Reflux questions

[Lousli]

My daughter is 6 weeks old and generally pretty calm and happy and gaining and eating well.  She is EBF.  However, like my other two daughters, she spits up all the dang time.  

And she doesn't like to lay flat so sleep is getting to be an issue.  She doesn't scream or cry, but she grunts and groans loudly and eventually wakes herself and us up.  I wish I could explain the noises she makes, but she is clearly uncomfortable.  She seems most comfortable sleeping on my chest with me propped up, but I'm not sleeping well this way and I'm exhausted.

When she is awake, I notice a lot of hiccuping, sometimes gagging, sometimes a little coughing/almost choking noises.  She spits up right after feedings, but also just randomly throughout the day.  She has a lot of gas as well.

I am kind of wondering at what point to see a pediatrician about reflux.  Do reflux meds just make it more comfortable (reduce acid?) or do they actually make them stop refluxing?  What else can I try?

I was looking at sleep positioners, but I see that they are not suggested because they are supposed to be a suffocation hazard.  Last night, I put her to sleep on her tummy for a while and it seemed to help a little.  It helps also if I can keep her upright after feedings, but if I nurse for 30 minutes or so and then keep her upright for another 30, it means I'm getting only an hour of sleep at a time.  

Help!

[Knitting Mama]

I don't know if you co-sleep, but the way I made an incline work for my daughter and still was able to get sleep myself was by putting her head and shoulders on my pillow, and then putting my arm under the pillow under her neck to snuggle her. It kept her propped well and we all slept. When she was napping and I wasn't, I just wore her in the wrap. Good luck!

[superlove]

Wow, this is really brining back the memories!  I TOTALLY feel for you... reflux is so hard!  DS was puking his brains out from the time he was around 2 weeks old til around 4 months old.  He was in discomfort, but I think the discomfort was more colic.  So I think he was actually what they call a "Happy Spitter" even though he was really really fussy from the colic.   I smelled like rotten milk all the time, cause i was covered in his puke.. we could barely go anywhere cause he was a vomit fountain.  It really sucked!  but then it magically stopped around 4 months.   I changed my diet a lot and sometimes it seemed to be helping and other times it didn't seem to make a difference.  But that is definitely something to consider ( eliminating certain foods like dairy, eggs, soy, etc...)  

The meds generally just decrease the acid, so that when they spit up, it doesn't burn. You could try it and see if it helps with the discomfort.

Another thing we tried was cranio-sacral, which i'm not sure if it helped or not, but some people say it helps, especially if your LO had a traumatic birth.

We used the tucker wedge and sling for a while, which has a little harness and a steep incline.. which was really a pain in the ass, but I guess it stopped him from choking on his spit up.... 

I also swaddled him and propped him on his side alot, with his back against the side of the crib/bassinet and a pillow in front (for naps).

We gave him probiotics, but make sure you get dairy free probiotics.

I tried feeding him on a wedge at an angle.. but that was no help...

I also held him upright after feedings... and so my whole life was feeding and holding upright,.. and there was hardly any time in between.. 

The moby was great, cause i would just put him upright in that...

If you don't want to try the tucker wedge, you could try the nap nanny.

anyway, hang in there, it will go away, even though it can be so hopeless feeling, at least it was for me.

let me know if you have any questions and keep us posted!

[superlove]

Oh, forgot to mention... we finally got desperate, especially with night time sleeping cause he was sleeping on my chest, and the wedge was just so awkward...  so I bought a swing and had him sleep in that for naps and night times.. I resisted for a while but finally gave in, and it was REALLY helpful...

The upright angle helped a lot, and the swinging kind of kept him asleep if he puked.. when usually he would wake up.. So it soothed him enough to keep him sleeping.  Actually, now looking back on it,.. it was the thing that helped the most. Then when the reflux got better we weaned him off of it.

[QuestionGal]

Everything you listed sounds like reflux. The grunting sounds may be her trying not to reflux. DS would just spit up all over everything, DD fights it so hard until it comes pouring out her nose. 

It sounds like you are doing all the tricks to help cope with reflux but it still isn't working. If you choose to use medication you will still need to use some of those tricks. Especially the sleeping on an incline. The swing was a godsend for us, as were pacifiers. Both kids regularly slept/sleep in the swing.

With DS I held out on giving him medication but eventually felt it wasn't fair to him, he was so uncomfortable (not a "happy spitter"). With DD I put her on the medication much earlier when I saw her stop breathing twice because of the refluxing. Hard to explain but it was SCARY.

Once on medication they still spit up but it 1) isn't as frequent and 2) doesn't seem to cause pain. We've only used Zantac, I was not interested in trying Reglan b/c of it's personality/mood altering side effects. 

I'd suggest asking that the script be written for the largest dose in the range (there is a range of several ml's per pound of weight) so that you have some wiggle room.  They outgrow their dose quickly (you'll know when because the signs will return (hiccuping, increase in spitting up, screaming/grunting/turning red when lying on their back).

You can certainly talk to your pedi about the medication and stop using it if it doesn't work.  There is a website that lists out all the symptoms of reflux, I'd suggest going to your pedi prepared with why you think your DC has reflux (like a written/printed out list of reflux symptoms that your DC displays). 

As far as the weight gain is concerned some babies respond to reflux by refusing to eat (this was DS) and some by overeating (DD).  Some pedi's prefer only to prescribe medication if the baby is not gaining well so you may need to have a response ready.

As for sleeping on an incline... if your baby is in a co-sleeper you can prop one end of that up (use books under the legs?). In a crib you can lower one side of the mattress. You can also put your bed on an incline though I think that's a bit more of a challenge.

Have you seen the "Nap Nanny"? That gets great reviews for reflux sleeping and if your bed is large enough you might be able to put in bed with you?? 

ETA: FYI reflux will flare up and worsen at around 6-8months (when you start solids) then fade.  We stopped having to use medication just before DS's 1st birthday though he still sometimes has "yucky burps" at 3 1/2.