View Full Version : i think my baby has reflux
My daugter lily is 5 weeks old today. Up until 4 weeks she really was an angel baby. Then a week ago her feeds went haywire. All of a sudden she started screaming, pulling off the breast, scratching me and pushing away during feeds. i thought it may have been behavioural so i just keep forcing her to eat. I went to the GP a few days later who said it could be reflux or colic. But as she is putting on 390-500g a week she was relucant to do anything about it. After much begging she suggested i try .8ml of mylanta 5 - 10 mins into a feed.
Over the next few days i just thought i was doing it all wrong. i started to feel like lily hated me or didnt like the taste of my milk. She started getting more clingy and relucatant to be put down to sleep or have her nappy change. i pushed on with the routine because i was adament not to establish any negative sleep associations.
Yesterday when DH got home I said " i'm going and i dont know if i'm coming back!" i walked out to door and left him with the baby. to his credit he grabbed the pram and baby and chased me down. i was so fatigued from the terrible feeds and extended unsettled period after each feed and the vomit (down my back, in my ear or hair, she even got me in my mouth once (50 points)). I told my DH that i am thinking about weaning just so i can get some more sleep.
Then i found this section on bubhub and had a look at the risa website. reading what relux is just sounded exactly what lily was doing!!
Today i went to child health who watched us do a feed. the nurse said she definatlely looked reluxy. on her advice i will go to see the paeditrican on monday.
the nurse was negative about the use of mylanta. what should i do? i am not sure if it is working.
I would also like to know what are the other medications that are tried and in what order/dose are they usually tried.
as far as developing negative associations i decided to let lily take the lead - the worst association i can think of is eating = pain. or mummy breast = pain.
I am working through the emotions that come with the idea of relux - poor child, poor me.
As usual when I hear stories like yours, my heart breaks!! Reflux can be such a cruel condition and it is really common for the parents, ESPECIALLY the mums, to go on an emotional rollercoaster ride. I can remember feeling such a failure, and soooo inadequate. I felt like I was doing nothing right, and everywhere I looked around me, I felt like everyone else could do it no problems. That of course made me feel even worse.
What makes it even harder, is that not many people actually understand reflux, and how overwhelming it can be- so you arenít likely to be getting much support or understanding from any family or friends. That can be further demoralising, because then we think we should be able to cope, and we start to wonder if we are exaggerating, or we just simply canít cope, when everyone else can. The reality is though, that reflux can be devastating, and many families struggle to cope- especially in the initial stages.
It is really important for you to know that this isnít your fault, and you arenít doing anything wrong!! Every child with reflux is different, and what works for one may not work for another, so to make it even harder, nobody can tell you exactly the right thing that will help most. It is all trial and error and trying to take it a day at a time. If things arenít going so well at the moment, it just means you havenít found what the right answer is for her yet, not that you are doing it wrong! (hope that makes sense)
Good on the GP for diagnosing reflux, though it makes me cringe that treatment isnít offered simply because her weight gains are good (once again quite common). I think a lot of doctors are taught that reflux is only an issue if there are weight issues/failure to thrive, but some reflux babies can be quite distressed (like your child sounds), yet still they manage to put heaps of weight on.
I think you are doing the right thing, by the way, with regards to letting Lily take the lead with feeds. Some bubs do associate feeding with pain (or nausea) and some will refuse feeds. Continuing to force the issue is more likely to create that association. Also, I have reflux myself, and I learnt why some bubs refuse to feed- it makes them feel worse if they do. As an adult, I know I have to eat, yet when my reflux was flaring so badly, if I forced it, I always wished I hadnít, and I finally understood why a baby would refuse. They donít know they HAVE to eat, so why would they do something that made them feel so awful. I knew and I still couldnít force myself (I lost heaps of weight at the time too).
So, you are doing something that I would have recommended, and that is trusting your instincts. I know it can be hard to do that sometimes, especially as we start to lose confidence in our parenting abilities (or lack of). Itís good that you were able to look past that and still do what felt right.
As to medications, there are a few that can be used- Mylanta, if it does help, generally only works for a short time frame, so if it is needed more than occasionally, other medications are usually prescribed. (It never helped my son either when he was a baby, though for some reason it did later on).
