Getting Baby with GERD (reflux) to sleep and STAY asleep

[Tear78]

Our little one is 4 1/2 weeks old and she went on medication last week for reflux. She's no longer arching her back, screaming in pain, and waking out of a sound sleep to cry inconsolably (thank GOODNESS, poor little girl!). However, she often wants to nurse constantly (like, four hours straight if I let her), and every time she drifts off to a seemingly sound sleep in my arms, when we lay her in her crib she wakes up groaning and then spits up all over her clothes. She will sometimes lay there groaning for a long time unless we pick her up and keep her upright and soothe her back to sleep. I'm getting exhausted, and my boobs are frankly getting worn out.

I've read about inclining her bed, but I'm nervous about her sliding to the bottom of the crib and ending up in an unsafe position. She will sleep undisturbed for hours in her car seat but that's not great for her spine, I've heard. She'll usually sleep like a dream in our arms (except sometimes when she's crying inconsolably for hours in the evening), but we need to get sleep, too. I'm not feeling comfortable with cosleeping at this time. Does anybody else have a similar situation and have advice on how to help our little girl sleep without discomfort?

We just bought some pacifiers which I am nervously willing to try after reading that it can help keep the acid in her tummy. Her breastfeeding latch is pretty well established, so hopefully it won't interfere. I'm also wondering, how do I know when she's actually HUNGRY if she wants to suck ALL the time? Thanks for your help!

ps - is this the best forum for this? Thanks!

[yentroc]

Hugs from a mama with TWO former refluxers.  

First off, if your latch is established, I really would recommend pacifiers if your LO will take one.  They helped soothe my refluxers tremendously.  

Secondly, sleep is really really difficult for most babies with reflux.  With my first, I just didn't know what was going on, so my dd really suffered (and so did we).  When I had my second, I recognized reflux right away (and his was much worse).  The best thing we did was take him to an OT/feeding specialist at Children's hospital who built him a custom sleep wedge.  It was great.  Before that, the only way he slept was on my chest.  

The other thing I would offer is that the biggest healer of reflux is time.  Both my kids outgrew it by 9 months or so.  Sounds like a long time from where you are, I know, but do know that it will get easier.  

[bk_hope_2_b_mama]

our daughter is almost 11 weeks old and has been very refluxy from the beginning. believe it or not, some of what you're saying sounds familiar to me and has lightened up already - a month ago i was searching constantly for answers to this issue, and i'm already on to other things! we decided not to even pursue medication, and our pediatrician agreed that time was the best cure for reflux. she is still a very enthusiastic nurser, likes to comfort suck often, and wakes occasionally to often with reflux. however, she doesn't seem to be in pain anymore (she doesn't cry or squirm with the spitting up, as she used to) and it somehow seems less dramatic.

we also tried a pacifier (which i was reluctant to do) and she wouldn't really go for it. so if she spits up a lot and seems upset about it, i just put her back on the breast and let her comfort nurse for a while. this often resolves things for her. i also found that letting her sleep on her tummy on my chest after burping her worked really well during bad spells.

in the end, i'm finding it difficult to distinguish what comes first - more refluxy because of general fussiness, crying and gulping air? or fussiness because of reflux? i will say, though, that as her general fussiness has decreased, so has the reflux.

good luck and congratulations on being a new mom! it's wonderful, isn't it? :)

[Carlyle]

Hey, I'm so sorry this is still such a challenge. Yuck :(  As you know, my "solution" to the problem was sleeping with my boob in her mouth next to me in bed and alternating delirious walks around the house with her in the sling to get her to sleep when she was inconsolable and my nips just.couldn't.take.it.anymore...then having dh sleep sitting up in "daddy's chair" (as it is now called) with her in the sling so that he didn't have to put her down.  Because she would wake up if she did.  And then sleeping WITH her at EVERY nap...which served a dual purpose--helped her sleep longer AND helped me be more okay with all the night waking because *I* was getting more sleep.  Slightly.

About the car seat/spine thing....if you're going insane, using the car seat to help her sleep is fine.  Her spine will be okay (she was supposed to be curled up in your womb for an extra 3 weeks anyway).  There comes a point where being so sleep deprived is worse than whatever it is you're doing to help her sleep, you know?  She needs sleep and so do you.  Do what works.  Sleep IS a combat situation.

