As most of you already know, we have been cursed by the reflux monster with both our girls. Now Pooker had it pretty bad, needing to be hospitalized for 4 days when she was only 3 days old. (You can read about Pooker's Story.)
There are two different forms of Reflux (aka GER), Silent Reflux and Loud Reflux. Our daughters were cursed with both! Pooker had Silent Reflux and Kit Kat has Loud Reflux (although here recently it is turning into Silent Reflux).
Luckily what you do to help one....is the same for the other. So I wanted to take the time and blog about what we did/do and what tricks we found.
I blogged about Pooker's hospital stay here, so I will spare you that story. Pooker had to visit a GI Specialist MANY times in the first year of her life. If your child has GERD I highly recommend seeing a specialist. Nothing against Pediatricians.....but they are not all that knowledgeable in GER.
Silent reflux is when the liquid is not spit out, but instead swallowed. This can be very damaging, as the acid goes up and back down again.
Here are some symptoms of Reflux:
*Frequent spitting up or vomiting; discomfort when spitting up. Some babies with GERD do not spit up – silent reflux occurs when the stomach contents only go as far as the esophagus and are then re-swallowed, causing pain but no spitting up.
*Gagging, choking, frequent burping or hiccoughing, bad breath.
*Baby may be fussy and sleep less due to discomfort.
Warning signs of severe Reflux:
*Inconsolable or severe fussiness or crying associated with feedings.
*Poor weight gain, weight loss, or failure to thrive. Difficulty eating. Breast/food refusal.
*Difficulty swallowing, sore throat, hoarseness, chronic nasal/sinus congestion, chronic sinus/ear infections.
*Spitting up blood or green/yellow fluid.
*Sandifer’s syndrome: Baby may ‘posture’ and arch the neck & back to relieve reflux pain–this lengthens the esophagus and reduces discomfort.
*Breathing problems: bronchitis, wheezing, chronic cough, pneumonia, asthma, aspiration, apnea, cyanosis.
GERD may cause babies to either undereat (if they associate feeding with the after-feeding pain, or if it hurts to swallow) or overeat (because sucking keeps the stomach contents down in the stomach and because mother’s milk is a natural antacid).
I often blamed myself for Pooker's horrible pain, while she nursed. Reflux does A LOT to you as it does to your babies! However, breastfeeding is one of the BEST things you can do if your child has reflux. Just be strong and hang in there. But keep in mind... breastmilk is most likely better for reflux than formula. Since breastmilk is easily digested, so it leaves the stomach faster and can be less irritating when it is refluxed up.
The tricks we found were:
* Not laying them flat for 30 mins after a feeding
* Reflux babies more often hate tummy time......so bare with them
* Keep them elevated at about 30 degrees while they sleep. This helps encourage the fluid to stay down....but to be honest if they are going to "reflux up" it does not matter their position
* Try not to jostle them following a feeding....see above for the same reasoning. Again....to be honest if they are going to "reflux up" it does not matter their position
* Burb them OFTEN during feeding. I burbed every 5 minutes, then as they got older I burbed them after each breast
* Maaloox was a SAVIOR with Pooker. PLEASE check with your pedi or specialist before giving them this medicine
* I also have/had over active let down with both babies. This can GREATLY irritate reflux! Pooker would get 2 breastmilk bottles daily, when my letdown was at it most fierce. I would pump those two feedings. Kit Kat HATES bottles...so this trick did not work with her
* Poor weight gain (PWG) and Failure To Thrive (FTT) are also very common with babies who have Reflux. For Silent Refluxers....it is the pain associated with feeding that makes them eat less. But for Loud Refluxers it is just trying to keep what they taken in, well, in. Pooker had Poor Weight Gain at 5 months old. She was at BARELY 12 pounds and at the 3rd % for her weight. Luckily her GI Specialist knew how important breastfeeding was and suggested I give her 1-2 ounces of pumped milk following each feeding. I did this for one month and she began to gain weight!
* Medication, Prevacid and Zantac for example, might be needed. Both of my girls responded best to Prevacid. Reglan should ONLY be given if all other medicine has proved not to work and all other options have been tried. This medicine can DANGEROUS....pooker had a HORRIBLE reaction to it before we pulled her off. It was prescribed by her Pediatrician. Later her GI Specialist informed us he does not give that out to children and did NOT want her taking it.
*When feeding, keep them as elevated as possible. I invented (okay named) our position "the Souders' Sit." They are more so sitting up on my lap as they nurse.
* What you eat may bring on the pain! I could not drink orange juice with Pooker. (Still too scared to try it with Kit Kat!) So you might need to look into an elimination diet.
The hard part is knowing there is not much you can do for your baby. You give them the medicine, you try to comfort them when they are clearly in pain, you help them to breath again when they are having a reflux related Apnea episode, and you clean up their spew. But your heart will break, you will get angry and upset, and you will feel like it will never end. But most babies grow out of it by the time they are one yr old. You can do it! Give your baby the best you can and hang in there. I survived 11 months of breastfeeding a Silent Reflux ravished daughter. IT WAS HARD! And a good friend told me she was sure most women would have given up (I love you Jo Ann) and how proud she was I kept going. Just take one day (or heck one feeding) at a time.
Feel free to email me at email@example.com if you have questions. I am sure I forgot some tricks. Besides it helps to have a support system!