Calling all reflux gurus!

[Janie]

Especially those who have knowledge about diet etc as I'm still BFing PT.

I'll try to keep this brief......DS was born 5 weeks early, and we've had a number of feeding issues, hence us doing both BF and FF. He had a little bit of silent reflux as a tiny baby, but TBH I wasn't too concerned about it. I think I was very focussed on his feeding and weight gain. He has always been a mixed bag of a baby LOL in that I think he's 'good' yet others seem to think he can be hard work. Yes, he has periods of screaming, but don't all babies? As he is my first I've had nothing to compare him to. Anyhow, he is unsettled at times, but it's never really fussed me, I just cuddle him until he is okay. He has always slept well, only wakes in the night for a feed and always goes down for a sleep after each feed during the day. The last couple of weeks I have felt like things have been slowly unravelling.......sleeping has been less good, but I assumed that was probably age related, or a growth spurt or some such thing. The last couple of days it has rapidly deteriorated, to the point where he is waking every hour at least during the night, and cannot sleep for longer than 20 minutes during the day. I can only get him to sleep in my arms or in the carrier, and even then it's only for 10-20 minutes. He is very unsettled, will not play on his mat (which he normally loves). I put him on half AR formula last week, as suggested by my MCHN, and increased it to all AR two days ago. I thought it was helping, but it seems not now, he is vomiting as much as ever (up to 8 times after a feed), and I think it makes his choking episodes worse, probably because it's thicker. So I've gone back to half AR, half S26 Gold.

So, I have booked Nicholas in to see our GP tomorrow afternoon on the recommendation of our MCHN. Is there anything I should know before I go in there? As in, do you think there is a particular med that works best etc etc?

And those who know about dietary problems, any tips? Whe I saw the LC she thought that his weight gain problems might be due to him being intolerant to wheat and/or dairy. As he started gaining good amounts of weight I never really changed my diet. But now I'm wondering if something I'm eating could be making this situation worse?

Sorry, I know it wasn't brief, but I will grateful for any help you can give!

[Janie]

Yes we are still BFing. I'm trying to get through the threads, but it's hard when you've got an unhappy bub! He was gaining weight at a very rapid rate, which he needed to do to catch up. He still hasn't caught up(he weighs about 5.6kg), which is fine, but I really don't think he's gaining like he was a couple of weeks ago.

I'm not against changing his formula, but I would like to know why you suggest it, and why you recommend the NAN HA?

Thanks for taking the time to respond Caro

[christy]

Sarah.... my story is different to some.... but I'll give it. As you know I've dealt with breastfeeding issues as well as reflux. Both my girls were/are refluxers. Matilda lost weight and screamed in pain, she didn't sleep, she was on meds & on the advice of our GP & paed she was put on an HA AR formula and I weaned her alltogether. She continued to suffer & has had big issues with things since, a few weeks ago I found out she is extremely allergic to milk and that was most likely the cause to her reflux issues as a baby.

Jovie, I went to a LC who said she was dairy intolerant and likely to have issues with milk. I did an elimination diet on her advice & went off all dairy & soy, I trialled goats milk formula but it didn't help. After a month of trial and error her reflux disappeared, at 6 months it was gone, when I trialled milk again she got ezcema and reflux symptoms again, when I trialled soy it was the same response. Also after a month of total elimination diet she started feeding really well. So every month I do a trial to see if she's "grown" out of it. BUT she's a different baby to Matilda, gaining weight like a champion, sleeping well (which could just be her anyway) and no screaming in pain.... not even with teething.

So for Jovie, she hasn't needed any medication. I have taken her to an allergist with Matilda and she is allergic to dairy, soy, oats, banana. Now I know, and if all I have to do is avoid those foods it will be great.

[Janie]

OMG Caro, my eyes are falling out of my head after reading through that thread! My head is still spinning a bit, I'm really not sure which way I want to go ATM. Just wondering, I've bypassed the paed in this case because it takes so long to get in, and I just can't wait, but can the the GP prescribe losec? Or will he just give us Zantac? I'm a bit unsure as to what will be best for him.....and I need to research the losec a bit more. Thanks for your encouragement

Christy, I've just read through your reflux story............what a battle for you and your girls! You are an amazing mum. I am already sure that Nicholas has a problem with soy. Unfortunately I am a little bit lactose intolerant, so don't drink cows milk, usually soy. It really seems to upset him so I drink rice milk for now. I'm thinking I need to be stricter with eliminating dairy from my diet, because I do eat things like yoghurt and cheese. I am aware that a percentage of people who are lactose intolerant are also intolerant to soy, so I'm guessing that Nicholas might be one of them. It seems very daunting! Though I am happy to do it if it means we can keep BFing and that Nicholas is happy

Thank goodness he is having a sleep now, albeit a very unsettled one. I know he needs help, but I really feel that just putting him on meds may not totally help him. Someone said to me today that when I put him on solids he will probably improve. But I thought if he has intolerances then it might be worse!

Christy, would you recommend seeing an allergist? How would I go about finding one? I guess I could speak to my LC, she specialises in nutritional medicine, so probably knows someone.

I think I need to sleep on all of this - if Nicholas does LOL! Thanks so much for your responses, please keep them coming

[Michelle71]

Sez - sending you big hugs My little man is unsettled too ATM so I can empathise with the lack of sleep and screaming. I hope you find the answer and some relief soon.