One of the medications commonly used is Zantac. It is a syrup and has a really strong flavour. It is weight related, meaning that as a bub puts on weight, the dose of Zantac needs to be increased to keep up with the dose/kg ratio. It can work really well for some children, but not for others.
Other more effective medications are the class of Proton Pump Inhibitors. Losec (Omeprazole) is most commonly used in this class, and is much more effective than Zantac. It isnít easy to administer as it is either a capsule format that needs to be partly dissolved and then either spooned or syringed in. Occasionally it is made into a suspension by a compounding pharmacy, but the bottle only lasts 2 weeks maximum, so another hassle for the parent. All up though, the hassle can be worth it as it can make a big difference.
It really depends on the doctors experience and personal preference if he chooses medication, and if so, what he does, and what dose. There is a big range of what doctors will prescribe. Some doctors will prescribe Losec first, while others prefer to see if Zantac works.
Another option that they may consider, is a trial of removing dairy from her diet (and since you are breastfeeding, it means removing dairy from your diet too). Not all bubs are dairy sensitive, but a large percentage seem to be. That just may be something theyíll look at.
Please donít be too hard on yourself. As I said, reflux can be quite devastating, and parents often donít get a lot of support- perhaps because reflux is so common it is virtually ignored, but there is such a wide range of severity that people generally donít understand. It is okay for you to feel sorry for yourself, and for you to feel all those other emotions (there is guilt, grief, resentment, anger, jealousy as well as all the positive emotions). Donít feel as though you donít have a right to all of those emotions, because you do.
We are happy to offer support if you need more than just letters- you can either private message me your phone number, or email it to our addy at info @ reflux.org.au (no spaces) so we can call. As you may have seen from our website too, we offer members further support with online parent groups, regular newsletters, printed literature and depending on where you live, coffee mornings etc.
We are all reflux parents ourselves- we have been there, done that, and know how bad it can get- which means of course we know how much support families may need, and are happy to help in any way we can! You just have to let us know!
Hope that helps in some way. I did want to mention too, that even though it presents like reflux, there is always the chance it isn't. conditions like urinary tract infections can actually present in a similar fashion, but i presume the doctor considered all that when you saw him/her last week. I only mention that because you titled your letter 'I think my baby has reflux'. If you aren't totally satisfied it is reflux, then follow those instincts once again and ask for verification from the doctor
Sorry so long,
thanks for your reply.
At the moment the days seem long and the nights seem even longer. Lily is sleeping for periods of 1.5 hours during the day/night but rarley any longer. Is there a reflux reason eg. tummy empty leads to reflux? the other confusing issue is at her age she could be going through a growth spurt.
I read somewhere not to feed a reflux baby more than every 3 hours. WHy? if she wants it why deprive her. she often cluster feeds in the evening every 2 hours. yesterday i tried to extend her feeds a little longer than 2 hourly and she cried for 3 hours straight - finally fell asleep at the next feed as soon as her tummy was full!! :banghead:
Any advice on when to best try the bath? i have tried before, during and after a feed. she enjoys it at the time but if i do it before she is too upset to eat properly. and if i do it during or after she :barf: .
I feel like those around me do not understand what is going on. my mother although generally supportive keeps jumping to conclusions - it is what you ate for dinner last night; she is eating too much; she is not awake for long enough etc. it really annoys me.
I am second guessing my resolve that it is reflux. Maybe i just cant cope with having a baby.
It may help you to know that all those doubts and confusion are really normal for reflux parents, especially mums. Those kinds of questions, like maybe I just cope with having a baby; maybe it is just me; maybe Iím just exaggerating; maybe this IS normal and I just cant cope; etc etc- is very typically going around in many heads when it comes to reflux. They are all so different, but have so many striking similarities, and that rollercoaster ride is very normal.
