6 week DD can't lie on back...help please.

[Mitsouko]

Hi, my poor little DD is just absolutely unable to lie down comfortably on her back. I suspect colic and reflux but not getting anywhere with treatments. She sleeps well in her sling, lying upright on my chest or on her tummy over my lap, but put her on her back and within 20 minutes max she will be writhing and grunting in agony. Left unattended this erupts to colicky howling which can last hours. She is bf on demand every 90 minutes 3 hrs. DH gives a bottle of expressed milk once an evening so I can get 3 to 4 hoursin the spare room. We have tried infacol, colief, infant gaviscon, elevating co sleeper cot with books and several sessions of cranial osteopathy but not had any success. Know I probably just have to wait it out but hoping for some solution. My back is shot from the sling and I am sooo tired...

My dd1 sounds identical to yours. As a tiny baby, she was hysterical when placed on her back and this being pre-MN and her being my first, I had no idea why. At around 3 months my mum took charge (I was beside myself with lack of sleep by this point) and put her to bed on her side. My dd instantaneously went to sleep, and I really mean instantaneously - within 5 or 10 seconds. I think she was exhausted too. If she rolled onto her back, she became hysterical again. Prop her on her side and again within seconds she was asleep. I took to wedging her on her side with towels and a bag of rice. This worked initially but as she got bigger and stronger she could push them away and would roll on her her back at which point hysteria would kick in. At one point I was getting up 15 to 20 times a night simply to stick her back on her side. It was a low point! It resolved itself overnight at around 5 1/2 months when she learned how to roll over by herself.

Incidentally, if you are going to stick your dd on their side, I wouldn't tell your HV. I did, I was told that this would probably kill my baby. Not really what I wanted to hear when I hadn't had more than 3 hours of sleep a night for the previous 4 months. And of course it's bollocks. The stats are pretty clear. The risks of SIDs is massively increased by babies sleeping on their fronts but only slightly increased by sleeping on their sides and there is some speculation that this increased risk is because some babies on their side will slip forward onto their tummies. I suspect that tummy sleeping in combination with a movement monitor is also basically fine.

lovely words Milla :) your spot on with what you said :)

Go back to a and e if no joy at GP on friday. I wouldn't usually advocate doing that but I have been in your situation and did just that. We were desperate, and it did the trick. Tell them how desperate you're feeling, and how you are absolutely certain your baby's in some sort of discomfort.

Meanwhile, you could always try getting the GP to prescribe a PPI like omeprazole/ lansoprazole directly. They can do this, it's just that many don't like to because they are unlicensed for infants IIRC. Ours prescribed Ds's no problem in the interim, while we were waiting for paed referral to come through.

Think the doula is an excellent idea. Go for it, use your savings, and don't worry about that: you need to get through the next few months with your sanity intact.

Milla is right about the risks of having a limited diet. It is much harder when you're already vegetarian. You will have to ensure you get sufficient calories and nutrients, which is a headache you frankly don't need at the moment.

Think lots of hummus, avocados, ginger biscuits (many are dairy free), dark chocolate (Lindt 70 and 85% is milk free IIRC but may contain soya leicithin if you are also avoiding soya). fortified oat, almond, rice or hazelnut milk can provide additional calcium and something to put on your cereals. I would also take a multivit and mineral supplement if you're not already.

Nevertheless, I would still stand by the milk-free suggestion, because specialised formulas are not necessarily the easy alternative. Aside from one brand (and we have tried them ALL in our time) they taste disgusting and therefore getting your baby to accept them can be challenging. There was a point when we had to flavour our son's with fairly hefty amounts of banana Crusha. Not recommended but it was the only way to get any of it down him (I stopped BF fairly early for a variety of reasons with him). Some babies will drink hydrolysed formulas OK, others not, so the palatability issue may not crop up of course.

Staydown formulas are sometimes recommended for babies with reflux where cow's milk allergy is not a factor. Some people swear by this but others find it makes no difference.

