Seeking Advice on Infant Reflux

My 1st daughter had mild reflux as an infant. We used the formula Enfamil AR which has added rice cereal to make it thicker. This worked great for her and the reflux was under control quickly.

My 2nd daughter had much worse reflux. As a newborn she would not only spit up ALL the time, she would arch her back, open her mouth and turn red when she refluxed. As she got older the pain associated with the reflux reduced but she spit up ALOT and OFTEN! This lasted until she was about 9 or 10 months old. We tried 3 different formula's and she took the medicine prevacid. The medicine helped ease the pain associated with reflux (which is when she would turn bight red and look like she was choking in her sleep). We eventually put her on soy based formula. This really seemed to do the trick in reducing her discomfort and the frequency of her spit ups. We switched to regular soy milk at 1 year, but a couple of months later we tried regular milk and she did just fine.

Good luck and just try different things until you see what makes your little one the most comfortable.

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hi, J.!

just wanted to let you know that you are not alone. my 3 year old started on reflux meds at 6 weeks and finally came off at 1.5 years old. my 9 month old little girl also started meds around 8 weeks and continues on them. i have exclusively breast fed both of them and never switched to bottles or formula. i did extensive research and found out that cereal added to breast milk does not work! you can buy a thickener called thicken it, but it is expensive and the research shows that it helps with aspiration but not with reflux.

you can do some things to help, though. keep your baby upright for at least an hour after you nurse. this can be challenging especially in the beginning, but it really helps. my kiddos have also slept in a sling and a reflux wedge to help with the night time breathing issues.

you are not alone. if you need any more help, please let me know...i'm happy to let you know my experience!

-B.

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Hi J.,

My son was diagonosed at 2 weeks old with reflux and he had it until he was 1 year old. He too was on Zantac and prevacid. Zantac ended up working better than the prevacid for him but I have also heard good things about prevacid. I breastfed him until he was one and from everything I researched about reflux, breastmilk is best for reflux. The thing we really found helpful was to elevate him as much as possible and especially when he slept. We found a special pillow that was a large wedge and there was something attached to the pillow (sort of looked like a cloth diaper) that secured him and kept him from slipping. When we got that pillow he did so much better, slept so much better etc. etc. He also had some choking episodes that were very, very scary so I completely agree with one of your other posts about learning infant cpr - it's good to know anyway. having a child with reflux is challenging but you will get through it. Go with your motherly instinct on things, don't always trust what the doctors tell you. They always want to medicate and suggest things that may or may not be the best thing for your child. Do lots of research and maybe even get a second opinion.
I can look up the name of that pillow and send it to you because it was a lifesaver for us!!
Good luck!

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Hi there. I am going through this myself. I have a 2 month old--we started out on Zantac with ehr, and it didn't work very well--still kept puking and having difficulty breathing. My doctor placed her on Prevacid, and it has been like night and day. Maybe check with your doctor about this option. Am sure they asked you to keep her upright to sleep, etc? My daighter sleeps in her bouncy seat. As far as a timeline, not sure on that yet, since our issue is so new too, but the doctor says we'll just see how it goes and time will tell. Best of luck!

B.

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Hello, I responded on your last post... my daughter has GERD and she is now 5 years old. She had a endoscopy and biopsy to diagnose hers. Some babies out grow it by the first year and some will never out grow it. My little girl takes prevacid daily. I brestfed her and didnt start cerial until she was about 5 months old... but there are varying degrees of reflux, so depending on how bad your babies is; you might want to consider pumping and adding the cerial to a bottle on the feedings before bed times. But I def. would NOT stop brestfeeding your little one. I would recomend asking your pedatrician for a referal to a Gastro. Dr. We have been seeing Dr. Edward Patterson for about 3 years now. Good luck!!

