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Thread: Advice: Fussy baby, cries with spit up. Reflux?

  1. #1

    Default Advice: Fussy baby, cries with spit up. Reflux?

    Hi Ladies, have been lurking since pregnancy, but this is my first post. I'm hoping to get your opinion on my situation and I apologize that this is long.

    My LO is almost 8 weeks. Since 2 weeks old he has been spitting up a lot and is very gassy. He spits after every feed, and very forcefully. I mentioned it to my doc, and we started nursing upright, holding upright, incline sleeping etc etc. By 4 weeks nothing had improved and he was now starting to spit out his nose after every feed and sometimes quite a distance. I wouldn't go so far as to call it projectile.

    He pulls his legs to his belly all the time, and every time I lay him down, no matter how long he's been upright, he spits. The important thing to note is that when he spits, he cries. He's obviously in pain when he spits and I end up holding him all day as a result. I put him in the stroller when we go for our daily walk, other than that, I'm holding him. I can barely go to the bathroom :-) (Please note also that I'm not complaining, I LOVE being with my son and if he needs me, I'm there. I'm just painting a picture).

    He typically cries quite a bit throughout the day, in between all feeds. I am constantly wondering if I'm doing the right thing as a result, but I just end up holding him and offering the breast frequently. He's happiest with me, either in my arms or in the sling.

    He doesn't fit the signs of pyloric stenosis, most notably because he's gaining weight normally. He was a few days slower than “normal” gaining his birth weight back and has been gaining more than “normal” ever since. He's not chubby at all, and is steadily gaining between 25-40g a day.

    I do not eat any dairy, including all hidden sources of CMP. I do not eat gluten. I don't eat either normally, but have only been strict about the hidden sources of both for a little over 2 weeks. It doesn't seem to help, and there is no mucous or blood in the diaper.

    I do produce a lot of milk and forceful letdown was an issue at the start. I nurse laid back, and when he was smaller I expressed some before letting him on the breast. I feed only one side per nursing session, unless he demands more, which he rarely does. I nurse on demand, 10-12 times a day on average.

    He sleeps relatively well through the night. We feed around 9:30-10 and he will wake again around 1:30-2, and then again at 5:30-6. He goes to sleep fairly easily after 10 and 2 without much spit up (after holding upright 30 minutes and several burps) and starts to get fussy after 6. So we get up and go for a walk.

    My real issue with all of this is his pain. He is in pain when spitting up and passing gas, and sometimes the morning poo after 6am feed. We were referred to a pediatrician and based on all his symptoms, most notably his pain with spitting up, he diagnosed GERD. I understand why, but after a week on prevacid I'm really doubting whether this is it. I understand it can take longer to take effect, but I haven't seen an ounce of improvement and I'm not interested in giving him medication if he doesn't really need it.

    I know this is a lot, and I've read a lot of threads on here with some of these issues, but there were none with all of this combined (that I found). Can anyone shed any light on this?

  2. #2
    Join Date
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    Default Re: Advice: Fussy baby, cries with spit up. Reflux?

    You know you have OP and forceful letdown, and everything that you mention are things that are caused by OP and forceful letdown (or are just normal- a baby wanting to be held all the time, for example, is simply and 100% normal.) So why look for zebras when it is probably a horse?

    The best cure for OP and FFLD issue is time. Unless you are pumping or doing anything else that artificially increases milk production, eventually your body will figure things out and the OP and FFLD will subside, and with that, I suspect these issues will lessen. I will not say they will go away, because spit up, gas, and fussiness are all entirely normal as well.

    Meanwhile, I would suggest, encourage baby to nurse slightly more often, even overnight if that is possible. If baby is usually nursing both sides at a time, maybe try combining more frequent nursing with baby nursing ONE side at a time, assuming baby (and your body) are ok with that.

    My oldest was also diagnosed with GERD - he had some signs- pain when laid flat, painful wet burps- and we also medicated baby with prevacid for some time. And I also later doubted that was the problem at all, because I certainly had OP and FFLD, and also, as I later learned, it is normal for a baby to protest when laid down, because they want to be held.

    Reflux just means something is coming up and yes that is normal but can also be upsetting and uncomfortable, without meaning it is GERD that requires medication. But I knew nothing really about breastfeeding at that time and did not even understand that that I had FFLD and OP. IN any case, I never thought the prevacid did much. What helped was nursing frequently and holding my baby most of the time. If you go to askdrsears.com they have a pretty good article on GERD, explaining what it is, what helps, and why it is over-diagnosed.

