Should I try the Karicare AR HA, or not?

[FellowTraveller]

My DD is nearing the 8w mark and has recently developed what seems to be reflux. SHe is on NAN HA1 (for about 3 weeks now) due to her sensitvie tummy and her sluggish bowels (not constipated as such just poos once every 4 days!) which seemed to cause her discomfort around the 4th day (quite bloated and very windy).The NAN seems to have helped a bit - now she poos every 2 days or so (poos are very very soft and dark green!). However, I am now concerned about her vomiting sometimes up to 2 hours after a feed. She seems to spill all over the place and has the hiccups at most feeds. She also appears not to sleep well and wakes up crying after 20 min or so - when I find her mattress, or the side of her head, quite wet! I have started using Dr Brown bottles which seem to really help with the wind...but she still vomits (she shows relief after a big vomit). Our paed tried her on Zantac which I don't think helped much (he was not sure if it was reflux - mind you we only tried it for 2 days or so). I try to burp her well halfway through a feed, keep her upright for 20 minutes after a feed and have raised her mattress too.
My question is this...Should I try her on Karicare AR HA to see how she goes?..My concern is her about her bowels (if they become sluggish again) and what if she does not have reflux?? And if I do, what sort of teat do I need (I have Dr Brown level 2 at the moment).

[RISA]

Hi,
Thanks for contacting our organisation. As you realise, it is really important that you do find out for sure whether your daughter suffers from reflux, or something else- there are a other conditions that present similarly, such as urinary tract infections, even though reflux is the most likely cause. It is of course really important to treat the right condition, rather than making assumptions. Just imagine if you treated it like reflux, but ignored the real issue!

Have you been to the doctor’s again to confirm your suspicions? If not, then I would strongly urge you to do so. If you have, and your dr still isn’t sure it is reflux, and your instincts are telling you to pursue it, then please do so. I can offer some suggestions that may help if you need any.

If your doctor does confirm your suspicions, then please talk to them about what formula you should use. Sometimes thickened formulas aren’t the answer for reflux children- as they can sometimes be too thick to clear from the oesophagus if refluxed (which can cause more pain, not less). (sometimes though, it is the answer they need). Unfortunately, dealing with reflux is often a matter of trial and error, because working for one may not be the answer, so it’s hard to know what is best (even which teat they prefer).

Thickened feeds can also cause constipation, especially if bowels are already showing signs of being sluggish- another reason to discuss whether thickened feeds would be worthwhile trying with the doctor. If so, it may be better to continue with Nan HA, and thicken it yourself, so that you can adjust the thickness to what suits best.

Zantac often needs to be taken for a week or even a few, before you may start to notice an improvement, and for some, it may not be strong enough. Often too, doctors will prescribe a small dose to begin with, and increase it as the child puts on weight, and as necessary, so it may be that the dose wasn't high enough, or given long enough. That would be worth talking to the dr about as well, and perhaps trialling other reflux medications like Losec or Zoton.

I’m sorry that I can’t give you the specific answers you need, but please continue to trust your instincts, and you will find them. I really believe that a mother’s instincts are very powerful and should be listened to. You know that something is wrong, so please pursue it, and I hope you find the answers you need really soon.

Glenda