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Hi J.,
Congratulation with your baby!
We have the same problem, and I also was pressed very much to switch to a bottle. It was really annoying to pump, to feed with the bottle...again and again. Actually you will spend twice more time for feeding. No time for rest at all. The other concern, they told me that milk intolerance can provoke more reflux, so they advise me to feed baby with soy formula. They make numerous test and told she has moderate level of reflux. Long story short, she was on medicine and and we add special stuff to breast milk to make it heavier (I will check, may be I still have some)~ 2-3 weeks. I stopped pump and normally breastfeed, but continue with medication ~2 weeks more. Unfortunately, I did not remember the name, but I know that this medicine does not effect pH but relax mussels in stomach and these prevent reflux. Main advices that I get and which help us (actually my sister in law had the same problem, so we double our knowledge): allow baby to burp few times during and after feeding (let's tell after each ounce), put something under the one side of mattress to make an angel(do not put a pillow into the bed) and change her before feeding, because they always do it during changes.
Good luck, Hope it will become better soon. Our doctor told us that almost all children has it and it disappear before 6 months.
N..

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J.,

My daughter has it now. She's 3 months old. She's also on the same medication. We have been to Phoenix Childrens for this. They told me she would be on the med's untill about 6 months, most likely. Worse case is 18 months. My ped also said to bottle feed. The doctor at childrens said it probably won't help and if it does it will only be a little. Try keeping her head up for 20 min. after she eats. Just higher then her tummy. We also put a piece of wood under the legs to the head of her bed. I also know caffinee makes it worse, so I cut back. If you want to breastfeed than do it. Don't let anyone tell you not to. hang it there, it does go away. :)

K.

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J.,

My best friend went through this with her son. The good news is, she breast fed him till he was at least a year. The not-as-good news is, he was on his meds till age three. Breastfeeding isn't going to make reflux go away but it sure will give her a better chance of being healthy overall.

Sleeping on an elevated surface - either a pillow or raising one end of the crib - should help a little too.

If your doc isn't supportive of you breast feeding, either ignore him or switch doctors. There are other opinions.

For more information from a doc & his wife who also have eight kids and are very supportive of parents making healthy choices for their kids, see www.askdrsears.com

Good luck & don't be intimidated just because your doc has MD behind his name. You're the mom and must take all advice with a grain of salt and in light of your own intuition.

M.

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Funny you should mention this...Last week when I read your request I thought it sounded just like what we went through with my son. He always sounded "raspy" especially when he slept. At 3 weeks old, they did an xray and diagnosed reflux. No, your baby should not be too young to diagnose it properly. They give your baby something to drink, and then do an xray. The xray tech let me look, and you could see the liquid going up and down in his esophagus!

We tried Zantac, but the problem is he adjusted to it. It was effective at first, but the effectiveness wore off after a month. Then we moved to prevacid. It worked wonders! Things were totally different after that. I took him off the prevacid at 9 months old, although he still had a few episodes with spitting after that. I read that most babies outgrow reflux by a year old. If they do put your baby on prevacid, my doc had a card she gave us that made prevacid free. If your doc doesn't have one for you, I can send you mine since I no longer need it.

Also, I continued breastfeeding until my son was 10 months old. My doc said that because breastmilk digests faster and remains in the stomach for a shorter time, it was a toss up which one was better for him. However, she did say that if I gave him a bottle I should add cereal to it. I didn't ever bother to pump, but gave him a bottle with cereal about once a day.

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Don't let them convince you to stop breastfeeding if that is what you want to do. It truly is best for the baby. I tried the cereal to help my babys reflux and it didn't work. You could try it a different way - just feed baby a tiny bit of cereal mixed with water/breastmilk right after feeding. Do what you think is right for you and baby! Good luck :)

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both of my boys had extreme reflux, we had to do a lot of things such as adding rice to their formula. I also used a premade formula that was more thick to help them keep it down. Breastmilk and a lot of the powder formulas are too thin. You also have to be very careful how you hold the baby while feeding, more frequent burps (but never over the shoulder, etc.) and keeping them upright for as long as possible after eating. It is very hard on the nerves. You didn't say whether your child is spitting up, projectile vomiting, etc. but having a lot of rags and towels around is handy too. I did unbelievable amounts of laundry. The good news for us was that it got better around 9 months and they did not need any surgery. We also used zantac. We tried Reglan but it made them moody so I stopped that.

Good luck! I feel for you - reflux is difficult to manage.

