Is it PND? If so what can the Doc possibly do apart from meds?

[whensmydayoff]

My DH and mum keep nagging me to see the Doc as they think (and im starting to think) i have PND.

I have 2.9 yr old DS and a 11 week old DD. DD has terrible silent reflux and is so hard. She screams day and night. She needs held all the time, she wants to feed constanly which makes the reflux worse but thinks it soothes her. Wont take a dummy and just lives to breast feed. The people round here who get a smile from her is my boobs!

Im hating every second of it and I feel pissed off because my DS had reflux too which was hard but nothing like this. She will no doubt be my last as im not chancing another baby with reflux but im missing out on her. I want her to be 6 months old ASAP so I can get her on solids and off my breasts!!

She is a beautiful little baby and I know im going to regret wishing her away. Im actually jealous at baby groups. I see mums with happy baby's and they tell me what they are like and I feel angry inside.

Why can I lie her in a pram and take her for a walk. Why cant I just put her down on a playmat or in her bouncy chair without it causing her pain. Why can't she stop screaming just for one whole hour so I can relax and enjoy her like all these relaxed happy mums?

Im crying alot. I fly off the handle at the least thing which is not like me and have had a few hysterical moments where I seem to be loosing my mind and DS has been present and it's effecting him.. I don't seem to get over the slightest little thing, I dwell and mope about it. Sometimes I feel so low and withdrawn but then I seem fine the next day which is why im not sure if it's just the situation as opposed to PND.

The thing is, ive been to doc's loads about her reflux and not one of them asked if I was ok even though Ive been crying to them about her at times. They must think it's just the situation too.

I really dont want to go on medication so what is the point in going then?

DH made me make the appointment this morning but I feel so stupid going.

You sound exhausted you poor thing, your gp will be able to diagnose if you have PND or if it is just sheer exhaustion, go and talk to her/him, even just offloading how you feel will make you feel better, drugs are not the only solution for PND, your gp will be able to discuss alternatives with you

Hope you feel better soon

Hiya
I thought I was getting PND with my 2nd child but it turned out he had reflux. Assume you've tried infant Gaviscon? Worked for us, made the vomiting a bit more predictable anyway and the sun came out for me then. His reflux wore off about 6m when solid foods were established.
But if you feel crap you feel crap. Here's a link to non-medical things you can try (but try fitting them into your lifestyle, easier said than done.)

Back to the reflux, do you have a decent sling? I totally recommend one of these for letting you get on with things, keeping baby upright and getting them off to sleep. Takes a bit of practice, have a look on youtube for demos, but if you're desperate it's worth a try.

Also keep pushing a muslin at her in the hope that she will fall in love with it for soothing purposes. So much more convenient than toys/dummies and useful for vomitcatching too.

One more thing, how was your childbirth experience? If that is something you dwell on you could have Post Natal Post Traumatic Stress Disorder, often misdiagnosed as PND. Needs talk therapy not drugs.

Thanks everyone.

My birth was fab, it was a succesful VBAC and I was so happy for first 4 weeks.

Gaviscon didn't do a thing, her reflux is too severe. She is on Omeprazole and Domperidone.

Thanks for link I will have a look when I get a mo. x

Another reflux tip is to get some cheap fleece eg Ikea blankets £4 and cut some liners for carseat and pushchair. Just make a rectangle and cut 2 slits for shoulder straps - means you can whip them off if puked on, rather than the whole seat cover. Could also cut some big triangles for bandana-style bibs for her to wear all the time.

whensmydayoff, I honestly could have written your post 3 months ago. For the first 4 months of my DS's life I absolutely dreaded getting up in the morning. (he has bad reflux too.) I was exhausted by the constant screaming, very anxious and stressed out, very teary. I hated going out with him because I knew that if he started crying, he wouldn't be distracted like other babies, he would just go on for hours until the pain stopped. I was really jealous looking at my chilled friends with their chilled babies
I don't know what to say. I thought I had PND, but as soon as we got his reflux under control (and we were lucky as omeprazole works for him) I started really enjoying my baby. Talk to your GP. If there is a possibility you have PND, rather than just being exhausted, the sooner you get help, the better.
Is your DD under paed care? If so, have you told them the meds are not helping her? She should not be in pain. Maybe the doses need upping? Is there a chance she is also cow milk protein intolerant? I can't remember if you said on your previous threads, sorry.

hi, im sorry you're having such a horrible time!i know this feeling so so well!i also didnt want to have to go on meds but it was needs must as i was just in a terrible mood one day, then fine the next.i must say, they took 2weeks or so to kick in but when they did- you know that feeling you get when you go for a walk on a sunny day and everything feels great?thats how it felt.totally worth it, will do you no harm to take them anyway even just for a couple of months. i hope you feel better soon.

duende how long did it take for the omeprazole to work properly? Did it take a while to get the dose right or was it instant?

