Early weaning/reflux

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My 19 week old DS is under paediatrics, dietician and specialist nurse for silent reflux. We had an appointment with specialist nurse in late August and I told her that he had started vomiting a lot more, she reassured me that reflux can peak at 4 months. We briefly discussed weaning early to be continued at our next appointment on 5th October. He is not on any medication under medical advice, this is not negotiable. We've been there done that with a couple of meds which worsened our situation.

Anyways I heard him coughing throughout the night in his Next To Me tonight (which is, of course, on an angle). 5.30 comes and I can hear him spluttering, flick light on and roll over and he's absolutely covered in vomit, all over the sheets, spluttering and choking. It has been our most frightening experience to date. This was 1.5hours after his feed.

In terms of readiness, he has no tongue thrust reflux, good hand eye coordination, excellent head control but is not sitting independently yet. He's in a Joie high chair which has a high back on it and he sits quite comfortably in it. It reclines slightly so he chills in the chair whilst I'm bottle washing and plays with his toys. He can sit semi independently in that he just needs to hold our fingers for balance and isn't wobbly at all whilst doing this.

In truth, the choking has terrified me and I'm now looking at starting to wean a couple of weeks earlier than anticipated. I wanted to combine spoon feeding with BLW but I don't think BLW is possible for him at the moment?

I intend to speak to our healthcare professionals but I'd also like some advice/opinions from you experienced mamas. I've read quite a few threads on here with some people being a little mean towards mums who are considering weaning early, please no nasty or patronising comments as I won't tolerate them. Any genuine advice and experiences (bad or good) would be much appreciated 😊

We did BLW (no purees, just "normal" food") and it's not recommended for babies under 6 months. Give him a month and he might be much more stable sitting up. In your position I'd stick to purees first and then add in finger food as you get round 6 months - a few of my friends did this with no problems. He'll likely only be taking tiny amounts to start with - I found it a bit disappointing how much my usually hungry, massive DD ate to start with!

I weaned early on the advice of the paediatrician (she was medicated for silent reflux). We started at 5 months and she really took to it. Milk feeds had been a battle from the start and caused her so much pain. Solid food has been great and she's a good eater.

We started really slowly with mushed veg (spoon fed) and we'll cooked batons that she could hold in her hand. By 6 months she was on 3 meals a day and we started introducing potential allergens then. We soon found out she actually has a lactose intolerance, which would explain a lot in hindsight.

I can recommend the book Weaning Made Easy by Rana Conway. She takes a very sensible, pragmatic approach.

Weaning early was absolutely the right choice for us. Good luck with whatever you choose.

I was worried about allergies and there was a big study by Kings called the leap trial, I think, which found early introduction decreased allergies. The trial had them starting very early, possibly around where your DC is now if not younger.

I think I started when he was around 4.5 months and it was fine. Started with purees but did lots of finger foods later on. My Dutch friend weaned at 4 months as that is the Dutch guidance. My mum shared the advice she was given for weaning me and it was rusks at 17 weeks I think! (And a nice clean bone for teething).

In summary I think you'll be ok starting soon, but it might have to be purees??

Have you ruled out CMPA?

The EAT study supports early weaning to reduce allergies.

My girls both had extreme reflux due to CMPA, with DD1 it was not diagnosed until she was 11 months old and with DD2 the paediatrician was convinced it was not CMPA but it was. We didn’t wean until 6 months due to family history of Crohn’s disease.

Thanks all. He has suspected CMPA and was on Nutramigen LGG for 8 weeks. We started the milk challenge under dietician about 2 weeks ago and he's now fully on cow & gate without any obvious symptoms.

He poops less frequently (which was part of issue before starting Nutramigen). I'm now wondering whether this increase in reflux has been caused by switching back to C&G 🧐 the dietician is calling us back in a few weeks, she did say it can take longer than a week for the symptoms to come on.

Posted by accident before I'd finished 🙄 today we've had lots of wind and posseting and not taking much bottle at all. Most bottles are a battle and have been for a long time. Hospital suggested little and often feeding as he has always gained weight. I'm keen to start on veg purées first but have just bought some baby rice, might give him a little tomorrow and just see what his reaction is. Let him guide me?

Obviously, it's entirely your decision but personally I wouldn't bother with baby rice, just go straight to veg. No need to blend, just cook it well and mash it with the back of a fork. Baby rice is ok as a thickener but it has pretty much no nutritional value.

Hello

Sounds like you've got all the right people involved. I'm a mum of 2 and my 2nd is now confirmed CMPA and possibly other allergies. He's now 6m old and we've had a really rough ride with reflux/ figuring out allergies/ slow weight gain etc. I'm also a children's health professional so in my role know all about the pros cons of early weaning and like you say many people can be very opinionated about early weaning. In summary- I'd give your dietitian a ring and chat it through. Our dietitian has been great at advising us. We started weaning early and for us it's been the best decision as it's really helped our situation. There are also quite a few Facebook groups for reflux/ allergies which can be helpful too. But really I'd chat it through with your dietitian as they are the experts in this.

