9 Week Old and Reflux

[@llli*rhaewynsmom]

I'm a first-time mom and I found out my DD has horrible reflux. I have had nothing but a hard time trying to breastfeed her since she was born. She even lost a lot of weight and had to be put on formula. She was gaining good, but still vomiting a lot and then would have such bad episodes that she wouldn't nurse or take a bottle, lose weight, then eat okay again.

It was only after she was put onto medication for the reflux that she started latching more than a few minutes at a time--this is ranitadine 5mg=1ml. The dosage of 1ml was increased to 1.25 recently. While we saw a difference at first, it just goes back to her vomiting like crazy. We even noted she has an issue with soy (WIC thought it was a milk allergy but it was the soy). She had a speckled-like rash all over her body from when she had it. She also gets it if I have more than a glass of soy and breastfeed her (very small amounts seem to be tolerated better). Right now she is on Elecare which is hypoallergenic, but still contains soy oil). My supply was going up and I thought I was doing good because she was latching for a good 5 minutes, then 10, then 20, and so on. My breasts felt really soft after she would eat and I was gradually able to decrease the amount of formula she was having during the day.

Then she started the vomiting fits all over again and getting frantic even with a bottle--worse than what I would consider to be normal. My supply dropped again and I don't think she was fully able to empty my breast because before the vomiting increased again, she was falling asleep, then would wake up 20 minutes later, go back on, suck a few times, and fall asleep again. This repeated for about 2 days before the vomiting was really bad. (i've maintained a pretty consistent diet)

My doctor says some babies just vomit a lot, but hers can be really forceful and at times she is in a lot of pain. I'm definitely worried about doing more harm than good with the medication, but it does seem to ease things up when the medication was increased, but now we're back to square one again. Pyloric stenosis does run on my fiance's side of the family, his mother had it, his brother, his sister, but him and his other brother were the only ones who did not get it. Since her weight is ahead of the game right now 44th percentile, they don't want to look unto it until they notice a significant and consistent weight-loss. I do understand the whole not fixing what isn't broken idea.

Sometimes I just feel like I'm going crazy and this is all normal, but it doesn't feel right. I just feel like something is wrong and it is so frustrating to not know what it is or how to help her. I actually thought her excessive vomiting was normal at first until the doctor said it wasn't with the amount of crying she does. I keep following the advice from the lactation specialist, but now I am wondering if I should just pump rather than worrying about her latching for right now? I am hoping we will find something that works for her tummy so she is not throwing up so much. She spits up too after each interval of feeding, but will outright vomit (it's forceful and comes out her nose) even up to an hour after a feeding. Usually the spit-up and vomit has a mucousy texture and is thick and white, although at times it looks a bit off-white maybe yellow-ish (not so much that you would notice it right away).

She handles the breast milk a bit better, but I am not making enough. I started supplements of fenugreek and alfalfa. I also bought milk thistle because I heard it also has lactation properties, because I cannot find blessed thistle in any of my local stores. I am just unsure of how much alfalfa and milk thistle to take so I am just taking the regular dosage listed on the bottle. The lactation consultant said she wasn't sure about the dosages for those and is use to just using fenugreek or prescription medication. Today I started noticing a big improvement!

Does it sound like I am on the right path? This has just been so overwhelming and frustrating to deal with. I hope things get better once we take care of her tummy troubles. I certainly wasn't expecting things to be easy, but this has been so hard and I've even cried over spilled breast milk. I knocked over the freshly pumped bottles a few times due to exhaustion. I am definitely looking for any advice and support at this point.

[@llli*krasota]

Have you given up soy in your diet? If she's that sensitive, you might need to be soy-free yourself. I have a soy-allergy and react (via contact) to Elecare. It's the formula in the US with the least amount of soybean oil, but it's still in there.

What about dairy? Could it be a combined milk-soy protein intolerance? My daughter's reflux improved dramatically after I gave up dairy. I'm already soy-free, of course. We were able to stop giving the reflux meds.

