Reflux and what can I do to help my baby?

My youngest had reflux. First dr said I wasn't burping him enough or that he was allergic to milk. I was told to see dr. Loubser at infinity clinic. Ds was placed on losec for 6 months. He would projectile vomit, wretch in pain any time he was gassy. We put him on sr26 ar I believe it was called. He avoid juice like you wouldn't believe ( he's 2). I think he realizes it may not agree with him. He does get sick occasionally now but mainly from overeating, high fever or teething.

angel joy you don't necessarily need to treat reflux, many babies reflux to some degree. My guy spat up enormous quantities, but weight gain was fine and he was not seemingly upset about it so all we did was elevate the cot and try not to overfeed in one go (and I watched what I ate a bit- EBF). He grew out of it by around 4 months and when we introduced solids we just had to be careful with certain foods. Its only when its affecting weight gain or making the baby miserable that you think about medicating otherwise its really just a laundry issue ;).

by reading all these posts it looks like my baby too has mild case of reflux.(exclusively breastfeeding) . he spits alot mostly during late afternoon-evening. not even one spit at night but i do keep him slightly elevated at night. my doc is persistent with one gas medicine only (which i have stopped since he is able to pass gas)and does not listen!! time to change doc.

oh and if you find thickening feeds helps (sometimes it does make a huge difference and for others it makes it worse as it stops the baby spitting up but actually makes the pain worse as the acid still rises and then goes back down again, burning twice) there are thickeners that can be used for breastmilk too, (not all can) either by adding to expressed breastmilk or by giving on a spoon when you breastfeed. here are some links that might be helpful, (this whole website is quite good in general actually); http://www.cryingoverspiltmilk.co.nz/alternativetherapies/probiotics/ http://www.cryingoverspiltmilk.co.nz/food/thickeningagentsforreflux/ http://www.cryingoverspiltmilk.co.nz/food/arformula/

Good post kiwispiers! Here are the contact details and info and Dr Waseem. If u do a search on here, you will find he had many good reviews. He is very experienced in gastroenterology, neonates and general paediatrics. He is also kind and sympathetic the a child's suffering and a parents anxiety. http://www.doctor-dubai.com/dr_info_display.asp?dr_id=2168 How prem are your babies and how old are they now? I agree that you should not give any water, only breast milk or formula. Gripe water can be given from 1 month old. I found Woodwards brand the best. Infacol is for gas. It basically brings all the little air bubbles together to make a big one and then easier for the baby to burp out or past out his other end. I really do feel it helps and there is no harm in trying it, it works for some and not for others. I don't know why your dr is being so single minded, but there are many different approaches to treating the problem, not just Gaviscon! Incidentally, how are you getting it here? I worked in 2 neonatal units here and it was always a battle getting it with the parents having to courier it in from UK. I agree that you should not give both a thickened feed and Gaviscon. If your baby is old enough for an AR formula, that would be very convenient so u could try and stop the Gaviscon if he settles. Breast milk is easier to digest, but some babies require a lot more intervention. Both my girls were exclusively breast fed and it made no difference to their reflux. The first was a massive projectile vomitter and the second was a silent refluxer with all the pain, swallowing and coughing symptoms. Personally, I prefer to give Zantac and Motilium rather than any additives. It takes a few days to really get working but the difference in the baby is amazing. If it were me, I would get a second opinion from Dr Waseem and or be more direct with your current dr that the current treatment is not really working and you want to try the next step. Regarding the constipation issue, if your baby is passing stool regularly, then he is not constipated as such, but the Gaviscon and feed thickeners will make is stool harder to pass, hence the red in the face, straining and moaning, it is a big effort to get a harder poo out than a softer one, another reason why I prefer medication like Zantac. Some drs prefer Losec, but it is a pain to give as it does not come in syrup form, only enteric coated tablets that you have to will have to crush and mix with water to give. Regarding burping your baby, the methods that kiwispiers describes below are good ie holding upright, I find patting firmly on the back at the baby's elbow level very effective. Also the lying down and slowly sitting up. Every mum works out the best way for her baby. Just try different things till u find a system that works. You won't know if he likes lying tilted to the side if u don't try. I feel it is safer anyway, particularly with a baby that has reflux, in the event that he vomits, the vomit will just flow out his mouth, rather than staying in his mouth and risking him breathing it in and choking.