[scarlet121]

HI there, I am sorry to hear that you are having such a hard time. When they have bad periods it is sometimes good to look at the things you have changed and this may be the reason why, generally with reflux it is either, food, illness or vaccinations on why they have flare ups.

With the formula I too would try the Nan HA first, there are other formulas that the doctor can prescribe but most would tell you to try an over the counter formula first and go from there.

The reason I suggest this one is that it is partially hydrolysed, which means that it is broken down into smaller particles so it is easier to digest, if you have problems with milk it is more than likely your little one will too. It makes it especially worse if you have a refluxer and you give them something like milk formula or thickened formula and it sits in their tummy for ages, it makes them reflux or vomit.

So HA is best. I would also take dairy and soy out of your diet, the same reason as above milk AND soy proteins are quite large and for a large group of babies hard to digest, again sitting longer, if you don't have these proteins then it can help. Rice milk is good.

With medicine, you have to look at the symptoms as to if he needs medication, sometimes just a variety of things can help, like swaddling at night, helps them sleep, giving them a dummy, holding them upright or carrying them in a baby bjorn, inclining the cot, putting them for tummy time instead of back time...

If the doctor does think medicine is appropriate, it will depend on the doctor, most generally start with zantac, it is a good medicine, just not always works for everyone, so they then may give another one like losec which a GP can prescribe. Just know that medicine will not stop vomiting or the reflux, just change the acidity, so that it doesn't burn, and generally makes them happier once they are healed up!

Good luck with the appointment.

[Janie]

Thanks so much for your reply Scarlet, very informative! I have always swaddled him to sleep since he was born, always had the cot/bassinette inclined, and as a premmie he has always had a dummy. If he is unsettled I carry him around in the baby bjorn, which helps him go to sleep, but he is really not keen on tummy time. He does have one of those big premmie heads, so it's hard to lift it! but he's getting better. I was giving him gaviscon in his last bottle at night to help him keep it down, but I've stopped that now he's on the AR formula. I tried giving it to him more during the day, but it just made his choking episodes escalate.

I don't know if this is normal for all babies, but he often does these vomits a long time after a feed, and they are just watery stuff. Sometimes he's okay with it, and sometimes he screams.

I am going to look at my diet, and at his formula, and have a good chat with the GP today and see where we go from there. Any more tips would be welcome though!

[jacquic]

Hi there,
Just thought I would tell you my story. My son was born a week late. I breastfed him, and he started showing signs of what I was told was bad wind from about three weeks of age. At this time he also started catnapping and being very unsettled during the day. He always slept fairly well at night, just waking for feeds. By about 9 weeks of age , things deteriorated rapidly. He was refusing feeds, was upset and doing a lot of back arching. We started on Zantac, with no effect. We then had him tested for lactose intoleranace, and were referred to a pead . The tests indicated that he may have lactose intolerance, so we started doing both formula and BF. He was put on Nexium tabs and mylanta. Things did not improve much, so we went to all formula feeds. Then we changed to soy, he was a little better, but not great. We then tried Neocate forumla, which is one that you can use for cow's milk protein intolerance. Within a couple of days we saw a significant change in feeds. Now, three weeks later a have a very happy and content little boy. So if things don't work out ask your pead for a script for Neocate, it was a God send for us. If you get the script you can then get the formula on the PBS scheme, and it is then very affordable. Good Luck.

[Janie]

Thanks Jacqui My LC actually suggested that if he didn't start gaining weight to put him neocate.........will have a chat to my GP, maybe we will need to see the paed at some stage after all.

[visitor2]

Sez which AR formula are you using ?
I found the S26 one still made Eleanor sick but the Karicre one didn't.

[Janie]

In a bit of a rush, the GP got us in to see a paed today, our appt is in an hour! The GP was reluctant to diagnose, that's why he's referred us, he's inclined to think it may be LI. So we'll discuss that with the paed, obviously, and maybe look at going onto Neocate, or one of the HA formulas. If he thinks it's reflux, or a combination of both, then we'll also discuss meds I suppose.

Christy, I need you! I recall you implying that the initial LI tests you had done for Matilda weren't necessarily accurate? What do I ask for? I really don't want to stuff around with this......if it is LI I want to get on top of it SOON.

Thank you so much everyone for your help. I'm sure I'll be back with more questions

Michelle, that's interesting.......he is on the S26 AR, so maybe a different one would be better?????????

[Janie]

The paed spent about 45 minutes with us, going over Nicky's history, adn asking lots of questions. He is positive it's not LI. He thinks there are two factors. Firstly, that he does have some acid reflux going on, and secondly that he is getting too much milk! I can't disagree with the second theory, it's quite possible. Anyone who has read our feeding history (it's very long so I won't go into it here!) will know that I'm paranoid about him getting enough, and putting on enough weight. I had already guessed that he was having more than he needed at this age, and for his weight, but it didn't occur to me that it might be making him vomit so much . And the vomiting is ALWAYS after a bottle.

So.....he wants us to try reducing his feeds (formula) a little for a week, to see if that helps with the vomiting. If I still feel it's necessary after that , try some zantac for two weeks. He doesn't think the two are related, obviously, but he doesn't like to try two things at once IYKWIM, which I agree with.

Nicholas has fed really well today, only a bit a crying during a bottle earlier this morning. So that's an improvement, I only hope it wasn't a one off day!

I'm still not convinced that there isn't some sort of intolerance going on, my instincts tell me something's going on there.......but I don't really know where to start with that, given that he apparently is showing none of the symptoms.

Must go, crying baby!