Thoughts on Health Visitors advice

[Strawberry06]

Bit of a long one so bear with!

My son is 6 weeks old today and recently has been a bit fussy before and after feeds (bottle fed Kendamil organic) and extremely difficult to burp. Screams, arches his back and wriggles all over the place. He also had spots on his face which to me looked like baby acne and has cleared up. He also has one very large runny poo per day but I've heard runny poo is common on kendamil.

Last week I was trying to get hold of HV but couldn't so saw a GP and straight away he said he had allergy and prescribed Neocate formula. He also said the spots on his face weren't baby acne but a sign of reaction. I must admit that I felt it was a bit of a knee jerk reaction to prescribe the milk as I've heard about mum's fighting to get it!

Anyway HV finally got in touch and after explaining everything to her she said to up his feeds to 5oz as it sounded like he was still hungry. So I did this but it wasn't making any difference in that he was still hard to burp after so I dropped it back down to 4oz.

I didn't tell HV I'd seen GP as I was concerned she'd just go along with what he said.

Anyway over the weekend it's been hit and miss when we feed him, sometimes he burps without issue, other times it's a struggle.

HV came round today and watched me feed him (luckily it was one of the worser feeds!) she took over and he guzzled a whole 8oz (in stages), burped easily and then fell asleep. So she came to the conclusion he is still hungry and to give him 5oz and also try infacol as well. It was at this point I confessed I'd seen GP and she actually disagreed that he had allergy and so that is the plan we have!

After she left he was content for a bit and then started getting upset so I fed him again (another 4oz) and he burped easily and fell asleep again! HV said he should be falling asleep after every feed.

I'm inclined to trust HV as she seems genuine and must have seen a lot of babies to know? I wouldn't have thought GP would be as knowledgeable and in hindsight I told him he was inconsolable which he isn't really (just maybe had a few evenings of excessive crying cause he was still hungry and me as a FTM overreacted!)

We'll see how it goes over next 48 hours and she's going to call me on Friday.

That sounds like silent reflux too me and he is comfort feeding to ease the discomfort from the previous feed which will make him reflux more cause more discomfort that he will try and ease with more milk. The back arching is a very classic silent reflux symptom

The reflux might be caused by a dairy allergy but we warned that the dairy free formula especially an amino acid one like neocate are very thin and trigger reflux so often need thickening and/or used alongside something like omperazole

She gave a 6 week old baby 8oz of milk? And thinks that’s ok? Is this with the neocate? The solution to reflux is not to keep feeding that’ll cause more problems, is he also on anti reflux meds? Try feeding him as upright as you can and if you can have him sleeping propped up a bit too that can help - doesn’t always.

the neocate might solve this in time or if the symptoms persist go back to the gp. He’ll be getting weighed regularly at this age too so hv can monitor that but I don’t think some hv really have nursed babies with reflux they obviously have experience with babies but some of the advice I got with mine was absolute garbage and I completely disagreed with the hv, who wasn’t happy I challenged her but I wasn’t going to be fed a load of nonsense.

Silent reflux. 8oz is far too much for such a small baby, many aren’t having that much at 6MO when they start weaning and overfeeding is a classic symptom because the swallowing provides temporary relief. All the symptoms you describe during feeding also fit. It also often goes along with CMPA especially when you consider there’s also a rash and iffy poos.

Based on what you’ve said I’d take the GP’s advice and switch to Neocate but also ask about medicating the silent reflux with omperazole and ask if they’d recommend a milk thickener like carobel.

HVs can be a mixed bag but any that watched a 6 week old drink 8oz, then said he’s still hungry so give him another 5oz is just so beyond useless and is giving shitty advice that’s going to make him unwell. I’d refuse to see that one again. Thankfully it sounds like you have a decent GP and HV involvement usually drops off until the 1 year box ticking exercise so you shouldn’t need to see them again any time soon.

Agree with silent reflux.
Both my kids have had it/have it.

My DD is 8 weeks and sounds exactly like yours, I'm using carobel in her milk and it's working great.
For burping I've been using dentinox and she's burping like a man after 6 pints.

8oz 😳
I agree with PP, silent reflux. Which often can be a symptom of something else (such as a milk allergy). Another thought - has your baby been checked for tongue tie?

Sounds exactly like DD who had reflux, the HV wanted to put her on gaviscon but I didn't want her on meds so young and ones that could potentially cause constipation so we switched to anti reflux milk. From the first feed she was a different child.

Thanks all. I'm worried now!

She did say 8oz is not for a regular feed and wonders if he took it to compensate for feeling hungry? He has been very screamy the past 2 evenings. Suggested to up it to 5oz as he's currently on 4oz, he does seem like a hungry baby but I don't know?!

I did mention about silent reflux/comfort feeding. Can't remember the response.

He very settled so far this evening, we've not had any back arching the past 2 feeds.