You might also try cutting out dairy (suck) for a few weeks to see if it makes a difference.  Depends how desperate you are...'cause it takes a few weeks to get out of your system and it might not make any difference at all 

I would also recommend cross posting this on "health and healing" and "life with a babe."  Here: http://www.mothering.com/community/f/45/health-and-healing  and Here: http://www.mothering.com/community/f/32/life-with-a-babe respectively.  (write x-posted in the title and it won't annoy people)  People on this forum are likely too sleep deprived to answer your question .  Good luck sweetie.  I love you.

[Tear78]

Thank you SO much everybody for your ideas and support! Last night was SO much better. She rolled herself on her side so we left her that way and she was so much more comfortable. We figured that if she could roll herself there, then it's probably ok, right? Should we be propping her so she can't roll on her stomach? We also tried the third brand of pacifier and she took it (thank you!) and it seems to help her keep the acid down.

I read somewhere that sitting upright is the worst position for reflux, and it hit me this morning: yeah, she sleeps like a dream in the day in the carseat, but it keeps her upright and slighly curled. MAYBE that was making the acid irritate her system all day so that at night, when she lay on her back, it was really irritating and kept coming up. Yesterday she wasn't in the carseat at all and she slept really well last night between feedings.

Carlyle, I've been sitting in our reclining couch with her tummy-down on my chest and she sleeps really well that way. Now I have to figure out how to do that with the Moby wrap so I can actually more safely fall asleep that way too.

Our doctor said yesterday that he doesn't want to make any changes yet, and that time will be the best healer in this. It helps to hear that by three months she may be feeling better without medication.

Thanks again for sharing your experiences, it REALLY helps!

[Carlyle]

Here are some directions: http://www.mobywrap.com/instructionpages.aspx?Topic=mobyinstructions  I wish we'd done that while I was out there 'cause it's a bit confusing at first, but you'll get the hang of it!  Sorry! ;)

ACTUALLY, do this page first: http://www.mobywrap.com/instructionpages.aspx?Topic=instructionsfolded  then this way: 

http://www.mobywrap.com/instructionpages.aspx?Topic=instructionsnewbornhug

You actually have a "sleepy wrap" which I found a bit stretchier.  If it's too stretchy for you, let me know and I'll send you my didymos wrap, which is (in my opinion) firmer and easier to work with.  Let me know!

Love you,

me.

Alllso, a bit about sling safety:

http://www.thebabywearer.com/articles/HowTo/Positioning.pdf (scroll to the bottom for info on wrap style slings like the moby)

http://sakurabloombabyslings.wordpress.com/2010/03/10/educate-yourself-proper-infant-positioning-in-a-baby-sling/ (with video)

and a quick "checklisty" type thing: http://www.babyslingsafe.com/

Edited by Carlyle - 8/20/11 at 4:24pm

[Carlyle]

AND hooray for a good night last night!  I hope you get many more of them SOON.  MWUH.

[colorbywords]

With the sleepy wrap, I found I have to tie it tight on me, then stretch it out to put the baby in so she's snug enough. We loved our sleepy wrap!

[MommyFirst]

PLEASE HELP ME TOO!  I am in such a similar situation with my almost-10 week old, though with a few differnces.  So...I'll fess up:  I'm a pediatrician, and when my sweet baby girl started profusely spitting up and occasionally screaming in pain first at about 3 weeks of age, I told myself it was just infantile reflux, and that it would get better.  And, it got much, much worse, until she started wretching and actually vomiting (including out her little nose).  As her pediatrician was out of town, I spoke with one of my friends, a peds GI doc, and he said, "Why aren't you treating your poor baby?"  She's been on Prevacid now for about 2 weeks, and it has definitely improved her daytime symptoms.

Here's our dilemma:  we bedshare, and she won't sleep anywhere else.  (So much for the $300 on the co-sleeper...an expensive laundry basket!)  Lily simply won't sleep unless she is snuggled right up next to me, with her head resting on my breast.  Getting her to sleep at bedtime isn't the problem--it's keeping her asleep.  She nurses down, and then wakes up about 1.5 hours later writhing, groaning, and "hitting" me and herself, followed by a big ol' vomit.  She is then completely alert and awake; I have to get up with her, and try to soothe her without nursing, (which just exacerbates the cycle of puking), and we finally fall asleep about 1-2 hours later, just to repeat this again in another 1-2 hours.  I'm exhausted.

