reflux baby-enfamil a r information needed asap

[jeanini]

hi my 7 wk old dd2 has reflux she sometimes projectile vomits but mostly its silent reflux. very restless and agitated hard to settle. hiccups a lot. doesnt want the teat in her mouth and hard to feed. i have bought enfamil a r from the chemist and would like to know from any mums how to make it up. from reading the instructions it sounds like you have to boil the kettle and leave till its cold (but that could take hours) or can you boil kettle and leave for 30-40 mins and put into sterilised bottles. then cool them in a sink of cold water. then when cool add the powder then put them in the fridge. xx

The water needs to be slightly warm for it to dissolve - fromn what I remember! DS had this prescribed at at 4months after I just couldn't take being covered in sick all day anymore.

I used to make up bottles of water and let them cool and add the powder as I needed it- or like you say, cool them in the sink and then make it up. If you make up the bottles of milk the milk tends to separate and needs a bit of a shake to get it back to normal. Its very thick - you mught need fast flow teats.

Enfamil AR was brilliant at settling DS, wish I had gone to the Dr's before as he was just how you describe your DD2.

Hope that helps

hi jeanini I have enfamil for dd and I make up 24 hrs of boiled water in the sterile bottles and then just add powder when it is needed. Enfamil worked wonders on dds reflux as she was horrendous prior to starting it now she is still sick sometimes but without the screaming, arching back etc. You can actually get it on prescription from your gp. We got the enfamil from gp and were also referred to reflux clinic which helped with tips etc.

meant to say also agree about milk being very thick we had to put a little pinhole extra into the teats just to help. You may find your dd will still be a little reluctant for first couple of feeds as they expect to start feeling rubbish.

Hi Jeanini

Thought this might be you. Lost the previous post and never got to reply to your update.

I'm sorry your dd isn't getting any better and that you're getting conflicting info from the paeds. Can't believe one of them actually thought she isn't a 'good' baby because she won't sleep lying down . Hope your appt this week goes a little better.

I know the feeling re them not showing any signs/syptoms when you actually get to see a paed. I had it all the time with dd. HV, GP, etc kept telling me she looked happy and content but the minute I left all hell would break lose.

There is a reflux message board that has loads of information:

www.infantreflux.org/forum/default.asp

This page has lots of useful links on things like meds, positioning, feeding, etc.

www.infantreflux.org/forum/forum_posts.asp?TID=853&PN=1&TPN=1

Just bear in mind that it is an american board, they have medical insurance and their healthcare and some of their drugs differ from ours.

Thought I would let you know just incase you find something useful that might make your dd more comfortable.

Let me know how she does.
XX

cads- thanks again. i took her to the doc last week and said all the symptons and said that there is a formula that helps babies with reflux called enfamil.

she had never heard of it so looked it up. she wrote me a prescription for enfamil lactose free. and said try this and if no better try the other enfamil a r.

i went to chemist and decided that i wanted to try enfamil a r. first as i thought it would help her better.

she doesnt scream when i feed her. she still gets hiccups. she hasnt been sick since shes been on it. she is still unsettled. but maybe she is like that anyway.

im not going back to sma gold either way. the only downside to enfamil a r. is that it has made her a bit constipated. but im trying to give her cooled boiled water every day even if its half an ounce im sure it helps.

also the doc said not to give her gaviscon or domperidone which the hosp had said for her to take.
but i think the doc is right the milk is thick so i dont need gaviscon and i dont think it should be taken with it anyway reading the tin. even though the pharmacist said it was alright too.

ive been buying the enfamil a r. myself. i havent tried the enfamil lactose free that she has given me on prescription. i dont know what to do. should i be honest with doc and say i have tried enfamil a r and want a prescription for it. and say that as baby a lot better i havent tried enfamil lactose free.

ive been really down today i dont know if its postnatal depression or just no sleep and worrying about baby/milk/everything.

ive got my 6 wk check tom with hv and she will ask have i cried recently. answer yes. i think that ive got to try and not get too stressed.
anyway thanks for everyones comments really helpful. i did buy faster flow teats and now she can get the milk easier. for some reason she isnt lasting as long between feeds as sma gold. i mean at night its still 4 hourly but least of my problems at the mo.

