reflux and infant gaviscon questions

[SalTheGal]

Hi,

wow this motherhood stuff can be so confusing- and we are having a doozy with our first.

We have had a generally unsettled bub for most of the time.......he often appears uncomfortable- and we have been concerned about tummy pains and discomfort.

Not long ago I cut dairy out of my diet because many of his symptoms pointed towards milk protein allergy (deitary mods started 10days ago and we are just seeing some improvements in the 'bottom end' now).

Last week my GP also diagnosed him with reflux, and suggested Infant Gaviscon.

I have found your website very informative and have been following many of the tips listed, but still have some concerns.


Can you tell me a little more about the link between Milk protein allergy and reflux- if we get the allergy under control will that also control the reflux?
Can you also explain to me Sandifers syndrome?
The other symptoms which I think triggered the GP was a persistant cough, this worries me a little as it could be a sign of silent reflux? And I guess I a concerned about the extent of damage that could be occuring?
OK- now with the Infant gaviscon:

I am finding it a total pain to administer and was wondering if there is an easier option?

Following the directions means 15mls of liquid that we have to administer some how and my little one hates to take it and spits alot of it back out.


Can it be prepared in express milk?
DO you have to mix it with the full 15mls?
Can it be prepared ahead of time (ie, can I mix up a few lots at a time so it is ready to go at the end of the feed rather than having to prepare it whilst nursing a bub!)
Do you have to administer it every feed?
And the directions say to administer after the feed- yet DS has usually thrown up with his burps- so administering after the feed doesn't help this?
Can you suggest any other more cost effective options- giving two sachets of gaviscon every feed would mean a packet only lasts a few days, it is going to be expensive over a six month period!!!Thanks in advance for any advice you can give me........I am very grateful!:yes:

[RISA]

Hi Sal,
You’re right, dealing with reflux can be really tough, especially if this is your first experience of motherhood/parenthood. Even harder too because I’m sure you are getting the ‘Is this your first baby?’ question thrown at you!!! Really undermines your confidence, when you have enough to deal with already. Thank you for providing feedback on our website, by the way,and I’m really glad you found the information there helpful!!

You are doing a good job, so remind yourself you have good instincts, especially on those days that seem too hard. You have been to the doctor and confirmed the diagnosis of reflux as you suspected as well. Good on you, especially as he still sounds reasonably young.

Okay- there is a link between milk protein allergy/intolerance and reflux and from recent medical articles I have read, the figures are approx 40% of reflux infants suffer from cows milk protein intolerance. That means though, that there are approx 60% of reflux infants who don’t. From what I can gather, the best way of finding out if it is an issue is by eliminating dairy completely from the diet. If there is any noticeable improvement then it’s best to include dairy once again to determine if it was coincidence, and then remove it to see if the improvements can be replicated. Have you spoken with a dietitian since you have removed dairy from your own diet? It’s important that it is done with medical supervision as it is quite complicated to remove every trace, and also important to make appropriate substitutions.

If you get the allergy/intolerance under control will that control the reflux?.- if the reflux is caused by the allergy or intolerance then it should be, but that’s impossible to determine without a bit of trial and error. (sorry). Some families do get amazing relief from changing the diet, but while it may impact on other children, it may not be the only trigger and reflux may still be a factor.

Sandifer’s syndrome can present in a few different ways- but generally the child holds their head in an awkward position; either with the head bent right back, or to the side, or they may make repetitive movements with their head or shoulders. They can do it when eating, when sleeping, or at other times. I don’t know that the drs are sure about why, but it may be a way a child has learnt how to protect their airway from any reflux. It’s a position some learn instinctively.

Reflux can present in many different ways. The child can be a vomiter, but also have times when they reflux silently as well, so it can get pretty confusing and difficult to determine. Your GP sounds like he must be on the ball to have picked up on the possibility of reflux based on a cough, so well done to them. It is also really difficult/impossible to determine the degree of damage occurring, if there is any, but if you are concerned about the possibility, then it is really important you talk to your gp about it. Your instincts are good, so please don’t ignore your concerns. It may help to know though, that a cough is a common sign of reflux, and may not indicate that any damage is occurring at all.