I'm thinking that this is happening at night because it is the only time she is actually flat on her back.  During the day, she is in the Moby, my arms, or her swing, and is generally upright.  Does anyone have any ideas of how we could continue to bedshare with her snuggled next to me, but with an incline?  (I feel like the whole head of our bed should be elevated, as I don't want her falling off a normal sized wedge pillow that spans only 1/2 the bed.)  I just have not been able to get her to sleep in the co-sleeper, (which I could use a wedge and elevate the HOB), and I'll admit that having her snugggle with me is one of the highlights of my day. 

I'm also struggling with trying not to get too anxious about this.  I keep worrying about underlying anatomic anomalies that would cause recurrent vomiting, and I have to keep telling myself that this is still likely reflux disease, and nothing that requires testing or surgery.  Yeah, I'm a mess!

[AKChix0r]

I've been looking at getting the Fisher-Price Rock n' Play sleeper - if you read the bajillion positive reviews and don't overuse it, it sounds like it has been a miraculous sleep bringer for a lot of reflux babies.

[NapervilleMom]

Hello! We have the Fischer Price Rock n Sleep and it's O.K. However, I think it's responsible for ds's slighly flat right side of his head. As a refluxer, her prefers to turn right to "get away" from the reflux. We switched to the Nap Nanny and have been pretty happy with it. Also, check out the in crib solutions like "Baby Stay Asleep" and "Tucker Sling". I appreciate the post about the Moby. I can only hold baby boy up so much during the day before my arms need a break! DS is just over 3 months / 1.5 adjusted so we're hoping for some improvement in the near future.

[amberrowton]

I found out my baby had reflux when he was about 3 weeks old.  It was terrible.  He was constantly crying, arching his back and spitting up (vomiting) large amount with chunks in it.  It was also coming out of his nose.  His doctor put him on Zantac which worked for about 2-3 weeks then it quit working.  He then put him on Prevacid which seemed to work but it was a headache trying to dissolve the tablets because they don't completely dissolve.

I had a friend tell me about a compounding pharmacy so I had the doctor call in his Prevacid script there.  It has been a life changer.  The cost of the tablets were over $200 and once we switched to the compounding pharmacy, it is only $50.  The medicine is already dissolved... saves sooo much time.

The medicine has worked wonders for my baby until this week.  He is now 15 weeks old.  I don't know what has happened but the last 3 nights he hasn't been sleeping (which he has never slept all night).  He is up every 2 hours and spitting up all in his crib. He was sleeping his first stretch at least 5-6 hours... now we have regressed back to 2 hours.

I am exclusively breastfeeding and I really try to watch what I eat.  I don't eat dairy, maybe a slice a cheese every now and then, and I don't eat anything acidic.  I went back to work when he was 10 weeks and am pumping during the day... which is exhausting in itself after being up all night.

We did buy the Fisher Price Rock n Play a couple of months ago. I was swaddling him in the Miracle Blanket and having him sleep in the Rock n Play at night in it.  It worked great for a while but we thought he was outgrowing the Miracle Blanket.

He won't sleep on his back, so we put a wedge under his crib mattress and had him sleeping on his stomach, which was working fine, until now.  He will spit up and then wakes up because his face is all in it.  It's so hard getting him back to sleep.  He just grunts and squirms in my arms because his little throat is burning. I try not to feed him because it just repeats the cycle but sometimes I give in so he can have a little drink to soothe his throat.

I tried swaddling him again last night and putting him back in the Rock n Play. He hated being swaddled and cried because he wanted out. I tried laying him in the Rock n Play with no swaddle but he just wakes up because he starts sucking on his hands and hitting himself in the face.... Oh, and he won't take a pacifier.

I just don't know what to do any more.  I am so tired and I know he is exhausted as well. The sitter said he isn't sleeping during the day either.  I know how important sleep is for him right now for development.  What do I do??

I am so torn, my husband thinks we should put him on formula and give him cereal, but I don't know if this will help.

[Jfermdavis]

Amberrowton, I'm so sorry to hear about your situation. I know how stressful it is. We've gone through the same thing, and had luck with weighing her food down with cereal. Whenever she had a bottle we'd add 1/2 tsp (though the doc recommended full tsp) per oz of milk. Then we'd hold her on up for at least 20 minutes after feeding. You'll need to get level 2 or 3 nipples for the bottles, depending on the amount of cereal you add. It does take support from your husband because you may find yourself pumping more for bottle feeding. Unfortunately for a while our girl had a bottle 3/4 of her feedings, but after a couple of months she's better we're back to more nursing.
Best of luck to you!