    At this age, you might consider block nursing to decrease your milk production. But you will need to look at baby's overall gain (not daily, don't base anything ever off of daily gain is my advice, in fact, if you are weighing baby daily, stop immediately) to be sure the gain is rapid enough that you could take this step to rapidly decrease milk production safely. More on block feeding do's and don'ts: http://www.nancymohrbacher.com/blog?tag=Block+Feeding
    Last edited by @llli*maddieb; August 24th, 2015 at 09:58 AM.

  3. #3
    Join Date
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    Default Re: Advice: Fussy baby, cries with spit up. Reflux?

    Very interesting read, supersonic. I feel like you did a really good job of describing my situation Except that my son is not even 2 weeks old. He's my second, and although my 1st spit up a lot until she was sitting on her own, she didn't seem bothered by it, and it started later (6 weeks?) than with this fellow. He sttarted spitting up colostrum...

    I've been trying to manage my OP but even after nursing on a fairly soft breast, the spitting up & discomfort continue.

    We have our first ped appt next week. I'm keeping a record to show the doc. I just wish there were more peds with solid bfing knowledge. I think OP and forceful letdown are not the ultimate answer to what is going on with my son, but it would be nice to get medical advice from someone who understands how those things may play a role. Anyway...

    Here is that Sears article of GER(D): http://www.askdrsears.com/topics/hea...t-what-do-faqs
    Mama to a sweet kitty born July 2012 and monkey #2 born August 2015.

  4. #4

    Default Re: Advice: Fussy baby, cries with spit up. Reflux?

    Thanks for the feedback maddieb. I didn't think of it as looking for zebras, just trying to reduce the pain during spitting up. I guess all baby spitters I know are happy spitters and mine cries. Perhaps you're right and this is normal for some babies. I have no problem holding/wearing my baby all the time. I think that's normal too.

    I did do the block feeding for a week which helped OP, not the painful crying during spit up. We still nurse only one side per session, like I said, but I switch sides between feeds unless they are within 20-30min. Also, the weight gain I just averaged out to be per day and I don't weigh my baby daily, don't worry

    I'd much rather have nothing wrong and but I don't want to miss something that's hurting my son.

    @isabelofmtl: the ped I saw did ask about forceful letdown and other bf stuff. My own doc is pretty great too and wanted to make sure I see an LC before anything. It's only after all this stuff being done and my son getting worse that we started thinking there might be more.

  5. #5
    Join Date
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    Montreal
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    161

    Default Re: Advice: Fussy baby, cries with spit up. Reflux?

    Those sound like great docs, supersonic! Tomorrow is my ped appt.

    I'd love to hear how things progress with your LO.

    Right now, I'm looking at this Tucker Sling thing... Babywearing helps a lot in the day, but nights are a challenge. It's hard to hear and see your LO suffer, to any degree.
    Mama to a sweet kitty born July 2012 and monkey #2 born August 2015.

  6. #6

    Default Re: Advice: Fussy baby, cries with spit up. Reflux?

    Quote Originally Posted by @llli*maddieb View Post
    You know you have OP and forceful letdown, and everything that you mention are things that are caused by OP and forceful letdown (or are just normal- a baby wanting to be held all the time, for example, is simply and 100% normal.) So why look for zebras when it is probably a horse?
    Maddieb, I was just thinking more about what you wrote. Pain when being laid flat isn't a sign of FFLD/OP that I saw anywhere. Am I wrong? You mentioned that all the signs I listed can be attributed to FFLD/OP, so I just wanted to be sure I wasn't missing something.

    Quote Originally Posted by @llli*maddieb View Post
    My oldest was also diagnosed with GERD - he had some signs- pain when laid flat, painful wet burps- and we also medicated baby with prevacid for some time. And I also later doubted that was the problem at all, because I certainly had OP and FFLD, and also, as I later learned, it is normal for a baby to protest when laid down, because they want to be held.

    Reflux just means something is coming up and yes that is normal but can also be upsetting and uncomfortable, without meaning it is GERD that requires medication. But I knew nothing really about breastfeeding at that time and did not even understand that that I had FFLD and OP. IN any case, I never thought the prevacid did much. What helped was nursing frequently and holding my baby most of the time. If you go to askdrsears.com they have a pretty good article on GERD, explaining what it is, what helps, and why it is over-diagnosed.
    Since you wrote from your experience with a GERD diagnosis that babies sometimes just cry because they'd rather be held, this certainly could be the case with us, but it's definitely difficult to tell. I had read the Dr. Sears article before, and sadly, the list of signs does fit my LO better than the list of signs for FFLD. Having said that, I'm still not convinced it's GERD, even with the prevacid. My LO doesn't have the signs of gagging and refusing the breast, nor clamping down, for example, the only ones on the list are really gas, hiccups, crying in pain.

    At this age it's hard to tell if things are working because of time, or because of medicine. Either way, thanks for your advice and feedback. Much appreciated.

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