neocate is a completely hydrolised (predigested) formula that can be given from birth, even with prem babies and this could be very helpful if the reflux is being caused by problems digesting the formula. You could try to breastfeed more and give less (and eventually no) formula, as usually breastmilk is easier for a reflux baby, working with a lactation consulatant will help you in boosting your supply and finding positions that allow you to feed both babies at the same time so you are not spending an entire day breastfeeding. The problem with the word "colic" is that different people mean different things when they use it. For many people the word "colic" refers to wind/gas pain, and infacol would generally be what you would use for this if anything, although studies haven't shown that it is very effective and probiotics have been shown to be more successful. Try burping before a feed. My baby was hard to burp and I found the best way was to sit him on his bottom, one hand on his back to keep it straight and on hand supporting his head on his chest and below his chin, I would then very gently move his body in a "hula hoop" type circle (hard to explain in words sorry but hopefully you get the idea) I found that worked much better than the over the shoulder type methods. The other one is to lie them flat on their back for a few seconds and then sit them up and try again. Other people use the word "colic" to refer to a very unsettled baby, who cries a lot (for hours), especially in the evening and can be very hard to calm down. Drs don't really know the cause of this but up to around 20% of babies can fit this category. reflux refers to stomach acids rising up the throat, if the baby actually vomits them out then its reflux, if they baby swallows them back down then its called "silent reflux". There are a range of meds/treatments for this, keeping baby upright after a feed, elevating mattress at one end (do this by elevating under the mattress, so that the whole mattress is on a 45 degree angle as you don't want to hunch their body, gaviscon and thickeners (don't use both gaviscon and thickened milk unless your Dr advises it as they are more or less doing the same thing, preventing acids from rising. Acid neutralisers (like losec and zantac) and things like motilium which move the milk through their digestive system faster so there is less time for the acid to rise. None of these reflux treatments are for gas pain. Are you feeding him right before you put him down for a sleep, during the day its much better if you feed right when he wakes up instead, so that the milk has time to pass down his digestive system sooner, and he has time to get his burps and poos out before sleep time. The most simple thing you can do is hold him upright against your chest for around 20 minutes after a feed. If you give small feeds twice as often there is no reason why he should be hungry, as he will still be getting just as much milk. He has a very tiny tummy and its actually more natural for babies to feed this way. It sounds like he has maybe reflux (silent as you don't mention a lot of spitting up) and also gas pain, basically digestive issues in general, which is pretty common in a prem baby as their digestive system is not quite developed. I would suggest probiotics as they have been found the be really beneficial in both cases. Trying to move away from formula if thats an option and if not, trying a hydrolised formula (not sure what the situation is int he UAE but it can be expensive if not on prescription, try and find a Dr who will prescribe it) Your Dr is right in saying shouldn't give boiled water, that will fill the tummy even more which will aggravate the reflux and could have a negative impact on his weight gain. Check with a Dr if you plan to give gripe water in combo with any prescribed meds as they may not be recommended together. Ideally you want to avoid meds/gripe waters etc if you can, by changing the way you feed and hold your baby, but some babies do still need them, despite all that.

Just to add re formula, have you tried any of the AR formulas (anti reflux)? They work well too.

Have you elevated the head of his mattress? That is the first thing to do. Try placing him tilted to the right side to aid the emptying of his tummy - put a rolled up towel behind his back. Both my DD's suffered from this. It's awful to see them in pain. Make sure you burp him really well before lying him down. If he is difficult to burp, try Infacol before feeds. Gaviscon can be quite constipating so that may be why he is unhappy when having a poo. The only things that helped my girls was the medications Zantac and Motilium. In between, if they were uncomfortable, Gripe water worked really well too - it contains sodium bicarbonate which is an acid neuralizer. The relief is pretty quick. Also try to give smaller feeds more often. If he is not really responding well to the Gaviscon and the comfort measures, see your paediatrician again and insist you go for the next line of treatment. If he doesn't want to, get a second opinion. Dr Waseem is a paediatrician specialising in gastroenterology, so he may be a good bet for you. Hope you get sorted out soon.

when you say he is in pain pooing/passing wind, do you mean he cries or just that he seems to be red/faced straining? straining s ok, crying is pain. reflux shouldn't cause poo/gas pain and gaviscon won't help with this, all gavison does is help stop stomach acid rising after a feed, it doesn't aid digestion in any way. Is he formula fed, maybe he is reacting to the formula, you might want to try a hydrolised one as it could be a cows milk allergy which can present itself as reflux and gastric symptoms or if BF maybe a reaction to something you are eating. Big thing that helps with reflux is giving smaller feeds, so those 80ml feeds might actually be causing him pain. Try giving half that amount, twice as often.

Hi little zuzu Sorry you are going through this, it is very stressful to see your LO in distress. I am sorry I don't have a huge amount of time to write, but I have attached two recent links of previous threads on this topic that had some really good suggestions on them. http://www.expatwoman.com/forum/messages.aspx?TopicID=176011 http://www.expatwoman.com/forum/messages.aspx?TopicID=178650 Again, sorry I don't have time to respond properly, but I thought these suggestions might get you started! I will try and return when I have a spare moment. HTH