Silent reflux or CMPI... or nothing much at all?!

[poppymatilda]

Our baby started possetting a lot after feds shortly before her GP 6 week check up. We mentioned it at the appointment and were prescribed infant gaviscon.

We're doing all the usual things for reflux, e.g. have propped up crib, keeping her upright during feeds and after (we sit up for an hour even on night feeds to keep her upright), thoroughly burped her etc.

We've been using the Gaviscon for a week or so and it seems to stopping the sick. But now we have 2 new symptoms - She now squeals during and immediately after feeds, arching her back and generally looking pained, and when we lay her back down to sleep you hear her sort of gagging like she is trying to swallow down the milk coming back up her throat. This gagging can come on even 2 or 3 hours after a feed and really unsettles her and she gets quite upset. All we've found works is to take her out of her crib and hold her upright for a bit and comfort her.

I've read a lot on the internet about reflux, silent reflux and CMPI. Her symptoms seems pretty mild compared to what others describe and make me wonder whether it really is any of these things or maybe something else entirely?!

She was breastfed a very small amount when newborn (thats another story, I just couldn't get my supply up) but has been exclusively formula fed for a few weeks now.

I'm wondering about experimenting with some different formulas in the new year to see if that helps. She currently having Hipp.

Any thoughts welcome! Would be great to hear from anyone whose baby went through something similar.

How’s her weight going? If she’s gaining weight okay I would leave it. Doesn’t sound like she has other typical features of CMPI? Eczema? Hives? Posseting and being unsettled is just normal newborn behaviour and I wouldn’t want to use medications unless necessary. They have side effects. The gaviscon May be making her more constipated which can make them uncomfortable. Try not to overfeed as that’s easy to do with formula feeding and makes them more unsettled and likely to vomit.

I would personally just watch her weight and keep an eye on it. She might have reflux (it’s extremely common and normal in newborns) but she will grow out of it by herself as her system matures. I would personally only use medications if it was affecting her growth or if she was in a lot of pain. At 2 months newborn crying peaks and even for a healthy newborn can be up to 5h a day. By 3-4 months they become a lot happier and more settled.

Hope that helps!

Thank you, really reassuring. Her weight gain is normal so no concerns there.

She doesn't have any of the other symptoms of CMPI you mention so I don't think it's that.
Her poo is definitely firmer since starting the gaviscon so I wonder if constipation is bothering her a bit.

On the over-feeding front, it's hard to say. We reduced the volume of feeds back down to 90ml because the throwing seemed to get bad when we tried to go up to 120ml. Then the HV suggested we should put the feeds back up again because 90 not really enough at her age.

I'm kinda resigned to the fact that the greatest cure will be time and I think you've reinforced that view x

My baby was prescribed ranitidine at 4 weeks of age due to silent reflux but at 9 weeks of age it was suggested that actually he may have CMPA.

His symptoms were screaming, screaming and screaming for hours on end. Screaming becaused he was hungry, not wanting to feed and then screaming whenever he did feed. It was so, so upsetting because he was clearly in pain and the screaming would go on and on. The nights were definitely the worst and I would usually be sobbing out of desperation because I couldn’t bear to see him in so much pain sf not know how to help.

As well as being in constant pain and not wanting to feed he had really bad skin. He had horrendous cradle cap and dry red skin over his face and arms which is another reason why CMPA was suspected.

Your baby’s symptoms don’t sound too bad, just typically baby behaviour I think.

If your baby is gaining weight well, is only possetting and doesn’t seem too uncomfortable then I would reluctant to start with the Gaviscon because it can come with its own issues, like constipation.

Could you perhaps try the anti-reflux milks or comfort milks and see if they help?

I definitely echo was the PP said. Try comfort milk or anti reflux formula. Both my two have needed them until at least 6 months old. I'd try comfort first - it's a little thicker than normal formula. Anti reflux is VERY thick but was a saviour for my DS1.

It sounds like silent reflux. I’d start with comfort milk, then anti-reflux (or adding a thickener to her existing milk, like carobel). In fact they are all probably better options than gaviscon as over time it will increase constipation. At our children’s hospital carobel is usually the first thing the Drs suggest before gaviscon as it has less side effects.