It is also very normal for family and friends to NOT understand either, which not only makes you feel very alone, it can make you feel even more of a failure. Often with the advice people give, the message we receive is that we are doing something wrong, or there is something wrong with us. I know my own mum used to tell me such wonderful things like- there is something wrong with your milk, itís too weak, you donít have enough, it has to be something you are doing wrong because she cries every time you feed her etc. and of course we start to buy into it when we hear that so much!! I know that probably doesnít help knowing what your mum is doing is quite common- after all, you still have to deal with it all- but maybe knowing that others go through the same kind of thing, may make it a little easier to cope with. It sounds like your mum is trying to be helpful, even if she is going around it the wrong way. Have you tried talking to her about it? Perhaps you could let her know that it feeds into your self doubts at the moment??? Itís not an easy one to deal with, thatís for sure. I know my own mum would have been offended, but I perhaps should have also let her know how it made me feel when she offered her Ďadviceí. If I had let her know that I would have preferred her to say something like- ĎI can see there is a problem with her feeds. It must be very difficult for you when she cries like thatí. What a difference that would have made to how I felt and also to how I coped!!!! A bit of validation goes a long way.
I think, often when they donít sleep particularly long, it is due to discomfort, and perhaps sometimes due to them being so overtired they get quite wound up, which can make it even worse. It might make more sense if you realise that about an hour after a feed is the time that they are generally refluxing most- its when the acid levels are the highest and its when the stomach is trying to digest the feed most actively. Itís possible she is being disturbed by that, and hence she wakes up.
That is also the reason why they say to try not to feed them more often than 3 hrs. They need to have a chance to empty their stomach because if you feed them more often than that, itís likely their stomach hasnít completely emptied. That means if you feed them on top of that, they are more likely to reflux (a full tummy can make them reflux), and it can actually set up a cycle of reflux happening/ demand more feeds/ more reflux.
Because it is happening in the evening, there may be a couple of possibilities. One of them, I wonder, is if perhaps your milk supply has dropped by the evening due to being tired and stressed. Another may be she is uncomfortable and has worked out that a feed is soothing, and demands something to make her feel more comfortable (they often will use a feed as an antacid and ask for a feed for that reason, not hunger) It can be so hard to work out and also to stop that cycle. I donít know if I explained that terribly well, but I hope you get the idea at least.
It does sound possible too, because she did get so upset at having to wait, that it may be discomfort that is driving it. What do you think? Do you think that sounds likely, or not? It is really important that you use your instincts to guide you, and that you trust them. They have served you well so far, even though you are doubting yourself at the moment.
Lots of people can offer advice (as you already know), and that can be really confusing too, but you do still need to do what works in your own situation. Although it is recommended that reflux babies be fed smaller amounts more often, some will actually do better on larger amounts less often. They are all so different, so sometimes if you find a suggestion doesnít help, try the opposite if you are happy to try it. You just never know.
I am glad you are seeing the paed, as it does sound like reflux can be causing her a lot of discomfort. The fact that her baths are difficult too fits in with that picture as well. That can also be a tough one, though there are a few things I can think of- just depends on whether they suit you or not. Youíve obviously tried changing the timing of the bath, to no avail. Is there a time that you could choose midway between feeds? Or is she too upset even then? Or is that the only time she is actually asleep?
If so, you may either need to get really creative, or perhaps just sponge bath her for a bit. It may not make a huge difference if she doesnít have a bath everyday, even though it is so hot. (that reminds me, hot weather can flare reflux, so depending on what the weather is like for you at the moment, you may find that impacts on her and makes things worse)
Would you be able to get into the bath with her (with your partner nearby), and feed her in the bath? Kind of combine the two? Keep her upright following the feed, but delay dressing her until a little later on?
Or bath her first, then dry and wrap her in a cotton sheet and feed her without trying to dress her? Could it b the getting dressed part that distresses her (as she is probably laying down for that?)
Would a shower with you or your partner be more effective, which would also keep her upright- maybe she would be more comfortable like that too.
I donít know if any of those ideas are suitable to try, but it may have given you some ideas of your own too. As with all advice, its often best to listen, but if you donít feel comfortable with it, or it doesnít feel right for you, it is fine to say thanks, but no thanks. Sometimes ideas may be worth a try, while other times, they arenít, and that is where your instincts come in too.
Once again, I donít know if that helps, but I hope it gives you some ideas. What you are going through is certainly very common, and it sounds like it may help for you to be in touch with other reflux families to see that. Please let us know if there is anything else we can do to help, and please remind yourself you arenít doing anything wrong.
Went to the dr yesterday and diagnosised lily with reflux.
bit shattered as i was in denial.
prescribed losec 10 mg. got in made into a suspension from a compounding pharmacy.
other things i am to do :
1. never wake her to feed
2. never feed more frequently than 3hrly.
