Help! Silent Reflux advice please!!

[mumtolila]

Hi,
I have a dd who is 10 weeks old and has silent reflux. My gp has diagnosed it and we are on 1.5ml zantac twice a day. I use nanha1gold which i add a scoop of thickener at each bottle. She has been on the nan since i weaned her.

I'm having a really bad week with her, it is the worst yet, she still rarely drinks a full bottle (150mls) generally only half. She shows the general reflux signs, drinks initially and then pulls off after a while, arches her back, cries, screws up her face in pain, she is as stiff as a board at times which is just horrible to see her this way. She is hard to hold at this stage, i hold her up over my shoulder and keep a straight back, she rarely will burp. She thrashes about and refuses the bottle again.

She had her 8 week immunisation on tuesday of this week, do you think this is contributing to a bad run of reflux?

On Tuesday night, she vomited her bottle straight up. She hasen't vomited like this before, she did it again yesterday.

This week she has been inconsolable at times, just cries and cries and is stiff as a board. Even the dummy that usually helps her doesn't work. What do i do with her when she is like this?

My question is, do you think the zantac is even working? And i am hesitant to change formula's, i hear that they are all generally the same thing, and i don't want to be upsetting her digestion. Really is it going to make a huge help?

She is putting on weight so no worrys there, although the thickener could be helping that.

I was so upset and stressed yesterday, i also have a 4 year old so i guess i'm just looking for some advice. We are doing all the usual things to help manage her reflux, dd #1 had reflux too but vomited so i can remember all the things we did with her.

Please, do you have any suggestions to help, am i doing all i can and just have to live with it??? it tears me to pieces to see her so uncomfortable and upset :no:

Thankyou
Kelly

[mumtolila]

oh i mean't to add that when she isn't burping after a feed, is there anything i should be using to help her with burping?

Is it building up and then causing pain for her like when she cries and cries and goes stiff as a board?

I also noticed today and yesterday, so twice when i have changed her nappy that there is a small red stain in her wet nappy. Is this blood, it is only a small spot.

[RISA]

Hi Kelly

Sounds like you're really having a tough time with your little refluxer. But it also sounds like you're doing a great job with managing a tricky situation. You're doing the right thing to not be jumping around from formula to formula. That said, if it seems that your little one has some allergy or intollerance issues, there are prescription only formulas which may help her. They're not always easy to get baby to take though as they don't taste as good (from what I understand). Something to speak to your gp about.

Likewise, there are also different medications. The symptoms you describe could mean the reflux just isn't under control enough. There are some medications which neutralise acid and there are some which stop acid production altogether. Perhaps it's time you looked at the different alternatives. Your gp again may be able to advise you, or it may be time to ask for a referral to a specialist. If you had a paediatrician who seems to have an understanding of reflux, that may be the next step, or the person further along the chain is a paedicatric gastroenterologist, who deals specifically with gut & feeding issues in babies and children. Sometimes there is a wait involved in getting an appointment so try and get a referral and ring and plead your case with the receptionist if you're getting desperate. Maybe you can get in on a cancellation.

You're very perceptive (mother's intuition is amazing) to consider whether immunisation has made her reflux worse. Anything which puts any stress on the body of our little refluxers makes their discomfort worse. So if they're over-tired, have a cold, have colic or have just had their immunisation, there reflux will often be worse for a short time. Please note that it's just a short term reaction and not at all a reason to delay or avoid vaccinations! There are some babies who's reflux doesn't get affected at all - each baby is different.

Regarding burping, again each bub is different but if your little one has wind or colic which is making her uncomfortable, her reflux may be affected. Keeping her upright after a feed should usually help her to bring up any wind anyway. If you think she needs more help, perhaps one of the chemist medications especially for colic might help. There are many to choose from or ask your gp or gastro.

It may be helpful to start keeping a diary of her feeds, her sleeps, her unsettled periods and when she's getting her medications. Sometimes the information you record can help your paediatrician or gastro to see what they need to look at in order to help you. Most babies will grow out of reflux by themselves but you should have a baby who is comfortable to feed and sleep, especially when you're already caring for a four year old too, so if you don't feel her reflux is under control, make those specialist appointments and follow it up. As mentioned, mother's intuition is a great indicator as to whether there is a problem requiring follow up.

I really don't know about the spot in her nappy. It is definitely something you need to keep an eye on and follow up asap. Spots of blood in vomit are unfortunately an indication of severe reflux so this should be watched out for and acted on promptly.