With the Infant Gaviscon being such a pain to give- it is probably worth talking about that to the doctor as well, as they may be able to offer you an alternative. There is a range of reflux medications available, so if you are having difficulties, or not noticing any improvements, that can help, another one may be a better option. It is generally only used for short term relief, and if they find it needs to be given for a longer period of time, will generally offer one of the other medications like Zantac or Losec, which are designed to reduce the amount of acid in the stomach, and may only need to be administered one or two times a day. I would also let the doctor know that its expense is a factor for you, as I don’t think they consider that at times (in fact, I don’t think some are even aware of the cost).

Two sachets every feed sound like it is a lot to give a young baby, so I can imagine it is a terrible pain giving it to him, AND that he spits a lot of it out (all the more reason to talk to your doctor about it). It’s hard too, as you don’t want to associate feeds/spoons or syringes with a bad experience, so if he is really distressed by it, it might be another reason to ask for a different medication.

If you do continue to use it, I believe that it can be prepared in expressed milk, but it is best to check. It is meant to be administered soon after it has been prepared, so I think it is better to make it up as you need it rather than several feeds ahead of time. There is a medicine line you can call, which may be easier. (Ph 1300 888 763 Monday to Friday 9am to 6pm, and you can talk to a pharmacist and ask about all your medication concerns).

I hope that information helps, and if you have any other questions, please ask. Keep trusting your instincts,

Glenda

[SalTheGal]

Thankyou so much for such a prompt reply!

We have eliminated dairy from my diet for ten days now, and have just over the last few days seen huge improvements. I have been doing this under the guidance of a health professional- as you are right it is amazing how many foods have dairy hidden in them! The next step for us is to start re-introducing dairy to see what happens.

I am wondering if I should perhaps not be using reflux meds whilst trialling the dairy free diet so we can see which is producing the improvements?

Also, is sandifers syndrome a common occurance in reflux bubs? My little one always has his head leaning to one side, or arched back. We have been to a child chiropractor but I am wondering if the reflux is also contributing- if so are there any measures we can try to change his head position?

Thankyou for your advice re medication- I am going to head back to my GP armed with plenty of questions now, and will hopefully find an alternative that may be more suitable.

[RISA]

Hi
I happened to be online at the time :)

I’m really pleased to hear that you are being guided with your diet as it is such a minefield- not only to ensure you are truly eliminating dairy, but also to ensure your diet is balanced beside that.

I do understand your dilemma about using reflux meds at that same time as it can get really confusing. What do your instincts say about it? Do you think you would be better to wait and see if he continues to improve on the diet, and if it makes any changes when you do reintroduce dairy; or whether he is still uncomfortable enough that it isn’t fair to let him suffer? Perhaps it’s okay to do the medications now, but no point reintroducing dairy at the same time or you would have no idea what’s going on. It is confusing enough already, but the bottom line is, does he need something now, to help. Perhaps if he is, then it is more appropriate to get the reflux under control and then slowly try to work out what it was that helped??? Something to ponder, anyway.

Sandifers is not something that a lot of refluxers seem to have, but it is also not rare, if that makes sense (and I think probably underdiagnosed). In my experience, the only thing that controls the head position if it is Sandifer’s, is control of reflux. Once there is adequate control of the reflux, it should go away. Has the chiropractor made any difference? If your little one is trying to ease any discomfort, then I don’t know any manipulation would help.

Another note about that, if it IS Sandifers then it may be a consideration that he needs medication, as it may indicate he has a lot of discomfort- something to talk about with your doctor, no doubt.

I hope that helps further and wishing you the best with your doctor. It can make a huge difference when your doctor is supportive, so I hope you are able to get that from them.

Glenda

[SalTheGal]

Thanks very much for your advice.

I think it best to continue the treatment until the allergy problem is well under control- much more condusive to a happy bub!

You have also armed me with plenty of info/questions to head back to my GP with to discuss.

Thanks again!!:thumbsup: