2 month old reflux and nearly always unsettled, is medication needed?

[SophieRules]

He is rarely settled, doesn’t really last longer than a couple of minutes, unless he’s on my shoulder. In the rare moments he is settled his is happy and smiley. Infacol has helped his terrible gas so he’s not as in much obvious pain. However he spits up after almost every feed, sometimes a little, sometimes more, sometimes straight away, sometimes curdled. He hates sitting positions and being cradled, I am guessing because of discomfort, but what drs look at mainly is weight gain which is normal. He is exclusively breast fed, I don’t think it’s a dairy issue because on some rare occasions he has formula and wasn’t any worse. I don’t know whether to try and get medication for reflux or just wait and see. It’s so challenging having an extremely unsettled baby. My friends babies seem to just sit there in restaurants etc calmly on their laps and my baby is constantly squirming, crying or about ti cry. Having more sleep has also made no difference to the unsettled behaviour. What should I do?

Yes I'd look at medication and I probably would look at cmpa too even with the formula not making things worse. It might be that the dairy in your diet has been sufficient to get to peak unsettledness and you don't see any addition with the formula. A short 1-2 week trial of dairy free and avoiding high levels of soya (dairy and meat replacements) should give you an indicator of whether it will be worth doing longer. We saw a behavioural difference within a few days even if it was longer to see more substantial changes. Not having to be permanently held was one for the first things to improve.
My daughter wasn't diagnosed until 17 weeks by which point she had developmental delays due to being permanently unsettled within a month she was perfectly average developmentally. We had started medication at 8 weeks but only at low doses and it took the highest doses to treat her silent reflux, the lower doses were enough for the physical reflux and her GP hadn't picked up she was struggling with both and had completely dismissed the allergies.

My breastfed baby was the same and he had CMPA. I cut out all dairy and soy from my diet and he was a completely different baby within 2 weeks.

Zero crying, reflux, very settled, honestly it was like I switched babies.

Dairy allergy is a delayed reaction type. The dairy protein builds in their system for weeks. The only way to "test" is to cut dairy completely for 6 weeks.

Also infacol is not recommended for reflux.

Also, weight gain will be normal with CMPA because feeding soothes their reflux. So they will keep feeding to feel better but then that in itself will make them sick again.

My baby was like this and had cow’s milk protein and soya allergies. His temperament improved considerably when I cut out dairy and soya from my diet when he was about a month old, but he was still somewhat unsettled with horrible gas and silent reflux, particularly of a night, until he reached 5 or so months. I think his digestive system just settled down at that point. I was so desperate when he was about 4 months that we went down the medication route for silent reflux, but it tasted so foul he wouldn’t accept it (it was really traumatic for us both trying to get him to have it - I gave up after about a week). Luckily, his symptoms really settled down a month later and I’m so relieved he didn’t end up on medication. Just something to bear in mind. I know how desperate it can feel when you’re sleep deprived and exhausted, but trust me, it won’t be forever! My toddler is the happiest little boy now and those long nights and days stuck indoors with a screaming unhappy baby are thankfully a distant memory. I really hope it will be the same for you!

You have my absolute sympathy. I could have written your post 2 months ago. We had a massive shift almost on the day he turned 3 months old. It’s like he really hated being a newborn!! At 3 months he went from a 10 unsettled to a 6 and gets better each week. He’s 4 months old now, but those first three months almost broke me. He was only ever happy when he was asleep. He’s much better now, still doesn’t like to be put down, but at least he’s happy when I’m holding him.
I Hope your little boy settles soon

Omeprazole in liquid form from the GP and SMA Anti Reflux formula from the supermarket was a game changer for me.

Thanks for the replies, I think it may be best to review at 12 weeks

If you're so desperate, why not try to remove dairy and soy from your diet? CMPA is a bitch if formula feeding but extremely easy to manage if breastfeeding.

And note that if it is CMPA, the dairy causes inflammation and a lot of damage to baby's gut long term. The sooner you manage it, the sooner he can heal and you have more hope to introduce dairy early.

Have you elevated his cot? That was a great tip we got, elevate it at one end (stick books or something underneath the legs). We always found that helped and was doctor recommended.