There are some hints to managing reflux at the RISA website www.reflux.org.au . Our contact details are there and you can request a call from a reflux mum. We aren't health professionals so we can't give you medical advice, but we can certainly give you emotional support as we know how very hard it is to parent a baby with reflux.

Please make another appointment with your paeditrician or gp and perhaps get a referral to a gastroenterologist. Ring us at RISA if you need some support. We also have coffee mornings where you can meet up with other reflux mums. Sometimes it's just a relief to speak to someone else who knows what you're going through.

All the very best and let us know how she's going.

Julie for
RISA - Reflux Infant's Support Association
www.reflux.org.au

[mumtolila]

Hello,
Thankyou so so much for responding... it was totally refreshing and supportive to me.

My next question is well..what should i be expecting... Some feeds are just horrible some more tolerable.. She is such a happy baby when it's not feed time, sleeps through the night, getting better with day naps (or is that these past few days..lol) but sit down and feed her is a different story. Sometimes she can be uncomfortable straight away and she takes a long time to relax enough to have a drink then she will drink for a while, maybe 1/4 to 1/2 of the bottle and then pull off and just be uncomfortable, cries, stiffens back and is really hard to hold up or lie down. She usually does not drink any more of this bottle. But then sometimes she will drink a full bottle.

As i said before she is putting on weight...but is drinking less harmful? Should she be more relaxed then this? does this sound like silent reflux to you... she generally then fights the bottle and eventually falls asleep from thrashing about so much.

I would just love to see her relaxed enough to drink her bottles.

Any further advice appreciated.

Thankyou Kelly:flowerz:

[RISA]

Hi Kelly

Regarding her bottles, you should see your daughter more comfortable than what you describe. She should improve as her reflux improves. This could be as a result of a change in medication or a change in formula or she could just improve as she matures. Try to feed her in as upright a position as you can. Sometimes Mylanta can help if you give her a little dose 20 - 30 mins before a feed. You will need to speak to your health professional about that and what dose to give. Some babies will still reflux regardless of what medication they are taking so feeding can be slow and a little tricky, but as mentioned, as she gets older she'll get more efficient and things will improve.

It's great that she's a reasonably happy baby and having good sleeps overnight. Make that appointment for a review either with your gp or get a referral on to your specialist. Although some doctors like to say that babies get better once they go onto solids, this is often not the case so you want to improve how she tollerates her bottles before you consider solids.

Stay in touch. Consider joining up at RISA where you will have many mums in a similar situation who can share ideas and support with you. Details at www.reflux.org.au .

Julie for
RISA

[mumtolila]

Hi Julie,
I have booked an appointment to my g.p on monday and will be requesting a referral to a specialist/paedetrician.

This last week, my dd is having screaming episodes, not just crying but full blown screaming and i cannot do anything to settle her, she just have to cry it out. This to me is wind gone wrong.

She is making these weird sucking noises the last few weeks with her feeding. I haven't changed anything but i am thinking this is making her suck in air and then after a while we get these screaming episodes.

I have brought some infacol, is this okay to be using in conjunction with the zantac? I just think that now we have reflux with wind problems.

She still isn't drinking her bottles well at all, that is the main reason i am going back to my doctor.

Look forward to hearing from you:confused:

Thankyou for replying
Kelly:)

[RISA]

Hi Kelly

Great that you've got an appointment with your gp. Infacol is safe to use.

For the next couple of days I'd consider keeping that diary and making notes about when you've given any medicines, when you've fed & how much and then record sleep times and particularly unsettled times. I know it's hard, but it does help the doctors to see patterns. And it's so hard for us to remember each feed etc - we often just focus on the really bad unsettled times and can't be objective about everything else.

So, ask your doctor is Zantac the only option or can you try something else?

Also, is your gut feeling that she's reacting to her bottles (still isn't drinking a whole bottle coule be a sign). If so, ask doctor if there is another option to try for her formula.

Wind/colic can make reflux worse. Is Infacol what the doctor recommends?

I don't want to load you up with questions, but those are thing the doctor might be able to help you with, and really we can't advise you on those. As your doctor about the referral - should you go see a paediatrician or a paediatric gastroenterologist?

In most states there are 24hour child health nurse lines (in Brisbane we ring Riverton) so look up their number and if you've got a bad screaming episode it can help to ring them and they can talk you through it so you don't feel so alone and helpless.

I hope your weekend goes ok. Don't try and fit too much in during this unsettled period. It will just stress you out more and make your little one overtired which could make her symptoms worse. That said, do something nice and catch up with a supportive friend or head out to the park with a take-away coffee treat and have some chill out time with a magazine while your partner plays with your 4 year old.

All the best

Julie
for RISA