Reflux and stools

[Tamaralee]

Hi,

I have a 10 week old breast-fed bub. She has had reflux since she was born however I was told that she would not require meds for it as she is gaining weight beautifully and she only has some unsettled periods with it (ie she isn't screaming 24/7 with it... anymore :)). She is regularly distressed by doing poos... sometimes to the point of screaming/squealing until she is done and she has constant nappy rash - I have tried letting her air her bum lots and all sorts of topical treatments but the rash is always there. My question is (finally!) can reflux affect stools? Could her nappy rash and pain doing poos be partly caused by acidity in the poo or is reflux only when it comes up her oesophegus? I would appreciate any tips/advice that anyone has.

Thanks,

Tamara

[RISA]

Hi Tamara,
I’m not sure that reflux is what could be causing her pain as she passes a bowel motion as you are right in thinking that reflux is when it goes back up into their oesophagus. I really think it is best you continue to pursue it with the doctors –whether it is reflux or not, it doesn’t sound right, and you are obviously concerned. Your instincts count for a lot too.

Sure, some kids with a lot of acid can have a type of ‘acid burn’ on their sore little bottoms, but I’m not sure about it hurting as she tries passing it. Does she perhaps start to squeal once she is passing it, once it hits her skin? If so, perhaps some kind of barrier cream would help. If it is hurting before she starts to pass any motion, I don’t know what it would be, and even more reason to pursue it with the doctors.

(A tip totally not reflux related, passed to me by my mother in law, is that Mylanta on baby’s acid burnt bottoms can help, same as Mylanta helps with acid the other end!!- just dab it on and let it dry, and that may help if it is acid-related. I don't know if that helps or not)

Sorry I can’t be of more help and I hope you get some answers

Glenda

[Tamaralee]

Thanks for the advice Glenda. It's really frustrating sometimes as everyone keeps telling me "most babies fuss when passing a stool", however they are not there when she is doing it! There's a bit difference between fussing and absolutely screaming and squealing to the point of tears. I will definitely give the Mylanta thing a go! I have been using it for when she gets reflux and can't resettle but I never thought to put it on her bottom! :-) The squealing is before and after so it might be a combo of things. I will chase up again with GP.

Thanks again

[RISA]

Hi Tamara,

I hope the Mylanta on her bottom helps. How often do you need to use it to help her resettle? Is she quite unsettled or distressed a lot of the time? I got the impression that her reflux wasn’t too much of a problem now, or did I get the wrong idea? One other thing, if her reflux is more of an issue, is that any straining as she is trying to pass a bowel motion, can cause her to reflux. The extra pressure in her tummy as she strains can make her reflux. Does that make sense as to why she starts to squeal or scream? If you can judge it, and notice it before she gets too distressed, I wonder if giving her a dose of Mylanta at that point in time would help? Have you tried that already?

If her reflux is more of an issue, despite the fact she is gaining weight just fine, she may still need medication for a while.

I’m glad you are going to chase it up with the GP. Something sure doesn’t sound right, and it is so important that you trust your instincts. Despite what people say and how they try to brush it off, you are obviously concerned about it, and your instincts are really important. Mothers will often pick up on things long before it’s recognised, so good on you for persevering with it. Maybe it is still the reflux, or maybe it’s something else- that’s one for the doctors to figure out, isn’t it. All you can do, as a mum, is to continue to chase it up if you’re not satisfied.

I hope you get some answers. By the way, what do the doctors say about the nappy rash? Have they taken a swab of it? Maybe that would give some answers too.

Glenda

[Tamaralee]

First of all thank you so much Glenda for being so informative and supportive!:hugs: It is so reassuring to have a health professional listen. Poor Olivia being my first baby, I feel like she is being treated like an experiment! I have gotten rid of the nappy rash with a Hydrozol (rash disappeared within 2 days!) and have been able to stop the constant (ie 15+ per day) painful poos by changing my breast feeding (I apparently had an oversupply and Olivia was getting lactose overload). However, the reflux/colic screaming still continues. I am still thinking reflux as she does seem to calm down if I give her 2 ml of Mylanta (but usually this will only calm her down for 5-10 mins and then she'll start screaming again until she falls asleep from exhaustion in my arms). Also she vomits a lot (sometimes straight after a feed, sometimes an hour after etc). She also sometimes squeals/whimpers while feeding and spends literally all her spare time shoving her fist in her mouth (although I had just thought she was excited about eating her hand until I read it was a symptom). Whenever she cries she chews on her fist/fingers to the point of making herself gag/choke. The confusing thing though is she is a brilliant night sleeper! (Not complaining about that one!:yelclap: ). She has been sleeping from 730pm til 6am for the last week without a feed (prior to this she would have one feed at about 2am). So all these symptoms occur during the day, getting progressively worse until her final feed at 6pm and I get her off to sleep at about 730. If all the other symptoms seem to fit, how is that she is doing so well at night? Sorry for all the questions, it's just so good to be able to talk to someone about this who has knowledge on the subject!

