Reflux but reluctant to use Gaviscon

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I think my baby might have (mild?) silent reflux. After feeding he will arch his back, fuss a lot and cry, but normally settles down after 5 minutes or so. It only happens with about half his feeds - the other times he seems fine. I’ve raised the top end of his cot and keep him upright after feeds, which does seem to help.

I’m wondering whether I need to book an appointment with the GP - or whether I should wait until baby’s six week check in ten days time?

Also, I know that GPs often prescribe Gaviscon for reflux to begin with. Can I skip the Gaviscon stage and move straight onto ranitidine? I’ve read on MN that Gaviscon can cause constipation and am really reluctant to swap one problem for another. It’s just going to make my baby uncomfortable in a different way and what’s the point in that?

We had no problems with Gaviscon and she was on maximum dose. If it works for the reflux and causes constipation, the GP can give you something to treat that side effect.

There is a graduated care pathway which starts with Gaviscon and as you say it is mild, a GP would not likely prescribe anything stronger straight away.

There has been a recall on most ranitidine products so you may not be able to get this (due to possible cancer-causing chemicals in the formulation). Not sure there are many other options available, other than gaviscon.

I’d wait to see the GP at your appointment, at ours you’d probably only get a phone call from them at the moment

@Ihaveoflate how effective did you find the Gaviscon for your baby’s reflux?

There has been a recall on most ranitidine products so you may not be able to get this (due to possible cancer-causing chemicals in the formulation).

That’s terrible - I had no idea! Thank you for letting me know.

Reflux can damage a baby's throat if left untreated. We've had no problems with gaviscon. My hv suggested we try carobel if it didnt work. Its an over the counter milk thickener and is supposed to make it more difficult for milk to come back up.

My baby screamed in pain constantly and had to be held up high and in permanent motion. The Gaviscon worked to take the edge off and made feeding much more bearable. She had become scared of the bottle.

The paediatrician prescribed Lansoprazole at 12 weeks but she was already beginning to grow out of the reflux by then. We weaned early and she was off all medication by 6 months. She's a delight now but the first few weeks were traumatic.

Basically I would have chopped off a limb for any improvement in the early days so Gaviscon was incredibly helpful. I would have dealt with the constipation if it had happened but it never did.

Both my kids had severe reflux and Gaviscon was a godsend for us. It was a while ago but I don't recall any problems with constipation.

My little boy has silent reflux at the moment. We were prescribed gaviscon and it did make him constipated. What we do now is when he shows signs that he's suffering with the reflux give him a bottle of cool boiled water with the gaviscon in between feeds and only give him 2 ounces as the water helps with constipation. It seems to have solved both issues and he seems so much happier.

I didn’t know that reflux could damage a baby’s throat. I think my baby’s reflux is quite mild compared to @Ihaveoflate’s baby for example.

I’m now unsure whether to wait for the six week appointment with the doctor or to book in sooner! What would you do?

Honestly, from what you describe it appears to be quite mild. I would manage it conservatively (tilt cot, keep upright after feeds for at least 20 mins, burp frequently) and monitor. If it gets worse, you can reassess later.

People say otherwise, but IME baby Gaviscon just thickens the milk. If your DC is formula fed, then you can get reflux formula which is thicker. It can make your DC bunged up because it is a thicker, but it's nothing some water doesn't sort out and it does settle down in a couple of days. I've also had the screaming reflux baby from hell who refused feeds. Trust me a baby who takes a bit longer to poo is preferable. Gaviscon made no difference with my eldest, but ranitadine did. I also weaned him early.

When I had my youngest and he had the same symptoms as my eldest, we went straight onto reflux milk. I went to the GP and just asked for ranitadine straight away. The GP agreed, she had prescribed it for my eldest too.

What I didn't realise so much when my two were younger is that reflux itself is probably a symptom of something else. I've been told now it is likely my eldest had CMPA or similar. He has asthma, always had a bad chest and when he was in hospital after he was born he came out in a rash. At the time it was put down to an infection (I was ill after having him) but it did coincide with when he was first given formula. I will never know for sure now. But what I am trying to say it's get your DC checked out. Something like colief, which does something to break down the proteins in formula could help. Or if you are BF removing certain foods from your diet.

It doesn't sound as if it needs anything yet. I would just wait until 6 week appt.

If you do think he needs something then I would recommend Carobel.

My eldest had Gaviscon at around 6 months and it did help - but she was a happy spitter really, just sick lots and lots.

My youngest, GP went straight to ranitidine as she said Gaviscon would make him constipated. His reflux was a lot more servere though so Ranitidine didn't work.

My DS had silent reflux - the giveaway for me was that he was always uncomfortable after a burp, and his breath always smelled really sour and acidic.

The GP prescribed Gaviscon, saying that trying it would do no harm to try it. It made a difference from the first bottle - he was relaxed and calm again. We never had any issues with constipation, and contributed to use the Gaviscon until we swapped to cows milk in a cup around 1 year old.

In your situation I would do as @Ihaveoflate has suggested and try the non-medicated approach for a couple of days. Either things will improve and you can wait till your 6 week check appointment, or they won't and you can talk to a GP sooner and will be able to tell them the things you've tried.

We've been dealing with silent reflux with my DS. Lansoprazole only made him so constipated, not even a prescribed sugar water solution would ease it so we had to stop meds. Just tried to hold him upright either resting on my chest/shoulder, upright in baby carrier and he slept on a wedge which really helped manage it.
Now he's a bit older I'm starting to think it's a cow's milk allergy as I cut it out and it's helping things.
Can you speak to your gp on the phone to explain and they could advise if you should be seen sooner

OP are you breast or bottle feeding? It worked for DD at 4 months when she was inconsolable around 3 minutes in to every feed (although to start with it wasn't every feed, it got worse over time). Got the infant feeding team to see me feeding her and they said silent reflux. First GP I saw tried to print me off the NHS page on colic... he must have seen the expression on my face as he then prescribed gaviscon. It didnt work to start with as it says to give mid way through a feed when breastfeeding and she was already in pain by that point. Saw another GP (who was wonderful) who said stick to the gaviscon but give before every feed. She didnt want to give anything stronger until we'd ruled out gaviscon which actually worked when we gave it like that. I had to mix it up in a bottle with cooled boiled water which is a right faff (if bottle feeding you just mix it into the milk, so much easier) but she went onto it about a week before lockdown so at least I didn't have to try to deal with it when out and about! We managed to reduce it down to having it morning and evening and then dropped it completely after about a month when she started sitting up more. Let me know if you want any further detail!

Oh and at the time DD was having at least 4 poos a day the gaviscon had a welcome side effect of reducing that to about 1 a day!