thoughts on reflux treatments

[@llli*mer.mer]

I just want to start by saying THANK YOU!!!! I'm a first time mom and have been having mild but distressing BFing issues since DS was born. Most in my family had ANY issues BFing. (Those that did stopped trying before a month was up and they are in-laws and we all know how well most people get along with their in-laws) So as much as they would like to help they can't. I found all the support I needed here searching through posts at all hours of the night and day.

My DS is 6 wks (age corrected 2 wks. I had PROM and was induced at 36wks. No NICU needed, the only issue was blood glucose levels due to my gestational diabetes. That was corrected with just a few ml of supplementing formula for a few feedings.) We started with a nipple shield but were able to stop that for a week now. We have been struggling with horrible nights not sleeping unless he was being held, waking suddenly screaming etc. Then in the morning things seemed to ease up. Since I'm trying to go back to work soon I started to worry about these awful nights. I've always thought he might have some acid reflux but was told babies are just fussy and would grow out of it soon etc. I'm a speech pathologist and reflux and swallowing problems are sorta my thing but since I'm a new parent and have no experience with babies, bought the advice till now. I'm 99% sure he has daily bouts of reflux but they are not every feeding. I talked to my pedi's nurse and she agreed it probably was reflux. She said to add organic brown rice cereal to thicken. The problems this presents is that I would have to start pumping exclusively and i trust the other mama's that this is not fun. OR make and appt and probably start zantac. We are really granola-ie and I have concerns about both approaches. Any thoughts or ideas on which one would be best?

BTW: we have done all the other stuff like positioning and changing my diet with no improvements.

[@llli*sixyearplan]

Yikes. No way I would give cereal to a tiny baby.

More likely than reflux for a lot of new babies is forceful letdown. Or baby just wanting to be near mama all the time. Is it just crying and wanting to be held that are the symptoms? Excessive spit up? If no spit up, is there gurgling and wheezing? That could be silent reflux or forceful letdown.

[@llli*lovemygirlso1]

Whoa ok first off do not do the cereal. This is an ancient way to treat it that does not work and often makes it worse. Trust me. I have a severe acid reflux baby. My honest opinion? If you hate the idea of meds then at least get the reflux test done where the baby drinks a dye and they can see if he actually has reflux. If he does then you start the meds. Without Zantac my DD A2 would be so miserable. We tried a whole combination of things including Omethprezol, one that I can't remember the name of but starts with M that can cause anxiety and depression which it did, zantac, and combinations of all of them. We finally settled on zantac. She still has it quite bad but the zantac helps. We are seeing a GI specialist as soon as we can (wait list). Anyway we were told NOT to do any cereal or any solids until we see him. So I wouldn't do the cereal if I were you. Have you tried a nap nanny? It's helped us quite a bit. GOod luck! Feel free to PM me.

[@llli*lllmeg]

She said to add organic brown rice cereal to thicken.

This is NOT good advice for reflux in general and is potentially really seriously detrimental, health wise, for a baby this young.

I understand you have concerns about going back to work and being a wreck, but really, this behavior could be normal or due to something besides reflux. Please, before you start eping, rule out other possibilities, like OALD as suggested above. You have an exceedingly young baby, age corrected or not, and this really could still be new baby fussiness. Very young babies DO like to be held most of the time, this is normal, and it can include nighttimes as well. Have you tried bedsharing? If you have not and it is an option for you, you may want to look into the tips to make it as safe as possible and try it, many moms find it a big help.

If, as above poster suggests, it is truly GERD, I truly think that a very strong argument could be made for the most natural/healthful option for your own and your child's ongoing health to be to continue to nurse at the breast and give an appropriate medication, than to start exclusive eping and exclusive bottle feeding. Nursing at the breast, besides being way easier than eping, promotes the normal development of the entire oral cavity and jaw region, nevermind the very basics of nursing being such a great way to very easily connect with and comfort a child, this last becomes more and more important in the next several months and/or after mom returns to work. Not only is eping a pain, it is much more difficult for a mom to keep her milk supply appropriate long-term when doing so, so many moms who stop nursing to ep find they have to start supplementing with formula ultimately. Surely, if you are granola-ie, the most granola-ie thing you can give your baby is your own delicious all-natural human milk from the source (when possible) and for as long as possible.