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J., You have received some really good advice. DO NOT stop breastfeeding. The artificial DHA in the formula's is helping create more reflux and digestion issues. DO NOT add cereal. The dangers of cereal to their immature digestion systems can be real. Until a baby is 6 months old their systems cannot handle cereal or food. It can potentially be very dangerous.
Sleep the baby on an incline of 30%. If you contact me I will tell you how to build a reflux nest that will put your baby to sleep on the incline.
You may try and take diary out of your diet and also any foods that would offend an adult with Reflux. Many times this helps immensely with your infants reflux. Yes they will outgrow it.
There is NEVER a case where you should quit breastfeeding. To do that jeopardizes your child’s ultimate development.

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One of my boys was a premie and had very severe reflux among a long list of other issues. It will depend on how severe your child's condition is and if there were other issues mixed in. He didn't have difficulty breathing, he just stopped breathing on a very regular basis. He was off the heart and breathing monitor a week before his first birthday but has never quit taking medication. He will be 18 in a few weeks. He had surgery for his reflux at age 11, too sick to have it earlier, and will need another in a few years when he stops growing. He still takes medication but not as strong a dose as before his surgery.

I nursed Jonathon for 9 months, and when I needed to mix his medications with milk I pumped a bottle for him, but it was breast milk as well. If you want to try the cereal trick use breast milk, formula made Jonathon so sick it wasn't worth it. But don't worry, bottles or breast your baby knows you are there for her and will love you just as much. Another thing you need to watch are her teeth. The acid can destroy them, especially molars, and his have been repaired over and over, about 30k in dental work so far.

My very best advice for you is to take an infant cpr course. Most moms don't need it, but there are some, like me that had to use it. It's better to know how to do it and not need it than need it and not know.

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My middle child had reflux pretty bad, and the doc wanted to put him on meds, but he was already on 3 meds for a heart condition, so that wasn't an option to me. We did the bottle thing with cereal, although he wasn't breastfeeding anymore. The concocktion is 1 Tablespoon of rice cereal for every ounce of formula. Avent bottles have a nipple designed for thickened formula so you don't have to cut your own. I don't see how switching to formula is necessary, however, because you can pump and use the breast milk. If it's the bonding that you want to keep going through breastfeeding, why not do every-other feeding by breast and every-other feed through bottle with the cereal? If the doc is concerned about the breathing/reflux while she is sleeping, you could try the bottle/cereal only before she goes to bed/naps. Best of luck to you.

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Hi J., I didn't really read your other responses so I apologize for any redundancy. My son is a year old and has had reflux since he was 2 weeks old. My first piece of advice is to stop going to your pediatrician with this problem--go to a gastro specialist. The pediatricians we have seen do not know nearly enough info about reflux to give my son the best care he needs. We see Dr. Schenkein at Phoenix Children's (she has an office at the hospital in Phx and one in the PCH clinic off of Southern and Higley). She told me stop dairy and caffeine which I did and it helped my son tremendously. Dairy and caffeine are two of the biggest offenders in infant reflux. She at one point suggested switching to formula, but I told her that I intended to breastfeed and did not think formula was the right choice for our family. She respected that and never brought up formula again. My son started on Zantac but it would cause him to get constipated and didn't relieve his reflux enough. Then we started Prevacid. He has now been on Prevacid for probably 8 months or so. It works well and you only have to do it once per day...however, if your insurance doesn't cover it, it is crazy expensive. Unless your son is allergic to your milk (which is not the same as reflux) I don't think there is any reason to stop breastfeeding as long as you're willing to adjust your diet. It was really hard for me to give up dairy...I am a serious dairy-a-holic, but I did it. I am now reintroducing dairy to my diet and have also started giving my son dairy. The dairy has definitely affected his reflux, but it's getting better. At a year old we are now trying to see if we can wean him from meds. He'll be good for a couple of days but then needs meds again. My husband has had reflux since infancy so we think our son may be plagued with it for life as well. Oh, and I haven't read your other post about the breathing problems, but my son had that when he was only a few months old and it was because of reflux. He would have these terrible coughing fits when the acid would come up and one point he was wheezing when breathing. We had a bronchoscopy which puts liquid into the lungs and then sucks it back out to check for foreign cells when he was 5 months old and everything came back fine...and strangely, after that procedure his breathing went back to normal! I really do encourage you to take your baby to a specialist. Dr. Schenkein is pretty straight forward, but she is so good and very thorough. Good luck and if you have any other questions feel free to shoot me a message!

