PLEASE HELP 12 week old unsettled since day 1, silent reflux or cma?

[LaceyLou42]

I know my baby is in pain but I just don’t know why. Symptoms: squirming and straining during bottle, straightening out after bottle and crying, wet burps, crying most of the time he’s awake, never stops himself when he’s full (I’ve tried feeding him more/less/smaller amounts more frequently), grunts and strains for hours when he wakes up on a morning and lets out VERY loud farts, doesn’t sleep much during the day but sleeps most nights from 10pm-7am, brings up clear liquid between feeds which sometimes smells acidy, only poos once every 4 days and has had constipation previously (had bouts of it before starting comfort milk).

Things tried: infacol, gripe water, gaviscon, lactulose, and has been on comfort milk since 8 weeks. Nothing has helped his unsettledness. I’ve done all the practical things: bouncy chair, swing, sling, cycling legs, tummy massage, baths, taking him out, you name it I’ve tried it.

The only thing that sort of helps is putting him on his tummy with white noise on.

The GP has now prescribed omeprazole to try but I have to wait for it to be ordered in. If this fails then the next thing to try is hypoallergenic milk apparently. His skin is fine except for some cradle cap. He DID have a face rash between ages of 2-4 weeks which also was on his chest but I put that down to baby acne and he hasn’t had it since. His weight gain is fine.

I really hoped at 12 weeks he would settle down but he hasn’t what so ever. In fact yesterday was his worst day yet. It’s exhausting.

Have you tried pace feeding? Would also recommend looking into the tongue tie possibility. Reflux isn't a diagnosis, it's a symptom of something else be it CMPA or tongue tie.

Sorry I can't advise on the amount of milk as we've always fed on demand either bottle or breast rather than counting oz.

[quote LaceyLou42]@FATEdestiny I think if I have him a 20oz bottle he would drink the lot, honestly, he’s always drained bottles & I remember weeks ago telling the HV how much I was feeding him and should I give him more and she said I’m already feeding him a lot, when I did try and give him an ounce more he had the lot and brought a lot of it back up. I’ve been constantly told to feed him smaller amounts even by the GP who has said I sound like I give him too much and he’s either “greedy” or is “drinking because it’s soothing his throat because that’s what some reflux babies do”. It’s hard because I understand what you’re saying, but at the same time I’m scared to give him more because overfeeding can cause problems in itself like tummy ache, bloating and reflux. However I am now tempted to try him with a 7oz bottle out of curiosity.

He’s awake A LOT. The most I’ve ever known him sleep in one day is 3 hours. Today he’s probably had 2. How much should he sleep during the day?

Should I put him back on regular milk?[/quote]
However I am now tempted to try him with a 7oz bottle out of curiosity.

How much do you give currently? And how often does he drain the bottle fully? Generally speaking if at any point baby drains the bottle completely then subsequent bottles want to be bigger (to match growing stomach volume)

No reason not to give 7oz bottles. Baby's stomach capacity is the limiting factor and just like some babies have bigger feet/legs/arms than others, some babies have bigger stomach capacity.

As a alternate, you could keep bottles at 6oz and make them more frequent. 2 hourly 6oz bottles would work.

He’s awake A LOT.

He will be, if he's sleeping through the night. Moreso than many 12 week old with broken nights.

But naps are still vital and necessary. How often and for how long are naps currently? He could do with having a nap after being awake for about 1h30-2 hours throughout the day (but that will depend on how long the nap is).

It might be, for example, you day is repeating cycles of:

● Wake (note the time time, so you start settling back for next nap 90 mins from waking)
● Full Feed (7oz bottle, keep going until baby stops)
● Long, gentle, upright wind cuddle in your shoulder with lots of back rubs and swaying. Get at least 1 (pref 2) burps.
● Floor time (inc nappy change)
● 90 mins from waking up - Top up feed. Offer what's left in the bottle.
● Wind cuddle and settling to sleep with dummy.
● Asleep again

Wake and repeat. Over and over and over again.

Sounds very similar to my baby:

Always unsettled.
Distressed crying for hours on end.
Feed refusal.
Always seeming in pain.
Cradle crap, some dry skin.

My little one had reflux and CMPA was suggested to me when he was 9 weeks old. He also had to have a tongue tied cut (twice) and we also saw a cranial osteopath (male sure you get one who specialises in babies) who was AMAZING!!!!