Tamara

[RISA]

Hi Tamara,
I am so glad that I have been able to help, and please don’t apologise for asking questions. This is your baby you’re worried about, and that’s what we do!! It breaks my heart though that you are still doing it so tough, and feel like nobody else is listening. It’s not right! It is great though that you have been able to work out some of the problems- hopefully that helps you be able to believe in yourself!!!

I know it can be confusing when your bub displays all the signs of reflux, but then sleeps really well, so then you start to wonder if that is possible. It may help to know that there are plenty of reflux bubs who do exactly the same thing. I don’t know whether it is because they are so unsettled during the day they drop from exhaustion at night, and sleep through; or whether perhaps they reflux more during the day. Being a good sleeper at night doesn’t mean they aren’t a refluxer.

It sounds like she is quite distressed from her reflux, so it may be necessary for her to go on medication, or for some other changes to be made. The fact that the Mylanta does help, even for a little while, shows that you are on the right track, surely. Even though some babies can gain weight beautifully (like my own son), this doesn’t mean their reflux is not a big issue, and they can still have pain and other complications from it. My son ended up needing to go on quite a lot of medication in an attempt to control his reflux, and weight was really not a relevant factor (he was a comfort eater and piled on the weight at times). They may have done things differently if his weight had been an issue, but he was still given medication in an attempt to control it.

I think the best advice I can give is to continue to follow it up while you have concerns. If you don’t think your doctor quite understands what is going on, then it can help to keep a diary of each day. Keep a record of when she feeds, sleeps, cries, is unsettled, vomits, refluxes, or anything. Sometimes that can help give them an idea of what life is really like. Even just let the dr see what you wrote to risa- about her day. That says an awful lot about how unsettled she is. Also, it can help if you take someone with you who can verify everything you say. For some reason, a mum is often seen to be overly emotional or exaggerating (especially a first time mum), but if someone- partner, family, friend can back you up it helps for you to be taken more seriously. (I don’t know why that works, but it often does) Please keep trusting your instincts and follow it up if you continue to have concerns.

Something that comes to mind from what you describe, is a dairy intolerance. Has anyone ever suggested that before? It may not be relevant to you, but there are a lot of reflux children who do have food intolerances, with cows milk being the most common. (but of course a lot of children don’t) It may be something to consider at some point, though you would definitely need to talk to your doctor if you ever wanted to follow that up.

I hope that helps, and please keep asking questions as you try to help your child!!

Glenda

[Tamaralee]

Hi Glenda,

After seeing my GP again we trialled Olivia on Infant Gaviscon - it was great for stopping the vomiting but a disaster to administer (trying to get a bub to take 30ml of water/gaviscon after a full feed is near impossible) so we gave up on it. HOWEVER, after reading your suggestion about dairy intolerance I looked up info on how to do an elimination diet and spoke with a naturopath. I've been dairy free for a week now and already we are noticing big differences. For one thing - she is actually doing proper poos now - no more diarrohea! Her refluxing also seems to be settling a little, but I'll give it a couple of weeks before I ask my GP for something other than Gaviscon. Is dairy intolerance hereditary? It makes sense to me as I can't tolerate a lot of fatty milk products like full cream milk, cheese etc and my sister was allergy tested a while back and is allergic to milk protein.

[RISA]

Hi Tamara,

Thankyou so much for your feedback, and I am so pleased that you may have found the answer you need to help your little girl, and that you are doing it with advice. It can be so difficult to properly eliminate dairy, and to substitute it to maintain adequate nutrition, and that’s really important, for both of you, so perhaps a dietitian can give you some ideas if you continue it.

Even if it doesn’t completely stop her refluxing, it can help her be more comfortable, so well done for following your instincts, and trying something that you felt was worth trying. I wonder if you also have a cow’s milk intolerance or allergy. Have you ever been tested yourself?

I don’t know if cows milk allergies are necessarily hereditary, but I think the tendency towards allergy is there. I would think it is a good idea to let your doctor know what you are doing, and how successful it has been for her. Is he aware of the family history?

Keep on doing what you’re doing, and thanks so much for letting me know. I really appreciate it.

Glenda