious first time mother. We were relatively lucky as after a week of seeking advice about the increasing vomiting, I took her to out of hours on a Friday night who sent us to a children’s a&e as she was too young for them to deal with. The hospital admitted her as she was so young and then after a few days, PS was diagnosed. I don’t know how I’d have coped if it had gone on much longer at home.