i took her clinic and the hv there said not to raise the cot and the baby has to get used to the cot flat. i thought thats odd it goes against what everyone else advises about reflux.

when i feed her in the night because she has to remain upright for a while after having her milk. ive just been putting her into her pushchair and she seems to sleep better in it.

i know it isnt ideal but i just think you have to do whats best for your baby.

sorry for essay but i just wanted to get it all out. xxx

thanks cads for the websites i will try and look at them later. xx

oh Jeanini

. Sounds like you have conflicting advice coming at you from all directions. Unfortunately, there is a lot of trial and error in solving reflux and it is so frustrating. I know exactly how you feel. I promise it does get better but just not overnight.

I don't think you have PND. Sleeping deprivation and dealing with things for which there is no magically pill can make you feel very low and is very worrying, especially after you have been through the worries of pregnancy and birth.

By the time ds was 8mnths I was wrongly diagnosed with PND. I use to get stressed, cry a lot, doubt my ability as a mom and even have anxiety attacks. My problem was that ds was thriving so the doctors didn't think there was anything wrong with him and just thought I was being neurotic.

He wasn't losing weight, didn't have eczema, didn't have diarrhoea so he couldn't possible be cow's milk intolerant or have reflux. He was only diagnosed with reflux at 4mnths and milk intolerance was diagnosed until he was 13mnths.

At one point he was waking up crying 6-8 times per night yet no one could tell me what was going on and they just thought he was one of those babies, even though I knew he wasn't and that something wasn't right. I landed up having to do a lot of my own research before they started to take me seriously.

If you look at the reflux board I recommended, you will see that there are a lot of moms that feel exactly the way you're feeling.

In answer to your questions:

1. Enfamil AR - I would stick with it for now. It sounds a lot better than she was doing before. It will take a little time for her oesophagus to heal so see how she does after maybe a week. Can I ask why they decided to take her off the ranitidine? Also, just tell the doctor that you can't see why the paed prescribed the lactose free because unless they establish that she is lactose intolerant you can't see how it would help her.

2. Enfamil lactose free - The paed most probably prescribed it because one of the symptoms of milk intolerance can be reflux and with some infants removing the offending food/milk solves the reflux. However, in my experience and from the research I have done it is unlikely that she is lactose intolerant. She is more likely to be cow's milk protein intolerant (CMPI). I have noticed that a lot of HVs, GPs and paeds often confuse the two. Both of mine were wrongly diagnosed as lactose intolerant by two different PAEDs when in fact they are CMPI but they still needed reflux meds. I was told by one paed that food intolerances aren't a medical problem, only food allergies are. If you want more info on this let me know.

3. Raising cot - I could shoot some HVs, not many of them are clued up on reflux. I would raise the cot. DS cot was raised until we moved him to a bed at 22mnths. He never had any problems with "getting use to being flat". His reflux was completely over by 8mnths but I still kept the cot raised because of his ear infections and also I found it helped him breathe easier when he had a cold.
   DD slept in her carseat until she was 5mnths and then we slowly moved her to the raised cot, without any problems. I told all my doctors, hvs and even my chiro about her sleeping in her carseat because I was worried it might damage her back and none of them were concerned and just told me to leave her where she was most comfortable. I use to put a little cushion underneath it, at the front, so that she wasn't so upright and didn't sink down into the carseat. Also, the cot should be raised to between 30-45 degrees. We used books under the feet.

4. Constipation - hopefully, it will get better with the water and once her system gets use to it. If not speak to your doc as constipation can aggravate reflux because their little tummies are full with food and what comes out the other end (to put it in a nice way).

Hope your 6wks check goes well tomorrow and please find someone to take over so you can get some sleep. It will make you feel better and makes it easier to cope.

I'm here if you ever want to chat.
XX

PS - this is the 2nd time I've had to type this because my, not so dear, son switched off my PC just as I was about to post.

What were you saying about an essay?

