Paediatrician says I should wean at 4 months - would you?

[ready2pop]

My DS is now 13 weeks and suffers badly from reflux. This not only makes him sick but also causes him a lot of pain whilst feeding - he screams at the breast and thrashes around and as a result will only take a few gulps at a time. Then, because he has fed so badly he cries in hunger and we end up with a vicious cylce where he is crying pretty much all day. He really seems to be in agony and it is awful to watch.

Despite the problems, he has been putting on weight at a rate of knots. He was low birth weight but had doubled his weight by 8 weeks and is still gaining twice what the charts say he should each week. He's gone from 2nd centile to well over 50th since birth.

We've tried various medicines to cure the reflux but to no avail and his consultant now says we should wean him at 4 months. Her reasoning seems to be that solid food would be more likely to stay down so would stop his pain.

I know the WHO guidelines say 6 months and am reluctant to go against them BUT I also have a medical expert telling me otherwise.
I'm not really sure what to do.

DS is growing so well just on breast milk so I'm sure he could go to 6 months BUT he would be in agony the whole time. On the other hand, if we wean early now to stop the pain are we just storing up trouble for later?

Really don't know what to do for the best

DON'T DO IT!!! My dd had horrible reflux and we were advised to wean her early - all that happened was food-puke instead of milk-puke! What meds is your ds on?

Is it possible to get a second professional opinion, or to see someone who specialises in reflux?

Second Naetha's advice. See if you can get more professional medical opinions.

My GPs gave me the same advice. I did some background reading and decided it's bollocks.

He's probably gaining weight so well because although feeding is uncomfortable, the milk neutralises the acid and can temporarily relieve the pain. My DS had a bit of reflux (not very severe though) and he fed really, really frequently. I think it's common for refluxy babies to gain weight fast for this reason.

I agree, you should try to seek another opinion. I also wonder if some of the BF helplines might be able to help?

In my day (DCs now 8-11), babies were weaned at 4 months... and when DD1 who had been sleeping through from 10 weeks started to wake again at night HV said "oh she's obviously ready for solids". Go with advice for your baby... 4 months was good for DDs 1 & 3 (who had reflux) but too early for dd2 but as she didn't really eat much it didn't matter. Years later, 1 & 3 eat consistently but dd2 (slight compared to other pair) much more carnivorous... make of that what you will

The most important thing is that they gain weight and that is happening! Also, breast milk is not only easily the best food for babies but is the most easily digested, i.e. they will absorb far more nutrients from b/milk than they will any mashed up fruit, veg etc.

I too have a v pukey baby but, all things considered, this is more of a laundry issue than a health issue!!

I would try some veg and fruit purees.Its not about the weight gain thing,but the fact baby is in agony feeding I would try something else to hopefully help them

I would normally follow a doctor's advice TBH but a second opinion seems a perfectly good idea?

have you come across Living with Reflux? i assume so.

My DS is on a PPI drung called Losec which is supposed to stop acid production altogether. It's not working though and we can't increase the dose any more at his age.

It's not the puking that bothers me because I know from his growth that he is keeping enough food. It's the fact that he seems to be in so much pain all the time.

I would listen to your instincts. you seem unsure and needing more guidance so a second opinion would be helpful. or alternatively make a list of questions and get back in touch with your consultant. they are usually ok about that. you could even just email his/her secretary initially.
who have you seen so far, how experienced are they? what have you tried already? initially I wondered if it wasn't reflux but over supply of milk but I guess you've had tests done etc? ruled out any chance it could be dairy intolerance etc instead of reflux?

agree that solid food means solids puked back up. My DS was like this and a friend whose baby has bad reflux is the same now he is being weaned. The solids don't appear to have made much of a difference to him from what I've seen

pofaced, yes the advice has changed, but it is a for a very good reason as more research has been done on just how babies metabolise solid food. babies guts mature at different rates and although some may be able for solid food at 4 months, the gut can take 6mo to mature so it is safer to hold off until then.

I agree that the OP should get a second opinion or speak to a BFC about this.

Reflux is only one reason why babies who are gaining weight well behave unsettledly and miserably - and the fact your baby has not improved despite medication indicates you might want to look for other solutions than solids at this early age.

It could be, for example, that you are making a lot of milk, and this over-generous production is causing his discomfort. If you look up related topics on mumsnet (try 'one sided feeding' or 'too much milk') you'll find ways of coping better and helping your baby's discomfort. This is certainly something to try before solids.

pofaced - your advice is out of date. It is fine to share experiences on mumsnet, but not to use this as a basis for telling others what to do

readytopop, do you know why they suggest not to wean until 26 weeks?
The science behind it says that a baby's gut is not mature enough until between 17-26 weeks, unfortunately there is no way to tell which baby is ready at 17 weeks, and which is ready at 26 weeks, so by weaning your baby you could cause untold problems for it later in life.
I'd ask the Paed if he could guarantee that my baby was ready and would definitely not have any problems from my early weaning and see what he said, if he says he can, he' lying, which would make me take anything he said with a pinch of salt and ask to be referred to someone else.
Sorry you're going through this but I don't think weaning is the answer.

Readytopop, I have heard good things about losec, it's a shame it doesn't seem to be working for you. My dd was on ranitidine which seemed to work for her. The trouble with introducing solids, apart from the issue of 4 months being controversial, is that even when/if you do at 6 months, you have to go easy with a reflux baby, they can be sensitive to a lot of foods that a non-reflux baby isn't - tomatoes are one of the more obvious 'acidy' foods but there are lots of others that could also acerbate the reflux. It's another good reason to stick with milk as long as possible! Definately try block-feeding, as I had a problem with my ds when he was around 10 weeks displaying reflux-type symptoms (he doesn't have it) and it was down to oversupply and fast letdown. Block feeding really helped.

Thanks for the replies.

I'm pretty sure it isn't fast let down or oversupply. Those were my first thoughts too but tried block feeding etc... and it didn't make any difference plus DS has all the same symptoms when fed breast milk from a bottle too. Saw an NHS lactation consultant who, after watching DS feed, agreed with my GP that it was reflux and it was after this that we were referred to the dr who says wean at 4 months.

She is a well respected consultant specialising in paediatric gastroenterology -we did quite a bit of research about her before getting the referral so am pretty sure she knows what she is talking about. She has run plenty of tests on DS's poo so am pretty sure she knows as much as is possible about his gut.

Victorian Squalor - I do know the reasoning behind the 6 month recommendation which is why I am querying her advice. Without the relfux I would definitely have waited until after 26 weeks.

However, my DS is obviously in lots of pain with acid gurgling up and down inside him. Plus, I assume that if anyone is able to second guess when my DS will be ready to wean it is going to be the paedeatrician as it is her specialist field. She is only suggesting that we introduce baby rice now and says that this will not cause him any digestive problems in later life.

What I am trying to do is weigh up the very small risk of problems if I wean early against the continued pain DS will be in if I wait.