When are you going back to work? If you fear being too exhausted at that point, is there anyway your return to work can be delayed or eased into, such as with a pt schedule at first? No guarantees, of course, but sometimes just a couple or weeks make a huge difference in baby contentment in these early months.

[@llli*mer.mer]

He definitely has other symptoms, instant crying for no reason from a deep sleep, I can hear the reflux sometimes, wet and gurgled breathing, milk coming out is nose, some spit up not enough to worry about weight gain, arching his back with constant grunting and intermittent crying all day long, this gets worse at night when we lay him down, coughing, and gagging just short of vomiting. We are co-sleeping and he is with me unless I'm using the bathroom and does all this even if I've been holding him for hours. He has never refused the breast when offered, no clicking while nursing, I've never leaked once or had milk continue to flow after taking him off. I've also changed nursing habits to compensate for OALD just in case since yesterday and no changes as of yet.

[@llli*lllmeg]

Hey I think we posted at the same time! I wanted to add- have you followed the discusion here? http://forums.llli.org/showthread.ph...iet-Frustrated ? Some ideas for handling reflux sans meds.

[@llli*mer.mer]

When are you going back to work? If you fear being too exhausted at that point, is there anyway your return to work can be delayed or eased into, such as with a pt schedule at first? No guarantees, of course, but sometimes just a couple or weeks make a huge difference in baby contentment in these early months.

I arranged to go back to work at the beginning of April and DS will be 3 months (2mo age corrected) for just that reason to give him more time. Unfortunately that is the best I can do. Not only is my FMLA up then, my husband is self-employed and my job carries all the insurance and pays for both our income taxes. The other reason I'm worried about returning to work is I work an hour away with 11 hr days so I'm gone 13 hrs and am concerned about being behind the wheel that tired all the time.

What about gripe water?

[@llli*lovemygirlso1]

I have tried gripe water. It didn't work at all for A2. The stuff is so nasty that it was hard getting enough into her to help and even if we did it didn't seem to help much. Colic tablets didn't help at all either.

[@llli*lllmeg]

I arranged to go back to work at the beginning of April and DS will be 3 months (2mo age corrected) for just that reason to give him more time.

But that is ages from now. When you said soon, I thought you meant next week or something. I know it seems right around the corner but 6 weeks is a lot of time in the life of a newborn. Things may (again, no guarantees) be very different by then.
Personally I am not a big gripe water fan, it never did anything for my oldest who had pretty bad reflux issues (see story in other thread,) but, also I am a purist and really do not like to see young babies get anything besides breastmilk unless medically indicated. Others I am sure have different opinions on this.

Speaking of which, since your baby needed formula supplementation shortly after birth, this may be part of what is going on. I do not have time to delve into the precise research right now, I can try to later this weekend....but I am pretty sure that when formula or anything else is introduced into the gut in the early hours it can set baby up for some gut issues that may take some weeks to heal. This is not to say the supplementing was not necessary, sometimes it is. But it may still have caused sensitivities.

[@llli*mer.mer]

But that is ages from now. When you said soon, I thought you meant next week or something. I know it seems right around the corner but 6 weeks is a lot of time in the life of a newborn. Things may (again, no guarantees) be very different by then.
Personally I am not a big gripe water fan, it never did anything for my oldest who had pretty bad reflux issues (see story in other thread,) but, also I am a purist and really do not like to see young babies get anything besides breastmilk unless medically indicated. Others I am sure have different opinions on this.

Speaking of which, since your baby needed formula supplementation shortly after birth, this may be part of what is going on. I do not have time to delve into the precise research right now, I can try to later this weekend....but I am pretty sure that when formula or anything else is introduced into the gut in the early hours it can set baby up for some gut issues that may take some weeks to heal. This is not to say the supplementing was not necessary, sometimes it is. But it may still have caused sensitivities.

Yeah i didn't finish my thought I was meant to go back Feb 27th but spoke with my boss and pushed it back to April as of yesterday.

I wanted to be a purist too (our whole birth plan etc. went out the window with the PROM. So far nothing has happened the way we planned except for having a healthy baby ). But it was formula or NICU and IVs and no holding let alone skin to skin so formula seemed liked the best option. I remember reading about it causing GI issues but forgot about that till you mentioned it.