Hi, sorry to butt in but my DD (17mo) had silent reflux for 4 months. We had a terrible time getting docs to take this seriously or be any real help. After trying absolutely everything, we put her on Infant Gaviscon and she was a changed baby overnight.
Why did your GP say it wasn't a good idea to try this? DD was on 10 sachets a day mixed in with her milk. She had all the same symptoms, terrible to feed, very unsettled at night. The only way she would sleep was lying on my chest upright in our bed.
I have such sympathy for what you're going through. DD used to cry 8 hours a day for 4 months. I really think the Gaviscon may be worth a go. I've recently been told that premature babies are put on it as a matter of course in hospitals now.
I really hope things get better for you.

thanks again cads and ess. the reason the paed took her off the ranititidine is because when i gave it to her before the milk she projectile vomited. i took her to hosp and said could it be the drug and thats when they suggested domperidone instead.

i tried gaviscon in her bottles for about a week and there was no improvement with the screaming when feeding. and when i said to the doc about trying diff milk ie. enfamil a r. doc said to stop the gaviscon and domperidone so that any improvement would be from the milk alone.

touch wood she hasnt been sick since i put her on enfamil a. r.

we have both got our 6 wk check with the doc on wed. but the doc not very nice so i dont expect much help. diff doc to what i saw before who prescribed enfamil.

in my experience doctors are clueless when it comes to reflux there must be someone professional who can help/advise parents more.

it just seems that its left to us to try and find out information ourselves from internet etc..

when i saw hv today she was no help. i said that i had been advised to raise cot not lay baby flat. and she said yes thats right. she also said be carefull who i take advice from incase its out of date.

all i know is that mn has helped me more than doctors or hv. i think that the best advice/help comes from mums that have been through the same thing.

im on maternity leave from mothercare and thats what i liked most about the job, helping other mums with problems that i knew what to do/say to them.

i feel a bit better today i had a good cry yest and i think that dh then realised how bad i was feeling and as he is off work this week we will take it in turns to see to her at night.

i have given the docs letter requesting that she have a prescription for enfamil a r instead of enfamil lactose free. i lied and said i had tried lactose free and there was no improvement in her symptons.

thanks cads for taking the time to write me essays i really appreciate it.

ill have to go now dh wants his computer back.
i will keep you posted.xx

hi cads- i couldnt get on to those websites you quoted. what browser did you use?

also ive tried raising cot with books and she is still restless arms and legs waving about all night. if we raised it more how do you stop them from falling to the bottom.

i know they are feet to bottom of cot anyway but when the cot is tilted their feet and legs will become bent up at the bottom.

me and dh are racking our brains for a solution.

i had 6 wk check with doc who wasnt any help whatsoever. but i did get the prescription for enfamil a r.

i cant believe im typing this in the middle of the night. but ive just fed her and im keeping her upright for a while before i try putting her in the cot again. xx

also i asked the doc what to give dd2 for constipation and she advised to put 1 teaspoon of brown sugar into 2 z of cooled boiled water. i thought this was a lot of sugar into not much water.

i gave it to her in 3 oz of water. it didnt work and also when i rg hv to check it was right. she said they hadnt advised to do this for years and it could give the baby a sweet tooth.

has any other mums given anything else to their little ones for constipation? at 7 wks old. i do try and give her cooled boiled water every day but she doesnt like it and i can only manage to give her half an oz. xx

InfantRefux Org

Just testing whether I have figured out how to do links.

Hi Jeanini

I'm very at the lack of support you are getting from your HV and GP. What do they tell you when you express your concerns and how you are feeling?

We seem to be having a hard time with reflux too. DD has had a virus this week and it seems that everything makes her reflux flare up. Although, we don't have the screaming we do still have a lot of fussing, difficulty feeding and spitting up some days which drives be up the wall from pure frustration. Our carpets look and smell lovely (NOT). Last 3 days have been bad and DH found me sitting in the armchair crying buckets when he got home last night. Doesn't help that I have picked up dd's virus and haven't been getting enough sleep.

How is your dd doing with the Enfamil AR?

