How do you know if baby has vomited all of its feed?

[MinnieMin]

My little one has silent reflux and recently was told by a health visitor that she hasn't gained enough weight.

Since then I've been measuring the amount she drinks and making sure she hits her minimum (I've been advised is) 22oz. She's 4 months old, and aside from silent reflux, she also vomits if she drinks anything over 3oz at a time.

Today I gave her milk, and she drank 2oz, so I gave her another and she drank another 2oz and then projectile vomit. It's worrying me both for her, and is disheartening for me because she refuses the bottle and feeding her is an experience that I try to create (walking her around the house, singing to her).

The vomit had coagulated bits in it, and there was quite a lot of it, but I'm not sure how much I should feed her to hit the minimum our doctor told us to feed her.

Thats why I wanted to ask how do you know how much a baby has vomited of their feed? Whether I should just feed her all of it again, or just give her a break and see it as a missed feed.

You sound like us, down to the walking feeding distractions... Every single feed during the day. We dont have too much vomit these days with omeprazole, except these last few days as LO (3 months) seems to have a bug. I always assume if he vomits within 20 minutes of a feed and it soaks us through us both, it's all come up. Hes usually ravenous again pretty soon (although obviously doesn't want to take the bottle due to aversion, we have to wait until hes pretty much asleep). If its longer after the feed, we estimate as best we can.

We have been on a feed diary since 2 weeks (under direction) and estimate the losses. Our LO can only stomach 4oz as well or he vomits - we're very slowly working to increase it, but have made our peace (well my peace) with the frequent night wakings.

If she's underfeeding and poor weight gain, leave her 20 or 30 minutes and then try again ounce by ounce, just so theres something in there and it has a better chance of staying down. She cant be happy going to sleep empty. Is she medicated for the silent reflux?

It's really hard and massively stressful. Good luck :)

Thank you, I’ll try again. I just managed to feed her 2oz and am now waiting.

It’s so stressful, but because she’s gained the weight she lost, the doctor won’t prescribe her anything other than gaviscon. I went back to the doctor and this particular one told me I need to feed her 30oz a day based on her weight and when I became concerned that she wasn’t hitting this target, she changed it to 22oz. I’ll get her weighed again next week.

It’s disheartening and it’s worrying that she’s not well and there’s nothing I can do to help. My last GP said it might be that she’s a fussy eater - so no help there.

As much as I am sad you’re also going through this, it’s reassuring to hear I’m not the only one. Thank you for your help!

After 3 months, I believe the standard is 120ml per kg per day as a rough guideline. Our paediatrician has us aiming for 130ml per kg given the poor weight gain, but anything above that is also good of course. That works out as about 30ml per hour for us - we aim for 90ml (3oz) every 3 hours. If your LO can only handle 3oz at a time, I assume you're trying to feed every 2-3 hours to try to get it in?

We were never given gaviscon due to severe constipation issues, but had ranatidine for about 8 weeks. It helped loads with the pain and vomiting, but became ineffective for a number of reasons gradually.

Weve had a lot of useless doctors and health visitors over the months. We were only sent to paediatrics as an emergency case the first time because the reflux was affecting his breathing so badly (they gave us ranatidine). The second time I begged for help for many many weeks as I had been having to force feed for weeks, which was horrible. We eventually got referred back after I lost my shit at the dr. They were unhappy enough with LO feeding that they admitted us for tests, obs, and tried their hand at feeding before changing our meds.

What I'm trying to say is that if you're not happy with how it's going, do whatever you need to in order to get referred to paediatrics. Most GPs are not specialists in anything beyond typical baby care or infant reflux, and you may get more appropriate help from paediatrics.

Before the omeprazole, we were on the verge of extremely early weaning out of desperation not to see LO starve. It put me in a bad place, I became paranoid that he would be taken away from me for not being able to feed him or keep him growing. I'm ridiculously happy now he will accept being fed to sleep while being walked or dream fed and his weight is on the mend!

By the way, I assume you've considered cows milk protein issues? It often goes hand in hand with silent reflux. We didn't have any obvious symptoms, but LO has been so much more comfortable and actually able to poop once he was put on allergy formula....

Sorry for the essay!

While I try to feed her every 3 hours, she won’t drink until every four hours minimum - otherwise it’s as though I am force feeding her and she’ll cry and cry.

So, I feed her 3oz - 30 minute to 40 minute wait. Then have to feed her the rest while she is falling asleep. I don’t like Gaviscon either as it gives her severe constipation, but without it she doesn’t even touch the bottle - period. So I mix in tummy massages and try give a little water in between feeds as the doctor suggested (like this is easy thing to do 😫)

I’m at the stage where like you, I’m also about to lose my sh-t. The previous doctor went through the basics, hold her upright. And just patronising spiel about being a first time mum, how she’s a fussy baby.

She’s currently 4 months so I tell myself another 2 months till she eats. But I feel so bad for her, can’t be nice having to drink something that makes you feel so awful, yet be reliant on it. And on top of that, constipation all the time. I just feel awful.

I’m going to visit the doctor again on Monday, and I will make sure they arrange for me to see the paediatrician. How did you find out about the dairy protein? Did you suggest or was it the doctor?

I’m so happy your little one is much better, and that it gets better, albeit just a little bit. You’ve definitely been through so much, and so many of your experiences resonate with what I’m feeling and going through.

Thanks for sharing your experience, I’m definitely going to head back and see if there’s any alternative to Gaviscon for her. And not be afraid to lose it with the GP if needed. 😭😫