Considering weaning a reflux baby

[katieimpala]

Hi,

My son is 14 weeks old and 4 weeks ago was diagnosed as having reflux, and was given zantac by the GP. He has always been a chucky baby but only in the last 4 weeks has he started to scream during and after a feed. When he vomits he projectiles alot of his feed.

He breastfeeds so much that i am literally drained after a feed. And he normally feeds every 2 hours.

Up until 6 weeks ago he would only cat nap during the day (1/2 hour) and would go down at 10am and then wake at 4.30am and then 6am. Now he wakes at 12.30pm (i just re settle) then at 2am for a feed and then 3am and 6am for feeds.

Last week i was quite sick and had to have surgery on friday and he had to go cold turkey onto formula and i seem to have less milk supply.

This week he has been really fussy at the breast as it seems i can not satisfy him, when i finish a feed i literally have nothing so i have had to start giving some formula.

I am using Heinz Nurture Gold, he drinks the bottle and likes it but he seems to throw up so much more after a feed.

I think next week i may start weaning and was wondering if i should try an AR Formula or a thickener, so you think this will help him sleep longer and be more settled.

Thanks for your help.
KATIE

[RISA]

Hi Katie,
Gosh, it sounds like you have had a really hard time of it, and I am sure you must be exhausted. I hope you are managing to feel a bit better after your surgery last week, but it must be hard to recover with no sleep happening!!

I guess the first thing you need to determine, is do you want to give up breastfeeding, or are you considering it because it seems like you have no real choice at the moment? We would fully support whatever decision you make, but just so that you are aware, breastfeeding is still the recommended option for a reflux baby. Also, while thickened formula can help some reflux babies, it isn't the answer for others.

If you would like some support or some ideas on how to continue breastfeeding (it is possible to re-establish your supply), we can put you in touch with one of our mums who may be able to help- just let us know and we can try to organise that.

Okay- other than all that, as I said, we are happy to support you no matter which method of feeding you choose, or whether you choose to combine them.

It sounds like his reflux may not be well controlled. Have you spoken to the doctors about what is going on? They may need to consider increasing the dose of Zantac, or even switch to a different medication. Zantac is a weight related medication, and as bub puts on weight, it often needs to be increased, and on top of that, they often start with a low dose and build it up, to make sure they are giving them the lowest most effective dose. Sometimes it can take some working out to determine what is the most effective.

With his feeding, it sounds as though he is comfort feeding, which is quite common with reflux babies, but of course, at the moment, he may just be trying to build up your milk supply. With refluxers, they generally aren't driven by hunger, but by the need to alleviate their discomfort. It sounds like he was doing the same thing before your surgery though, so I am thinking along the lines of that it is still reflux related, but perhaps talking to a lactation consultant or osmeone from ABA might be able to help if you want to breastfeed.

What is his weight like? That might be a clue, and might help you figure out what's going on. Comfort feeders often put weight on really well, and some can put on heaps of weight!!!

Dealing with reflux is often a matter of trial and error, and it's even more difficult, because most people don't seem to understand what you are going through. They see a happy, healthy baby, and don't realise it is because you spend so much of your time making sure they are happy and healthy.

Some reflux babies have intolerances or allergies to certain foods, with cows milk protein (and soy) being the most common. It may be worth discussing that with the doctor too- if you are bottle feeding, then it may be worth trying an elemental formula such as Elecare or NEocate, and if you are breastfeeding, it may be worth avoiding foods with cows milk or soy. (if you need to do that for any length of time, it is important you seek medical guidance to ensure your diet is balanced).

If you do want to try thickened feeds, there
are lots of different ways you can try it. You can either use a commercially prethickened formula, thicken a feed yourself, or give him a feed and then offer him a spoonful of thickened milk afterwards. As I said before, thickened feeds can work really well for some reflux bubs, and that may be all the treatment they need. They generally work well for bubs who vomit, but it doesn't help with their reflux, if that makes sense. It might just reduce their vomiting, but they can still reflux.

For other bubs, it isn't the answer, as sometimes i think that the thickened milk gets refluxed, and it can be harder for them to clear from their oesophagus. There is no real way of knowing though, so if you want to try it, it may be worth giving it a go.

I wish I could tell you exactly what would be the best thing to try, but they are all different, and what works for one may not work for another. I know it's really hard, but it will get better.

I know that I haven't said much to be helpful, but I still hope there is something in there that does help.

Glenda