Constipation - Sugar water never worked for us either. We were also told to use very very diluted orange which didn't help and just made her reflux worse. Are your dd's stools hard or just infrequent? DD was prescribed Lactulose (are you familiar with it?) when she was 9wks, which worked but I had to experiment with the dosage until I found the amount that would help her go without giving her gas. Keep going with the water too. What if you try to add some formula to her water bottle. Maybe 1-2scoops formula to 4oz water then keep diluting more and more till she is taking water only?

I have figured out how to do links so hopefully you'll be able to get on those websites and find something that might help.

2nd link

We never had a problem with the raised cot because

1. I never put ds/dd in 'feet to bottom' because we've never used a blanket/sheet with them so we didn't need to worry about them slipping under the covers. Then when they were big enough we used a grobag.

2. DD slept in her carseat till she was 5mnths.

so the only time we had a problem was once they got mobile (rolling/crawling) they would get suck at the bottom of the cot but I use to go in and move them back. By this stage we could lower the cot a little so that it wasn't so steep. Also, they then started sleeping on the side/tummies which was a better position for the reflux.

Keep in touch and let me know if you need anything else.

HTH
XX

thanks cads- sorry your dd is ill and you are as well. thanks for taking the time to reply to me, i really appreciate it

the only diff in dd since she has been taking enfamil a r is that she hasnt been sick, touch wood. and she doesnt scream when i try and feed her. she does still scream after but i think this might be due to me trying to get her to have more milk when she has had too much.

like she might have only 2-3 oz when normally she has 4-5 oz. but when i work it out over 24 hrs she has had about 22oz which hosp has said is right for her weight. she is now 10lb 8oz.

but i just looked on back of sma tin and it says for 10lb baby give 30 oz of milk. all i know is that she is putting on weight ok.

in the daytime we have put her in the cot only raised by 1 thick book under the top end and she has slept ok.

why is it then that she wont do that at night?

she just seems really restless and spits or pulls her dummy out and if i dont put it back straight away she gets more and more upset and ends up crying.

then i put it back in and she does the same. she moves her arms and legs around as though she isnt comfortable. when i look at her thinking she must be awake she has her eyes closed.

but i cant sleep even when she does because im thinking she will wake in a minute. i give up we are still putting her in a pushchair in the night raised slightly and she seems to like it she still does wave her arms and legs around but not as much.

but i really want her to sleep in the cot at night. its a shame i cant put her in a different room at night but we only have 2 bedrooms and ds is in the other one and its tiny so i dont think i could put them both in there.

i could put him in bunk and put the cot underneath but id be frightened that he would be woken up in the night.

when ds was a baby we put him in his cot in his own room when he was 6 wks old and he was fine and we slept better because we only got woken up when he cried, not when he made noises all night
like grunting, straining noises.

i hope your dd is better soon and you as well.

xxx

Hi

How are you doing this week?

XX

hiya, well yesterday dh dismantled the cot in our room. weve come to the decision that she isnt going to go in it for a while so we have sort of given up in trying to put her in there.

i feel like ive kind of failed as a mum. and im worried about her back in the pushchair every night.

to make all matters worse dh lost his job last week. but he might be working self-employed soon so alls not so bad.

i hope everythings ok with you.

she is still on enfamil a r and its going ok. she is 8 wks and 10lb 8oz she looks like a chunk. so i dont have to worry about her weight.(touch wood).

she has slept across my lap on her tummy really soundly. i think she would sleep better on her front. but obvousily i cant put her like that yet. when do they ok to lay them to sleep on their front. i cant remember i think ds1 did it at about 5/6 months old.?

when they say a baby is constipated is that when they dont go every day or is it when they do a quite firm poo and strain and go red in the face when doing it. she is in this cateragory. god my spelling is getting worse.

this hot weather is a nightmare as well. we slept her in our room in her pushchair last night. but i still had a crap nights sleep. she slept ok stirring quite a lot but when i looked at her she still had her eyes shut.

i hope this doesnt mean she is going to be a rubbish sleeper. but maybe im just lucky that ds1 is a good sleeper. when he was her age i had him in a routine of feeding and nap times. but with her i dont know when she will have a feed each day to the next. and as for sleeptimes thats the same.

she seems to be getting worse on sleeping in the day. if we arent in the same room as her even for a minute she starts whinging and spits her dummy out. little madam!

but when dh picks her up she just stares at his face and stops moaning.

anyway thanks for asking how its going its just nice to chat to someone who understands. xxx

sorry ive just read what i put on my message on 21st july and ive repeated a few things. sorry about that.