Good luck!

I’m not sure whether people are still posting here, but wanted to ask... when you started weaning early did you notice if you gave milk they still threw back...

My DS is suffering awfully with reflux, he is five months today... and the last two and a half weeks have seen a real peak in reflux even though we have increased the dose of gaviscon he is just pouring it out not to mention his lack of interest in the bottle. The last two days we have given him some baby milupa porridge and he seems to have taken this fine doesn’t throw back the moment I give him his milk even if it is 45 mins later he chucks it back.

Also, we have spoken to a private paed who says it may be cows milk allergy but then I used fresh milk in his porridge I always did with my first and he eats that fine. Am I missing something?

We have booked in for a private allergy test but wondering if I am being a total doof by paying 300 pounds for a test he may not even need. My only concern is I don’t plan to introduce anything else until 6 months but I do not want to introduce stuff he may react too? Am I being overly cautious. Is it okay if he drops milk when weaning because he cannot stand his bottle ....

@Seeema2902 we have been seen by gen paed, specialist feeding nurse and nutritionist on the NHS. I was advised by the specialist nurse that reflux is at its worst around 4 months so perhaps this is why you have heightened reflux at the moment.

You can't test for a non-IGE cows milk protein allergy so don't pay the money. Non-IGE as I understand it (as explained to me by nutritionist) is a slow reaction I.e not anaphylactic, immediate rash, throat swelling etc. You see slower symptoms, ours build up way over the course of a week. We have eczema worsen, cradle cap but the worse symptoms are increased reflux and gastric. Poops none stop all day and absolutely full of mucous. Take the source away (it was cow and gate at the time) and it all settles down. That is the test for non-IGE CMPA. Your private paed should really have explained that to you.

Does your little one have any other symptoms other than the reflux? If so I'd recommend a visit to your GP, as for a trial on an extensively hydrolysed milk. We use Nutramigen as recommended by our GP. If symptoms improve (it can take a few weeks) you should be referred to nutritionist for guidance on a dairy free diet.

Weaning early absolutely helped us. My son loves his food and I'm finding dairy free really easy, the plan is to wean him back on to milk at aged 1 under advice from the hospital. His milk intake has reduced gradually but not until recently (I'd say 7 months and he takes 3 meals a day). I would be concerned about 5MO reducing milk significantly so early (any other reason - teething?). I was advised by paed reflux can cause milk/bottle aversion if severe - could this be why? Get on to your GP & HV if you need more support and don't stop until you get it. Good luck x

Hi,

Thank you for your response, some of it makes a lot of sense. I think we are so desperate to make this better remotely that we are at a point where we will try anything.

So in the morning today I made him porridge with 2oz of milk and he’s just having three oz in a bottle, so should that be his normal amount which is 6oz?

It is so hard to gauge what to do. When the HV spoke to the dietician they suggested trialing omeprazole but DS had already reacted to this with horrible diarrhoea so that was quickly stopped. They then suggested an extensively hydrolysed formula, but I felt very unsure about this as I felt like what if this isn’t a milk intolerance and I’m changing his formula without a proper diagnosis.

In the earlier days he did trial neocate for five days and I know this isn’t long enough but there was literally no improvement in symptoms.

I feel more comfortable not paying for a test and like you said it wouldn’t tell us about a slower reaction.

He did have cradle cap but this has improved significantly. Some eczema Just very slight patches but this has also improved significantly barely visible.

I could try the extensively hydrolysed formula but they do not want to thicken it. Up until now we have always used gaviscon to thicken and that’s where my reluctance is.

Would you say your LOs reflux improves once the milk was changed?

Re: teething he may be seems to rubbing his gums a lot

I posted previously under a different name.

What stands out to me is you say he has moved on to cow milk formula and the vomited is much worse. This screams allergy to his formula.

Even though with the fresh milk in his porridge he is fine? Or is this because it is more solid x

It could be the amount, or a build up reaction or just because none IGE reactions are not instantaneous.

@Seeema2902 DS can't tolerate gaviscon or carobel. After numerous visits to hospital I was advised by a very sensible Dr to feed little and often to lessen the reflux (less in the stomach less coming up). That definitely helped him up until he's become older and I think gradually grown out of it. I think around 5MO he was taking 4-5oz every 3-4 hours including 2 night feeds.

When we did the milk challenge (after a long period on Nutramigen back on to cow and gate to see if any symptoms) it took almost 2 weeks for DS to show symptoms which were then significant. It then took another 2 weeks of Nutramigen for the symptoms to alleviate. The gastro/poop situation was so bad that GP had a stool sample sent to hospital in case it was a bug. His eczema still hasn't calmed down completely and he's now got to use prescribed bath lotion and cream daily.

Providing your DS weight ok (mine is 75th centile so hospital wasn't worried about him losing a little) I would probably have a go of reducing quantity of Oz per feed and feed more often see if that helps, if not could be allergy. Hospital Dr advised me to persevere over a week even if DS was demanding more bottle. Also log the milk for a little while so you know how much he's getting per day, Huckleberry app very good. Hope this helps!