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I think you're right to question the doc's advice on breastfeeding. I would try any and everything before I stopped that. If it's reflux, try a chiropractor. Babies go through a pretty intense process when they're born, and if they're out of whack, it can affect the messages travelling up and down the spine. I know it sounds weird, but my sister and several friends swear by it for colic and reflux. Get a recommendation for a good baby chiropractor from a friend or doc, or call around to different offices and get recommendations from adult chiropractors you like or have heard of. Even if it's not reflux, it has been known to cure lots of ailments in babies. It fixed my son's constipation issues in one visit.

It sounds like a pretty shaky diagnosis, and interrupting breastfeeding on a guess might be a big decision you'll regret.

Good for you for checking out other options!

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Hi J.,
I just attended a doula conference and there was a lecture about infant reflux. What I learned was that to stop breast feeding is not the remedie. Having your baby sleep reclined or on her tummy helps. It will go away, but hard to say when, that differs from child to child. Keeping the baby upright as much as possible is the best way to go.
G.

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I've been there, done that! This is very hard on you I know. A few words of encouragement, it does get better and it will go away! This is only a small snapshot of time in your life, there is a light at the end of this tunnel!

I agree with Nancy H. and Greta's posts too.

My experience: Keep breast feeding. Do NOT put rice in a bottle either! You will be more frustrated. My daughter was on medicine for about a week and I hated giving it to her. It seemed to help her though. Things got better after about 6 weeks, and by 3 months, she was fine. She just needed to outgrow it.
Another trick that worked for me was to give my daughter ONE formula bottle at night before I put her to bed for the night. I did this when she was about 2 weeks old and continued till I weened her, which was an easy transition because she had both breast and bottle early on. I used LIPIL. I breast fed around the clock, but after the last evening feeding, I would go to bed, let my husband take over and give my daughter the bottle for her last feeding for that day. That way, I could get some well NEEDED sleep. Then I would get up for her feeding in the middle of the night. It helped her, me, and my hubby got some bonding time.
Good luck and hand in there.

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I have been through this. My first son had acid reflux - bad. And my friend just had a baby 3 months ago and he has it so it's fresh in my mind.

I was nursing so it would take me forever to feed him (you know how hard it is to feed a newborn, he'd fall asleep everytime he got near me!), then when I finally got him to eat, he'd throw it all up! I was a mess. I thought my baby was starving. But he wasn't. He kept gaining weight, so the doctor said he okay and he was. As long as he/she gains weight, he's/she's getting food.

We got through it and my son is now 4 1/2 and doing great! And your daughter will be okay too! Here's my advice:

1) I am very surprised your doctor said to stop nursing. My doctor would never tell me that. Instead I had to endure the brunt of it. The doctor put me on a strict diet (no beef, no soy, no dairy) because those are typically what bothers babies with reflux. I lost all my baby weight and it helped curb my babies acid reflux, so it was a win - win situation.

2) They also put my son on prevacid. I wasn't happy about putting a newborn on medication and I'd cry about it all the time but I didn't know what else to do. He took it for 6 months then we slowly weened him off.

3) When he was approaching 4 months they told me to add a little rice cereal to each bottle, just a tablespoon or so.
And when he was 4 months they said it was okay to give him a little rice cereal each day. Then at 6 months, it was full blown solid baby food. I would start with veggies as they are less acidic.

4) I rarely laid him flat. Accept for tummy time when he got older.
Only hours after eating would he lay flat to play (when he got old enough to play). As a newborn he was always angled, even if it was slightly.
When he was a newborn I'd put blankets under his upper body (like when we were in the living room during the day). In his bassinets under his sheet I'd put blankets too so he was angled.
When he hit about 4 months and could sit in those bouncers things, he was always in that or his swing (again when were in the living room during the day). NEVER FLAT.

When he was 6 months, he could sit up so during the day wasn't a big deal. And at night in his crib, I bought a wedge of foam and put it on his bed and used a blanket over the sheet to hold it in place.

When they are angled all the time, yes, he'd slip down and be lying funny so I'd have to get up and check on him throughout the night to reposition him (but what parent doesn't get up and check on their little ones? right?). That's the kind of stuff of mom's have to do. :)

If I can think of anything else, I will write you again.