HI

You have NOT failed as a mom. There's nothing you could've done to prevent her reflux and you have done a excellent job getting it diagnosed and finding a solution. She hasn't suffered more pain than she could have had, if you hadn't done such a good job. It wasn't easy either, was it? Saying that, I have come to the conculsion that motherhood is one big guilt trip but it's also a lot of love.

If she is more comfortable in her pushchair then leave her there for now. Besides it can't be as bad as having her in her carseat for 5mnths. Also, can you wheel her into a different room so that you can sleep better? Bathroom, passage, anywhere that isn't your room, you will sleep better and you will definitely wake up when she needs you. I found I was definitely more sleep deprived with dd because I could never get her to sleep at the same time as ds and she never slept for more than 45mins. By the time she was sleeping for 2hrs at lunchtime, ds had dropped his nap. So I have never been able to catch up on sleep during the day.

Yes, they do sleep better on their side or tummy. I think dd starts sleeping on her side at about 5.5mnths which then progressed to rolling over onto her tummy in her sleep. I use just leave her on her tummy. She had a strong neck by then. BTW dd is a better sleeper at night than ds was, even though her reflux and intolerances are a lot worse than ds's ever were. So there is still hope.

No set rountine here either. We work on the baby whisperers EASY routine.

Wake up (when she's ready)
Feed (usually 3-4hrs after previous feed)
Play (she usually manages about 1.5-2hrs)
Then sleep again.

I got very routine obssessed with ds which added to my 'depression'.

Fantastic news on the weight and Enfamil. I have my fingers crossed that she continues like that.

Yes, constipation is when their stools are hard and causing discomfort when trying to poo. If that is how she is then speak to your GP about getting her some lactulose.

When I was pregnant with dd, everyone kept telling me how much girls are hard work. Boy, were they right. We have a little madam on our hands too. She already has little tantrums and certainly know how to let you know what she wants. DS was such a easy, laid back baby. It was a real shock to the system.

Sorry, your dh lost his job and I hope the self-employed thing works out better.

We're still battling with dd, she won't feed properly during the day so is back to waking 2-3x during the night. We're really battling with weaning. She only has a couple of teaspoons of soilds per day which usually give her tummy ache or makes her spit up more. I am more and more convinced that her reflux has flared up.

Right off to watch some trashy TV.
Goodnight.
XX

hi thanks cads- im feeling guilty about putting the cot down so i will get dh to put it up again at the weekend. i will still put her in her pushchair but i will try and put her down in the cot in the day time every now and then.

dh not happy with putting the cot down then up. but thats what women are like changing their minds every few minutes!

sorry to hear your having a tough time with your dd.

i also know of another 4 wk old not liking their moses basket or cot. and they have resorted to having the baby in the bed with them. by the way also a baby girl.

my dd2 is worse in the evenings screaming and not settling at all no matter what we do. i fed her at 4.20pm she had 2 half oz. then at 6.30pm she was screaming the house down. she had another 4 half oz. she still screamed and then got hiccups and has only just gone to sleep its now 8.15pm.

i cant remember the last time i had time to do anything apart from doing the washing up, making up her bottles, and the washing.

all good fun eh? i didnt want to go back to work- im due to go back in april 07. but im seriously considering it and it will give me a break. i dont know ill probably change my mind in a few months time.

shes only put on 4 oz this week but im not worried. shes ok.

do you watch bb?
i think michael and spiral will go tonight. or it might be suzy and imogen i think if they go then it would be better. i think spiral and michael are a bit more entertaining. by the way the only way i get to watch bb is to tape it each night. im normally trying to get some kip about 10ish.

thanks again for listening.xxxx