Also, PM me your address if you feel like it as I have a swaddle pod or two lying around that you are welcome to have :)

Hi mitsouko
I am/have been in pretty much exactly the same boat as you! My DS screamed constantly from birth and there was no way I could lie him on his back. My family are all on the other side of the world. DH's are about six hours away (and actually wouldn't be all that helpful if they were closer). I'm also vegetarian and struggled with cutting out dairy - but it is worth it.

Briefly: DS is now 7 months old, and while things are not good, they are better than they were and I feel I understand a lot more now. Infant reflux is horrendous, particularly if you do not have an understanding GP. As awful as it is to be medicating babies I really do advocate high doses of reflux meds, as the poor little things just have no way of telling us if they're feeling better. Gaviscon doesn't generally work for breastfed babies, as breastmilk is so much thinner than formula, and the Gaviscon can't form a raft on top of it as it is meant to. Ranitidine is the next step, but will only be helpful if given at a high enough dose. When DS was eight weeks old I took him to a paediatrician in Australia, where I was spending time with my family. The paed was shocked at the dose he had been prescribed in the UK, and immediately tripled it, whereupon it started to show some effect. Make sure you have an accurate weight for your DD, then get hold of a MIMS or BNF (try the internet, or your local pharmacy will have one) and calculate the maximum dose for her. If this doesn't show improvement within a week then I would demand omeprazole.

Dietwise: yes, it is incredibly tricky being vegetarian and dairy free, but it is usually only cows milk protein which is the problem. Only proteins pass through into the breastmilk. Dairy fats are fine; butter and cream, therefore, pose no problem. So it's cheese, yoghurt and milk you need to cut out. And unfortunately, just reducing them will not be enough. For reasons yet to be fully researched, most reflux babies have an inflammatory response to the casein in cows milk. It causes inflammation of the lining of the digestive tract, which is agonisingly painful when in contact with acidic stomach contents. This inflammation can be set off by the smallest amount of dairy protein, so even 'just' having milk in your tea once or twice a day is enough to cause her pain. Luckily there are plenty of alternatives. Eat loads of eggs! Red lentils are generally pretty innocuous, and in fact most of the legumes shouldn't cause the baby any trouble. You may want to consider how you'd feel eating some animal flesh for protein. I, a lifelong vegetarian, made the decision to include organic free range chicken once a week, as this was the most ethically produced meat I could find.

Sleep position: as you've no doubt worked out by now, most reflux babies sleep best on their tummies or sides. Please be guided by her. You must remember that the SIDS guidelines are based on a number of risk factors. Other risk factors include: a smoker in the house; not being breastfed; being small at birth; being in a room away from parents. If none of these factors apply then I really wouldn't worry. Watch her and see where she is most comfortable. Use a monitor if it makes you feel better. I feel you are being unduly upset by her sleeping on her tummy. I taught myself not to worry about this by going through the research on the associated factors.
Please PM me if you need any advice or a friendly shoulder to metaphorically cry on. Things are not brilliant for us yet, but they are better than when we were where you are now. Good luck!

Have you looked at cutting out any caffeine from your diet (chocolate, tea, coffee, fizzy drinks)? Sometimes that has an effect. Hard if you're already tired I know .

The most likely dietary culprit is usually cow's milk protein. However, it is very difficult to eliminate, especially if you are vegetarian, so you might need a referral to a dietician yourself if you want to try this. From what I understand it takes 2-3 weeks of total elimination from your diet for the protein to be completely out of your system so you can judge whether there is any benefit or not. However, to try this you would need to cut out absolutely all dairy religiously, so you'd be vegan except eggs. Cow's milk is in all kinds of processed foods where you wouldn't expect it, so mums I know who've tried this have to become obsessed with reading every packet before putting anything in their mouth. It can be very hard, but for the ones who find it works it is revolutionay, so I thought I'd mention it in case you hadn't considered it.