Best of luck. Hang in there. :)

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I don't recommend a bottle, BUT, you can pump, mix a little bit of milk and rice cereal together, then use a supplemental nurser system so your little one gets that while you are breastfeeding. Another idea would be to mix it with breastmilk, but a very small amount on your nipple, then have baby latch on, or put a small amount in babies mouth (dilluted with breastmilk), then nurse her right away so that she swallows it. Just a few ideas. Do you have a good baby carrier? When my son and daughter both had reflux, I wore them in a gypsymama wrap all the time. You can nurse them upright, too, which helps keep everything down. I had them nap in there too. I also took them to a gonstead chiropractor to adjust their necks and backs. It took the reflux away MUCH quicker than it normally goes away on it's own. Both of my kids were out in the areas that effect the stomach and esophagus. Kirk Van Metre who is just west of bell and grand, is who they go to. We don't live close but he is worth the drive. He has 4 girls of his own and works with a lot of kids.

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My son was born with acid reflux, and he still has it at 16 months. It's not as bad as it once was. My pedi told me to crush his previcid and mix it with water about 10 to 15 min before I feed him. I breastfeed till he was about 8 months old. When I started feeding him solid foods, was when the reflux started to not be so bad. When he was about a yr old, is when I started giving it to him on a need too basis. When he hits a growth spurt, his relfux really kicks up, and when he's drowling from teething. My son also has an intolerance to dairy. So I would also suggest that you cut out dairy from your diet to see if that helps too. Good Luck

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Hello-I have been in your situation with my daughter. I was determined to keep on breastfeeding and the person that saved me was a wonderful lactation consultant. She gave me lots of suggestions and we didn't give up until we found something that worked. I ended up pumping milk and then using a S&S feeding system to help my girl get milk sooner, but not too fast. She then got milk from the S&S feeder and the breast as well-it worked. You could probably do the cereal thing in the S&S too. Prop your baby up in the bed and anytime you put her down. We used a boppy and a pillow on the floor and propped the cradle mattress up with a pile of books underneath. Also, use a sling to carry her propped up as well. Zantac did help, but also created constipation issues, just be prepared! I know you can get through this, but please find help. Doctors aren't always the number one advocates for breastfeeding.

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I've heard that cereal in a bottle can help for reflux (NOT for sleeping through the night or as a way to get solids). Perhaps it's worth a try mixed with your bm. A sloping pillow cna help, where they are sleeping upright. Outside of that, my best advice would be to contact an international board certified lactation consultant and/or LLL for further advice. Also, the breastfeeding community at Mothering.com is very pro-breasting in the sense that these ladies have some great advice that's helped others even when people were ready to throw in the towel or had gotten bad advice from other people. It's worth a look at least (its' free) just to see if you find anything interesting.

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Based on my experience, my advice is to PLEASE keep breastfeeding but eliminate dairy from your diet, at least for a couple of weeks. If she doesn't improve, you haven't lost anything, except for maybe a little extra baby weight :-). No formula, not even Nutramigen (which is expensive and smells awful), will be as good for your baby as your milk, especially if you can eliminate what may be causing her problems.

My son has a sensitivity to dairy that caused reflux until I figured it out and eliminated dairy from my diet (he was about 3 months old at the time). After eliminating dairy from my diet, he improved within a couple of days. It took about 6 weeks for all symptoms to clear, but now he does great as long as neither of us eat dairy. He will be 2 in a few weeks and we are still nursing a few times a day. Two friends of mine had babies about 6 months after I did, and both of them were prescribed zantac. Both moms eliminated dairy, and were able to get off their babies off the zantac as soon as they stopped eating dairy.

There are times when I miss dairy (mostly Indian food), but my love of dairy is less than my love of my son. Breastfeeding is the best thing for him, so I can wait a while longer to eat that piece of cheese.

Good luck. You are so right to question your doctor suggesting to switch to a bottle. Feeding a newborn cereal sounds crazy to me. I'm not a medical doctor, but from what I have read about newborn's digestive tracts, I can't see how adding cereal would help. I think it would cause the opposite, or plug up your little girl to the point that she'd be constipated and still having reflux.

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