Reflux or allergy

[Xfirsttimemum]

Hello, I’m new to mumsnet and have never wrote a post before but wanted some advice. I have a 7 week old baby boy who has been vomiting after feeds for 5 weeks now. He can’t be put down for a nap as he’s always sick and cries so sleeps 10- 15 mins here and there during the day and is exhausted because of it. In the evening he will sleep for a few hours then after his 2am feed will be very unsettled, rive around very uncomfortable and then be sick in the air which will then be on his face when I turn the lamp on. He’s clearly in pain most of the time and cries constantly. I’ve barely seen a slight smile or any happy time from him and it’s breakig my heart. I can’t eat or even go to the toilet as putting him down for minutes is a nightmare and results in sick and crying. His head end of the crib is propped up but this doesn’t help. Gaviscon has made no difference and we’ve started on ranitidine a few days ago but no change yet. He can be sick up to 3 hours after his last feed. He’s snuffly a lot, sometimes sick mucus, poos after every feed (bottle fed), makes sheep noises and generally just seems uncomfortable all the time! Has anyone had any similar experience of this? I’m just struggling to enjoy this time that should be so much more enjoyable for us both.

The mucous poos, the fact he poos every time he eats and the general miserableness would make me think allergy. The symptoms do overlap with reflux though so give the ranitidine 2 weeks and if he is no better as for a trial of hydrolysed formula

That meant to read ‘ask’

Agree with the above. DS had CMPA issues. Being snuffly, constantly unsettled, visible discomfort when feeding and after, mucous poos and constant reflux are all signs of CMPA. However as PP said the symptoms are very similar to reflux. As your FF you’d need special prescription formula which most GPs will only prescribe after trying things like ranitidine etc. If the meds make no difference (remember to check weight as the dose needs to be adjusted as baby gains) then go back and ask for a trial of nutramigen. If you have to switch the milk it can then take up to 3 weeks for dairy to totally leave the system. After this you’d then have to challenge the allergy to confirm. If you really suspect allergies to be a problem my best advice would be to be firm and pro active with doctors and HVs etc. IMO they know bloody nothing about it and often the info your given isn’t correct at all. Do your own research, right down the systems and if you’re not happy push for 2nd opinions and referrals to paediatricians or paediatric dieticians. The one we saw was fab.

In ragards to making baby comfortable while you try and figure it out- have you tried a sling? Keeps baby close and upright so more comfortable for tummy. Have you tried raising the head of cot/baskets etc. I always found DS was also more comfortable in his car seat and refused to lie in the carry cot of his car at all ever so it was never used. He’d wake after being put down, so I let him sleep on me. This is normal newborn behaviour anyway tbh and might be the same regardless. DS was much better after I cut dairy (he’s BF) and was a totally different child.

Good luck OP

Thanks both. We ended up at A&E on Saturday as he had his worst screaming in pain episode. The doctor was very dismissive (I know we weren’t an emergency, but I was so worried about him after the meds hadn’t worked and he was still in pain) he just basically said, give him less milk and cut all meds. He said he thinks it’s colic, but he cries all day and by the evening he calms down and can finally sleep through exhaustion so I can’t see how it can be colic, maybe a mix of reflux and colic, but not just colic. I’m going back to GP to ask for a referral to paediatrics in the hope that someone can spend some time listening to us and offer some tests. It’s just so horrible for him and I’m getting so down because of it :(

Colic is just a general term used to describe symptoms. It’s not an actual thing so don’t be fobbed off. Emergency docs won’t be in a position to make any plans for tiny babies beyond emergency ones so I would ignore what was said.

What does his sick look like? What does it smell like?

I have two kids - my older dd had very severe reflux and CMPI. She was extremely unsettled, would take an eternity to drink a bottle as she would scream and cry during it. Consequently her intake was low and her weight dropped. She was also seriously constipated and her sick was like cottage cheese. She smelled terrible as well. Like sick all the time. She wasn’t sick much as all though. Very rarely in fact.

She ended up admitted to hospital at 4 weeks as she went on complete feeding strike. They gave her ranitidine, domperidone and infant gaviscon as well as nutramigen formula. That combination worked for the most part. Her sleep improved massively and she was much more contented. It was only when she went onto omeprozole at 6 months though that she seemed no longer in pain when eating.

Younger dd has no reflux but does have dairy and soy intolerance. She lost weight after an initial good gain, comfort fed all the time, terrible mucus poo and blood in her stools. Her sleep went to pot and she became very distressed. She was breast fed so I cut out dairy and soy which improved everything.

I say all that as it may help point you towards some level of solution with your baby. It does sound to me like there is a digestive issue so a trial of prescription formula (for at least a month) and ranitidine would be a great place to start.

Good luck

Poor baby and poor you

What is baby’s weight gain like? Failure to gain weight can be another sign and another argument to get the doctors to listen.

You need to go to the GP and insist on being taken seriously. Don’t let them fob you off, print the NICE guidelines on suspected CMPA and take them with you, stand your ground, see different GPs if necessary, and if none of the GPs are helpful, insist on a paediatrician referral.

FWIW it sounds like CMPA to me although I’m not a HCP. The way to confirm the diagnosis is to exclude cows milk completely. So if FF that’s a hypoallergenic formula - they will probably give you nutrimagen at first but baby might need neocate. And if BF that means Mum cuts out all diary products and foods containing milk.

If all the symptoms disappear after excluding cow’s milk (you should see an improvement pretty quickly although for things to improve completely it takes longer, when FF I think it’s 2-3 weeks, when BF it’s 4-6 weeks as the proteins have to leave Mum’s system then baby’s) then you can be pretty sure about the diagnosis of CMPA. The way you confirm it for sure is by giving a small amount of cows milk again eg bottle of regular formula (if FF) or Mum has a portion of dairy product like yoghurt or milkshake (if BF) then if symptoms return you have confirmed the diagnosis.

I recommend cutting out cow’s milk before giving reflux medication, if CMPA is the cause of the reflux then you will be able to resolve it without medication. Obviously baby might need reflux medication as well.

Btw, I recommend a book by Bryan Vartabedian called “Colic Solved: The Essential Guide to Infant Reflux and the Care of Your Crying, Difficult-To-Soothe Baby”. IIRC it’s written by a paediatrician whose baby had reflux, and although it’s not completely up to date (it was published in 2007) I found it very useful and reassuring.

There are also FB groups with excellent information and support for CMPA and reflux.

He’s gaining weight fine, it’s just the fact that he’s very unsettled and cannot sleep or relax during the day, either because he looks in pain or because of the sick coming up when on his back (even 2 hours after a feed and being sat upright). His sick ranges from watery to lumpy and cottage cheese like, I wouldn’t say that it has a foul smell or anything. He’s also had green poo lately too, don’t know if that’s of any significance or not? I’m going back to the GP tomorrow to ask for referral to paediatrics. Until then, I suppose we’ll have to muddle through!

Yes green poo is another sign of allergy
Obviously gaining weight doesn’t mean there isn’t a problem
Please ask your GP to prescribe neocate or nutrimagen so you can start baby on it straight away
IMO this is more important than paeds referral (although that would be very helpful too, but it won’t be a quick fix as you’ll have to wait for the appointment)
If GP refuses to prescribe hypoallergenic formula you could buy a tub and trial it yourself, then if things improve you can use that fact to insist on a prescription from GP
I suggest you start a symptom diary that you can share with GP

Loads of useful info and advice on CMPA here
www.allergyuk.org/information-and-advice/conditions-and-symptoms/469-cows-milk-allergy