It took 5 months to get DS diagnosed although the real probs only started at 3 months and the omeprazole worked within 3-4 days and he was great.

DD has been on it for 4 weeks and it's went from 2.5mg a day to 14 mg a day split into 2 doses. I still can't feed her at certain feeds without it taking 2 hours of screaming, arching then screaming for 2 hours after it. Started Domperidone yeaterday but talking to other folk nobody really rates it.

baby1ontheway I like the sound of those meds! The feeling of walking on a sunny day would be fab right now . What were they?

Oh and no I don't get to see a paed as the doctor isnt taking it seriously because of her rapid weight gain.

My DS was underweight and lost some before the meds and he was taken very seriously. The annoying thing is - he wasn't anywhere near as bad but trying to tell them that.

I have ANOTHER appointment with Doc today and I know im going to loose it. I really want to be referred to the sick kids (childrens hospital in Edinburgh)as they know what they are talking about and were great with DS.

It took 24 hours to see a difference, but since then we needed to up the dose a couple of times and each time we needed about a week for the esophagus to heal and the screaming to stop.
DS is now on only 10mg, but I have heard that many babies need at least 20mg for it to make any difference at all.
Have you read this
and
this ?

Whensmydayoff, maybe if you lose it he will take you seriously rapid weight gain is very typical in babies with reflux (as you obviously know), it doesn't mean that they don't suffer. My DS was born on the 25 centile and climbed straight to the 75th. He was always feeding like mad. Our GP wouldn't take us seriously at first either, but I was in her office at least once a week, in tears, until she referred us. I'm keeping my fingers crossed for you today, hope you get the referal. Let us know how you get on. Un-mumsnetty hugs.

I can only echo what baby1ontheway said. Although I didn't get PND but AND (about 6 months into pregnancy). I was prescribed citalopram and I can say with 100% certainty that I would not have been able to cope with the rest of the pregnancy, birth and postnatal period without it. I should add that I've BF my DD and citalopram is said to be one of the safest ADs out there, both for the mother and the baby. I have a fantastic GP who wisely said that the most important thing is that as a mother you're fit and well and feel you're coping. The benefit that this will have on the mother-baby attachment far outweighs the truly minimal risk that the drug poses to the baby through breastmilk. My DD is now nearly 9 months and I couldn't agree more.

I wish you lots of strength and good luck. Please remember you're not alone and this period will be over soon. x

Another idea is to go see a breastfeeding counsellor to make sure your positioning/technique isn't slightly askew. I have heard that the tiniest thing can lead to reflux-like symptoms.

Have you tried expressing and feeding with a bottle to see if it makes a difference?

Interesting duende, I was all for upping the dose myself but it has stopped me in my tracks.

I hate the fact she is on it. It makes breastfeeding seem a pointless task when it is destroying stomach acid meaning they do not absorb vit B12 and Iron (I think it's iron). I keep thinking, Im doing all this horrible breastfeeding and she isn't any healthier for it.

Cant remember if Ive said but we started to give her a bottle of formula every night at 11pm. Feel a bit guilty because I think with all the meds im not doing my best for her but im so knackered. I think once you start BF you get a bit wrapped up in it and the guilt everytime you think of jacking it in, is enormous.

I envy girls who say sod that, not working - move on without thinking it's the end of the world. You know the mums I mean - the confident, non worry warts like myself.

Anyway, Doc was nice and I am being referred to Sick Kids Hospital. Doesnt know how long though.

I told her how I felt and she said it's early days to put me on anti depresants and we will review it in 4 weeks if I still feel the same and to go straight back if im worse or just want to do something about it. She said Id have to go on them for 6-9 months??

Thanks for all the advice and just knowing there so many others going through it helps - sorry if sounds bad!!

Glad you've been referred. Hopefully you won't have to wait too long.

Just wanted to say that I had PND and didn't want to go on meds at all, because it just made me feel I'd be even More of a failure if I did that.

But I saw a really nice GP and she encouraged me to try Citalopram, and if it didn't work I could always stop.

Honestly it saved my life. Even now if I see this GP I feel so emotional because of her, and the advice she gave me, my whole life turned round.

I could enjoy life again and the holiday we had that summer was the first one I'd enjoyed since the birth of my first child, 3 years earlier. Suddenly I could feel joy. And I could feel free of anxiety and weight and sense of total worthlessness.