Ooops, x posted with pp

Thanks again all, great advice and support all around - much appreciated!

I don't think I'm ready to give up breastfeeding, especially as the feeding itself has gone so well. I've ordered some Nutramigen but really only plan to have this on hand for nights when I've not been able to express enough for the bottle DD takes on my sleep shift. I think I can do the dairy free thing in a healthy way with some planning and creativity. I was actually vegan for about 3 years in my 20s - but that was when I worked at a natural foods co-op with easy access to goodies and a fat discount! I eat fish now on occasion and can step that up a bit. I need to take a better look at my diet anyway as I am now living off toast, bananas, apples, ready meals and probably too many biscuits.

If after 3-4 weeks we don't see any improvement then at least I can be fairly certain that it's not cow's milk protein intolerance causing the problems. I am really, really hoping that we'll see some improvement by 12 weeks anyway - the pediatrician said that the most common cause of problems like these was simple digestive immaturity and that in most cases it does get better with age, especially after baby starts sitting up. Really, if we can just get to the point of me being able to lay DD down AT ALL and her sleeping for a couple of hours or so then I will be very, very happy.

Yes, I am probably way too worried about the tummy and side sleeping stuff. Argh. Can't help it really. Wish it didn't give me such anxiety and that I could feel more relaxed about it, really do. I had a pregnancy loss prior to DD's birth, so maybe that explains a bit. I just feel like I have to do everything in my power to keep her safe. If my exhaustion was seriously compromising her safety, then I'd probably let her tummy sleep with a monitor. But as I'm managing, I want to follow SIDS guidelines the best I can. Really struggling, but managing.

Hi ladies - well, here we are with a nice update - DD is doing a bit better and what a relief it's been. Went back to the pediatrician and had reflux meds adjusted for current weight as she had a big growth spurt between 6-9 weeks. I am using a sleep positioner in her basket and she is oh so much more comfortable on her side. Got the movement monitor for extra safety as well. This is working a treat and she has been able to sleep in little blocks of 1-3 hours in the basket. I know that doesn't sound too impressive to most but it's a real improvement for us. She seems so much more comfortable, and the rest is doing her a real treat. DH and I still shift sleeping but we're hoping we can all move back in together soon once she just gets a little more settled. She's still having a few colicky meltdowns in the afternoons / evenings but hoping this will improve with age and digestive maturity. She's also getting a little better in the pram, which is great as I'm not feeling so much a prisoner in my own home.

Looks like there might be a light at the end of this tunnel - hurrah!

Oh, and I've been dairy free for 5 days now - not really minding it! It's pretty easy with a little planning. Forgot how much I liked Rice Dream. Got soy yogurts, dairy free margarine, some vegan ready meals. Eating a little more fish too. Actually feel like I'm eating a bit better and healthier since I have to think about it more. And having a baby that I can actually put down for a bit certainly does help!

What good news, mitusoko. 1-3 hour sleep blocks sounds normal to me, and I can bet you are very happy with normal after the last few weeks :)

Do you think the dairy free has made a difference or is it the meds?

Hmmm, its hard to tell. Possibly the meds and side sleeping as I've heard that the cows milk protein takes a few weeks to leave your system entirely. Will probably continue for a bit and then gradually reintroduce and see what happens.

Hi Mitsouko Glad to hear things are improving. We've been in a very similar situation and it's clear that DD is so much more comfortable on her side. Which sleep positioner are you using? We've been using rolled up towels but I worry that they are a risk in the cot.

Suchanamateur - we're using the Bebecal sleep positioner and cot wedge from babyreflux.co.uk. It's great. Here's the link:

www.babyreflux.co.uk/products/BEBECAL-Baby-Back-and-Side-Sleep-Positioner.html

You can buy both together in a package and save a bit. I bought a wedge for DD's changing table as well and as a result she is much more relaxed during nappy time and spitting up a lot less.

Hope your DD feels better soon.