Oh, and alfalfa is a legume. I'm fine with it, but it's in the same botanical family as soy. Fenugreek is also a legume. You might just keep an eye on things.

Good luck!

[@llli*sch.mommy]

oh mama that sounds very overwhelming, but it definitely sounds like you're on the right path!

My son had reflux and we found that in addition to the ranitadine (which we were giving 4 times a day at smaller doses), keeping him upright for at least 20 minutes after nursing helped a lot. We also nursed in a more upright position, and I tried to feed him for less time per session but more frequently (so that there was less in his belly). I also struggled with over active letdown and a pretty forceful flow which wasn't helping.

I don't have my links bookmarked on this computer, but there are some great resources at kellymom.com under reflux (or maybe it's listed under GERD) that will give you lots of tips to try.

As for your supply, nurse as often as you can. The best way to make more milk is to nurse more. In addition to the supplements you are taking, a lot of mothers find that nursing first and pumping after each session (topping up with formula if necessary) yields good results. Sometimes we are given the advice to feed a bottle and pump to cover the missed session, but your milk will increase faster if your baby is stimulating your breast as often as possible (much more effective than a pump). So, I would try to nurse every 2 hours or so.

Hang in there mama, you are doing great!

[@llli*rhaewynsmom]

Thank you for your replies. I did not know they were similar to soy and now I am wondering if that could be part of the problem. I try to avoid processed foods, but I do try to keep some tv dinners on hand when I am desperate. I usually have a homemade breakfast sandwich which homemade crescent rolls--no soy. Peanut butter with whole grain bread is a snack and sometimes lunch, but the bread does contain soy oil. Been looking for a brand that doesn't and I haven't found one yet in our grocery store. It seems like such a commodity just like corn is! I have an issue with soy myself, but I am fine with non-GMO soy. I am borrowing a bread machine as of tomorrow, so I can make my own bread.

I am hoping to use the supplements to get my supply up where it needs to be and hopefully be able to stop taking them. 3 glasses of soy a day seems to be where she has a noticeable issue. If I have just one glass, the vomiting is less and she doesn't get a rash. I've been staying away from soy in concentrated forms recently. Now it's only small amounts in processed foods which are just easier to make when she is having a rough day with fussiness. I have not noticed an issue with dairy. She spits up, but it is not the forceful vomiting with that. In fact, she seems to tolerate it better than the soy.

My fiance has been an awesome help, but his grandfather passed away last week and he has just been in a funk--which I completely understand. I am trying to relieve some of his stress so he can get through his grieving process. My mother has no problem watching her so I can get rest. She is really the only one who has offered us help and actually follows through. Everyone else offers and when we ask, we just don't get it. It would have been so nice to have some meals prepared... Usually the family will say they will do it, then they forget or they don't have the time--lots of excuses.

Yes, I did read some links at kellymom.com about reflux. I have been having her sit upright on my lap to nurse which seemed to help some. She certainly fights way more if she is laying belly to belly on her side--especially if she feeds on my left breast where her stomach is up higher. We have been keeping her upright for at least 20 minutes since 4 weeks of age.

I was actually using a hand pump for the first month until I got the electric, so that was just maintaining my low supply at the time and not doing much for the increase (I have tendonitis from using it so much, lol) She started to latch around 3 weeks, so I decreased the pumping sessions as she stayed on longer. I thought I wouldn't need to pump eventually because I was just going to BF on demand. At least, that was my intent. I really do wish there was something that would magically erase the reflux and get her back on the breast.

Thank you guys so much for being supportive and offering advise. It really means a lot!

[@llli*lllmeg]

Wow how stressful! It certainly is true that many babies spit up a lot, and it can look quite forceful and still be normal. But it is very unusual for it to be to the point that weight gain is adversely affected. In fact many babies spit up a lot due to over production/forceful letdown and these babies normally gain on the fast side.

I assume you have tried upping the frequency of feedings? (The idea being, smaller, more frequent feedings are easier to handle.)