But it sounds like your GP is right to hold off a little bit until you establish if you do have PND, or if your zest for life will come back once your baby's horrible reflux is sorted out.

Good luck and don't feel too alone.

Whensmydayoff, great news about the referal

I stopped bfeeding DS at 8 weeks. I didn't know he had reflux then. He just screamed every time he fed, kept pulling off and screaming more. I thought he wasn't getting enough milk or getting it fast enough and started suplementing with formula. By 8 weeks he was hardly feeding from me and my lactation practically died overnight. I wished the b/feeding consultants who watched him feed mentioned reflux. Anyway, yes, I stopped and at first felt awful about it. Really guilty and depressed. Now I'm just grateful and happy he can feed without pain.
Don't feel bad about giving him a bottle of formula if it means you're more likely to stay sane. You're doing great.

And your DC are both gorgeous!

Whensmydayoff, caring for a baby with reflux has been one of the most stressful and emotionally draining things that I have ever had to do. When my DD was around 9wks it all really began to get to me. Never felt that I had a 'day off' and even when someone did babysit, I just worried about how she was. I was exactly the same as you, felt like crying, losing patience, anxious etc. Eventually I had one particular day when I felt like all the joy had been sucked out of me and I couldnt even laugh at the things my DD 21/2 was saying. At this point I knew that for all our sakes, i needed to get some meds of the Dr. I dont feel that I could have coped with the situation without it.

Still cant say that I feel fantastic but am enjoying DD (most of the time) and dont feel like the joy has been taken out of my life. I was given Citalapram 10mg.

Even now my DD 7 months is still going through periods of vomiting (particularly if she has a cough, sore throat, is teething etc). I definitely see a difference in my moods during these periods. I feel that most people who have dealt with reflux for long periods will understand how it makes you feel. Doesnt necessarily have to be labelled PND but it definitely wears you down.

I went to the Dr today with my DD and finally got a referral to consultant. So fed up with just giving her Ranitidine and it not doing anything. She is thriving, ie gaining weight and is not crying all the time anymore. But she still vomited three times yesterday. Its soul destroying isnt it? At every break in her bottle, i pray to God to not let her vomit. (God obviously isnt listening most of the time!) lol Anyway, just keep telling myself that 'this too shall pass'! Hope all settles with your DD soon. Good luck

Tras sorry your having a rubbish time too. It is horrible isn't it.

Im starting to realise just how lucky I was with DS. As soon as he got meds (omeprazole and Domperidone) he was great and once on solids there was no problems at all. He did need them or he would vomit loads but he was just an easy baby after that.

More and more Im realising that it doesn't necessarily stop when they are on solids and im also learing that babies with reflux don't take their solids well.

Feel a bit gutted as I had planned to start solds as early as her first sign of interest (was 20 weeks with DS) and thought the hell would end - clearly not.

duende So as soon as you put DS on formula he fed calmly? You say he was 8 weeks but for the first 4 months it was hell - did he just continue to scream but you did'nt have the extra stress at feeding times?
Dop you think he was more uncomfortable on formula - so from 8 weeks until 4 months until you got meds, was his pain worse do you think?

Im asking because my DH feeds DD formula in 10 mins and she is zonked staight after !

I think partly becuase the dreaded tea time feed is when we give her second dose but it hasn't kicked in yet but will have by 11pm when he feeds her. BUT if it's because they are hap[pier on formula which the paed is adament they are not - Im going out to buy shares in Aptimal!

Oh and tras, Doc told me yesterday that Domperidone is a hugely expensive drug!!

They use it on patients going through Chemo to stop nausea. I bet thats why they aren't forthcoming with anything else.

I do think Omerprazole and Domperidone would be better than Ratidine. I bump into a girl with a 9 month old who only weighed 11lbs until recently and has a feeding tube due to serious reflux. He was on Ratidine and was then moved onto Omeprazole and Domperidone and now he is happy and gaining weight.

Sorry typing and spelling shocking!

do you have surestart centres in your area. i attended a PND therapy class in one of these centres and it helped me enormously. it helped meeting mothers who felt the same way and i could be honest about how i felt about my child as noone was there to judge.

I don't think they are happier on formula, no.
(unless they have a problem with which a specific formula can help - i.e. lactose free, or cow milk protein free). As far as I know breastmilk is easier to digest hence better for reflux babies. For me it was the fact that with formula at least I knew how much he took that helped a bit.

He was fine on formula alone only for a week or so, and then really started screaming blue murder at feed times. This continued (and was quite scary, with him choking, stopping breathing, etc) until he was put on omeprazole. This is when it got better for us, and I now realise how lucky we were. he was about 4 months old by then.

duende Damn!

Had been hovering waiting on that reply!