3. always feed from one breast only
4. always give as much milk as she will take.
all of this should build up my supplies of fatty hind milk and have less of the foremilk which can increase the burn in the oesphagous and on her bum (which has a terrible unfixable rash).
in the meantime things are very difficult as i deal not only with the relfux but with a cranky baby used to demand feeding.(and both boobies used to being emptied 2-3hrly).
is it ok to keep using the mylanta and the losec? the mylanta does seem to help her.
is their a support group or mothers group that meets in brisbane. some people who have been through similar experiences might help.
does the medication mean the bub feels 100% better? does this ever happen?
at what age do the reflux symptoms peak?
how will i cope with this feeding regime if she goes through a growth spurt and gets really, really hungry?
I am sorry that you are shattered about the reality of the reflux- I can totally understand that. You have every right to go through a grieving process as your bub isnít the happy, healthy bub you would have dreamed of. It is okay to be shattered, as it truly isnít what we want for our babies, so take some time to come to terms with it all. On the other hand, at least you know what you are dealing with, and you have a direction to head in now. Once the reality of it all sinks in, perhaps that will help a little?
It sounds like you got some really good advice re feeding. I know it probably seems impossible right now, but hopefully you will see an improvement fairly quickly, and hopefully those boobies will adjust fairly quickly too.
As she starts to get more hindmilk, you may find, because it will leave her feeling more full for much longer, she may not be asking for feeds so often (in addition to the Losec which can control the pain she may be feeling, which is why she is asking for frequent feeds). Just so you are aware, Losec in suspension form has quite a short shelf life. Did the pharmacy warn you about that? Did they say anything at all about that?
It should be fine to keep using the Mylanta, especially in the early stages, but you should discuss that with your dr- just to check as sometimes they prefer you not to. Are you able to give them a call? Mylanta has to be given away from other medications as it can make them less effective (an hour before or after giving them). If he thought the rash on her bottom was due to the high lactose levels and acid, then you may find that Mylanta patted onto her bottom is really soothing. It is an antacid and can be great for that too (a tip taught to my by my MIL)!!
Itís hard to say when reflux will peak, but often it is around the 4 month mark. Because you have done so well and gotten her diagnosed, and on treatment, you may find by then things will be under control all the same. Hopefully the worst it will be is right now, and things will only get better from here. As much as you want to deny it, and wish it away (trust me, we have all done that), you have still faced up to it and gotten help for her, so good on you for doing that. When things may seem a bit overwhelming, it might help for you to consider that, and give yourself a pat on the back for it.
Some babies go onto Losec and it works a small miracle. Some bubs seem to do incredibly well very early on. Others it can be not so great for, and I donít think its possible to predict, sorry. Unfortunately with reflux babies, they are all different, and what works for one may not work for another. You have the diagnosis, but it may take a little while before you find the treatment that best works for her. Losec is often very effective, but you may need to try a few different doses before you find something that works well; or you may need to try something else. There may be a combination of medications that seem to work better; or its possible it is food sensitivities and restricting diet will be better. It is so hard to know, and it does come back to a lot of trial and error, and listening to your instincts.
If she goes through a growth spurt, your body will adjust and make more milk. You may need to watch feeds much more strictly than if she didnít have reflux, but if you do feed too often, that can encourage more reflux as her tummy is full more often. This is a time when you do need to listen to your instincts though, and if you think things arenít working, let your doctor know. If at any time you have concerns, please donít hesitate to contact the dr, as it can take some time to sort it all out. He/she would expect that, and they do sound like they have some experience with reflux, and breastfeeding, which is great.
As for the support group in Brisbane, yes, that would be us . Our group is Brisbane based, and we have a lot of members in Brissie. We do have coffee mornings occasionally for both members and non members, but Iím not sure if there are any scheduled just yet. We do have informal get togethers that happen a fair bit with our members, who often arrange them amongst themselves, so if you are interested in joining, that can be a great option too. We also have an online parents group which seems to work really well and regular newsletters etc.
The meetings do happen elsewhere in Australia too, of course.