Before increasing the volumes in his bottles, try pace feeding your baby - there are lots of videos available on YouTube to demonstrate how to do this. If a baby is taking in a lot of milk it will cause stomach discomfort, just like how we feel when we overeat. Paced feeding is a very good method of allowing the baby to regulate their intake. However, if a baby does have reflux they tend to want to feed and feed and feed for the comfort and because the milk can neutralise the acid in the stomach and help reduce the pain. It can be a bit of a catch 22.

Also ask your HV to refer you to have tongue function assessed - this has to be done by a trained professional, not just any HCP as detecting a tongue tie can be very complex. Tongue ties can cause babies a lot of abdominal discomfort and my cranial osteopath said that a lot of babies she saw ended up having a tongue tie. The wait on the NHS can be very long, and because your baby’s weight is fine he probably won’t be a priority. You can find practitioners online and pay privately (they usually see you within a week) but it can cost about £150 to do this.

Removing dairy from my diet (I was breast feeding), tongue tie revision and 3 sessions with a cranial osteopath were what changed everything for me. My son was like a different baby.

@FATEdestiny the reason I limited him was because he was sick if he had more, I do feel he drinks and drinks for comfort, and I’ve always been aware that if silent reflux is his issue that over feeding would make him worse, it’s a difficult one, but will perhaps try an extra bottle today or offer an ounce again.

Thank you for your tips on routine!

LaceyLou42 all babies are sick after feeding. Well not all, but the vast majority. How much milk is brought up varies, some bring up a bit and some bring up loads.

The milk usually comes up as baby burps - which is why winding upright is important.

The fact baby is sick after a feed does not indicate they have had too milk.

Is this your first child? It might be that you are mis-reading what is normal baby behaviour as something it isn't.

@FATEdestiny in other words I don’t know what I’m doing and I’m starving my baby. Do you not think the first thing I ever considered was that he was hungry? I have tried giving him more and it made him more uncomfortable. I feed him as guided by his GP and HV. I’ll try giving him more again but I know it’s more than that.

I wasn't suggesting you (personally) don't know what you're doing. I was suggesting that all first time mum's are on a massive learning curve and one of the wonderful things about forums like Mumsnet is that there is help avaliable.

You would be very much unusual if you were not learning a million new things every week with your first child - it's what we all go through. Please don't take it personally, it wasn't meant as such ❤ Good Luck

@FATEdestiny all your advice is great, for a baby with no digestive issues. However, OP's baby has reflux, and pretty much all of your advice goes against medical guidance for reflux babies.

@LaceyLou42 please continue to listen to your GP and HV, you sound really switched on and like you're listening to what your baby needs. My DD was breastfed but we had the same issues with reflux, constant feeding then huge vomit fountains and inconsolable screaming. Gaviscon thankfully worked for us and she's much happier but i know it's not a silver bullet - i really hope you guys find something that works for you soon. Hang in there, and don't let people who don't know what they're talking about make you feel bad. You're not starving your baby. You're giving him everything he needs, including a mama who has his back and loves him.

@Bitchinkitchen thank you, your post made me well up a bit! I’m having a bad day.
But I keep plodding on like we all have to. Fingers crossed he gets sorted soon, I’m sure he will.

Thanks everyone

We all have bad days. It's also worth remembering that everyone on here is rooting for you and wanting to help (me included).

How is baby's sleep going today?

@FATEdestiny thank you, I appreciate that! I gave him 6oz bottles yesterday, and one 7oz one, he started whimpering when he had nearly finished the 7oz bottle and was doing his usual crying/squirming/straightening legs out afterwards. He also brought up a lot of clear liquid with bits of milk in about an hour later. He was no more settled at all. HV has weighed him today and he’s gone up a centile (25th) so she’s happy with his weight gain. He definitely cannot show signs when he’s full, so he is complicated and I never know if what I’m doing is right, but he’s growing like he should be which is positive! Hes been having 5oz bottles today and he’s had roughly 2 hours sleep this morning and 2 this afternoon (quite rare he sleeps this long during the day, he slept through the night as well again). He’s still his moody self though.

he’s had roughly 2 hours sleep this morning and 2 this afternoon (quite rare he sleeps this long during the day, he slept through the night as well again)

That's great sleep for his age! Was it all in one go, or as shorter naps?

His stomach must have a huge volume to take 7oz in one go, especially since he's on the smaller size at the 25th centile. It's a big disparity in internal organ size. Things like Prader-Willisyndrome could be considered, but I doubt you could get anything like that diagnosed as a baby.

Any news on the omeprazole prescription yet? That's the reflux medication which gives the best results in my experience.

@LaceyLou42 Hi, this sounds so much like my little boy! Do you have an update?