The book Making More Milk has lots of good info for increasing milk production. I am not positive it has exact doses of herbs (my copy is lost) but as I recall it does discuss many galactagogue herbs in detail. Kellymom does as well I think but you have probably seen her stuff-

If dairy is a problem, as well as soy, maybe it does not manifest as vomiting. Just a thought, trust me I hate to see moms eliminate food from their diets unnecessarily. This article may be helpful: http://www.bfmed.org/Media/Files/Pro...ish_120211.pdf


IS WIC providing you with lactation services? a professional IBCLC may have resources like books, chatlists etc, to find more specific info for you.

[@llli*rhaewynsmom]

she actually wanted my breast Saturday! Normally I try to gradually transition once she has had her bad food avoidance episodes. This time she has been much better! She will take it with the nipple shield first very easily and then half-way through the feeding, I can take it off. She isn't draining my breasts though, but she is definitely getting back on! I am so excited about this!

I go to both WIC and a lactation consultant at my hospital. The consultant acts like I'm not trying hard enough at times or as though she has better things to do, and WIC has been much more encouraging with the BFing, although they seem to be really off with the perceptions of allergies and such. I just opened the article so I will take a look and I will look into getting that book asap.

I realized something when I did call the lactation consultant. She said that having your period can cause your milk supply to drop and it should climb back up when it's done. I had mirena put in at my 6 week appointment and I ended up having very heavy bleeding on it which started 5 days after it was inserted. The past two days it has finally slowed down and I started noticing my supply picking back up. I'm not sure if this caused part of the issue. I didn't think I would have a period considering the pumping and nursing I have been doing. I think the fenugreek is also helping, but I have stopped the alfalfa. I am going to add it back in to see if that was bothering her though to be certain and then I will try the milk thistle back in and check that as well.

I do have a blood disorder and mirena was the best bet to try to control heavy menstruation issues.. I think it's called thalasemia or it's like that. I bleed very heavily to the point I get very sick. While I don't think the mirena is interfering, I am wondering if the bleeding from having it inserted was... Either way, it's probably good to note in case others are having any issues with that.

[@llli*krasota]

I bet a good talk with your hematologist could shine some light on the issue. Anemia (which thalassemia can cause) can cause a reduction in breastmilk supply. Heavy bleeding can exacerbate iron deficiency anemia. Are you on iron supplements? I also take folic acid and b12 to help with my anemia (platelet formation or something I'm totally blanking on now).

I'd look for a different lactation consultant. Heck, call your local La Leche League leaders!

Good luck. I hope you feel better soon.

[@llli*sweet13princess]

I'm also finding my 8 week old baby having similar problems. The doctor, of course, wants to go right to medicating her, but I'm not sure that's always the right way. Isn't there something out there like a Tums for a baby? I know we have gas drops... I can't believe there's nothing like that for a baby? She seems to have trouble 5pm-9pm at night. It's not gas (colic) because she has bubbles in her mouth and spits up, screaming loudly and arching her back after eating. Just started a week ago. Isn't there anything she can take on an as-needed basis? The pediatrician said no...*sighs*

Shannon

[@llli*lllmeg]

How about holding baby upright, burping frequently, nursing frequently (breastmilk soothes pain) etc?

I also had a baby with reflux and did not want to daily medicate. I asked about tums for babies and my pediatrician basically went on a rant about tums for ANYONE who has GERD and how they actually make the situation worse. I was shocked as I had eaten my weight in tums while pregnant with the blessing of my OB. Later I learned what the ped meant when I was diagnosed with GERD, (I had actual erosion confirmed via endoscopy, not fun) got on the right medication (a ppi) and was able to finally stop taking tums. Of course, diet changes would also have helped (me, as an adult, not baby) and I am still working on that. (love my coffee and chocolate....)
But I agree, it can be very concerning to medicate a baby. With our baby, we did try the ppi for a while and it seemed to help a little, but basically found that the comfort measures I mentioned above helped the most. Plus baby pretty much grew out of it.

This is the best article I know of about GER in babies: http://www.askdrsears.com/topics/par...-faq%E2%80%99s