If you are interested in joining, you just need to go to our website and go to the member application section. I can also give you some more information if you want it. Membership is totally up to each person, but just being able to talk to other families either in person, on the phone, or online, can be extremely helpful and we welcome any reflux families. I may be a bit biased (just a little lol), but I think itís a fantastic support group, and it helps just to know you arenít alone. It isnít unusual to not get support anywhere else, and itís often so important in helping us cope!!!!
PS sorry it got so long
Lily has been on the losec for nearly two weeks now and i have noticed some improvement. She is able to eat for longer now before she pulls off and cries. when she is crying once she has a burp and vomit she seems to settle down a little bit too.
The routine has worked well. we saw improements within 3 days. the milk supply has adjusted now and the main problem is feeling lop sided. She has even dropped a night feed. There are two times a day when she dosent want to wait 3 hours. the first one is after the early morning feed - she is always up and ready 2 to 2.5 hours later. i can hold her off with a walk or a drive in the car. The other time is in the evening when she can scream from one feed till the next (sometimes for 2 - 5hours). when she is next fed she is happy and goes to sleep for up to 4 hours. i must admit i have caved and fed her after 2 hours at this time. i have done this as i feel it is more due to a growth spurt and my milk being lower in the evening than the reflux. what do you think?
I have been started trying karicare thickened formula at these two unsettled periods in the home to fill up her tummy a bit more. have you tried using and if so when/how.
The reason i have tried the thickener is i have been at my wits end with the constant batttle after eating and i thought i would try it. i must admit that i have been thinking of stopping breast feeding just so i can have a rest.
i had a day stay at child health who wernt that helpful as lily acted perfectly when she was there. they said that as my milk supply is fast she is a gulper which can cause the reflux. this means that as she gets bigger she will grow into the milk flow and cope better. she also siad that all my children will have reflux. this was very upsetting.
i am starting to accept that there is not going to be a quick fix to this problem. it is going to take a lot of time and energy.
Iím glad that things sound like they are improving, but I know where you are coming from about it taking a lot of time and energy. It is really hard to accept that there is Ďno quick fixí, especially given the lack of support or understanding within the community. Reflux can be so stressful, but unless youíve been there, you just donít seem to grasp it, which makes it extremely hard for the family to accept it will take time!
I agree that its possible your supply may be lower in the evening, and it does sound like she may be hungry. If giving it to her at that time helps, and doesnít seem to cause any problems, then my opinion is go for it. My philosophy with reflux is Ďdo what worksí, so long as you are comfortable with it. Sometimes refluxers do the opposite of what generally works, so if that isnít causing problems, I donít see what the harm. If she was doing it all day long, then I would think perhaps it was reflux related, or a supply problem, but itís obviously not.
I actually started using thickened formula after a breastfeed- I would only give my son about a spoonful of it (that seemed easier to me than thickening my breastmilk at the time)- and that did seem to help (though I must admit more with his reflux than with stretching feeds). If you wanted to give it a try, then do so. If it works, thatís great, but if not at least you know youíve tried it.
Given that you have a fast milk supply, did the nurse give you ideas on how best to control that? Iím definitely not a breastfeeding expert, but perhaps expressing 20 or 30ml off first will stop that gulping at letdown, and also feeding her so she is feeding uphill may also help. Have you contacted ABA or a lactation consultant at all? We have a mum who is training to be an ABA counselor, so if you would like to talk to her, I can put her in touch with you? (if you wanted me to do that, could you email us at info @ reflux.org.au (no spaces) so we can privately email?
I donít know how anyone can say that all your children will have reflux, for sure. While your chances may be higher, I donít think itís a guaranteed thing. We have had families whose first child has reflux, or even the first few, and then the next one is perfectly reflux free, and they eat and sleep and are content like they say babies are like. If you think of it this way though- if you do happen to have another child, and they have reflux, you wonít ever be in the same position again. You have learnt a lot this time round, you have more of an idea of reflux, and have some supports in place- your doctor, RISA, and hopefully friends. Ė and given that your first child has reflux, itís often easier and quicker to diagnose, which means easier to get under control (generally).
I hope that helps, but please remember you aer doing a really good job, and if you start to feel a bit overwhelmed with it all, try to focus on all the things that are going well, and that you have done right. You are in a much better position than even a few weeks ago, so will itís easy to get caught up with whats still not going well, it can help if you look beyond that- and take it one day at a time cos it will get better at some point,
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