Hi. Thought the allergy forum would be the best place to post, since GERD, eczema and allergies are so closely related...and I'm guessing lots of people have experience here with both. I've searched the threads and couldn't find one that seemed close enough to our situation. Sorry if this is long. I'm not sure where else to turn as we live in a small town with one crappy pediatrician who I refuse to see. I'll be seeing our family GP next week about this....but I want to be prepared and researched first. There is no such thing as a pediatric GI in our area....would involve an 8 hour car trip, so this is not an option. I've also checked out some of the forums on infantreflux.org
dd2 has GER...and I'm suspecting GERD. Has not been physician diagnosed yet....but I suspect they will diagnose it based on clinical symptoms (more on this later). Currently napping upright in the ERGO on me (the only place where she'll nap more than a few minutes it seems. Too bad she doesn't like it when awake too).
dd2 is 7 weeks old, EBF and gaining weight well. Since week 1 has had a rash on her face, ears, chest. Midwife said it was just a normal newborn rash. However, it got really bad by about 5 or 6 weeks and then scaly,crusty in patches (looked like eczema to me) - nasty patches on her eyebrows and ears. She seemed super itchy (always rubbing her face on anything it touched). I started off by treating with humidifier, warm washcloth wipe followed by olive oil. Moved onto a moisturizer (KEYS luminos or tortuga www.keys-soap.com ) - helped a tiny bit but not a whole lot. Then it dawned on me that I should try eliminating dairy from my diet. Within a few days I noticed the rash starting to clear and her skin getting softer. HOWEVER, this is also the time when I upped the intensity of moisturizing (3-4 times/day washcloth wipe followed by application of thick layer of KEYS moisturizer. I had a couple of slip ups in the diet (lactic acid and butter flavour in a sauce) and ate food cooked in butter at a christmas party...the following days noticed some new rash starting. I still notice little patches of scaly red areas throughout her body, but they're pretty mild and I can clear them up with spot moisturizing...which makes me think it's just a dry skin thing. Currently her skin looks mostly great - the softest it's been since birth.
The jury is still out on the dairy allergy/intolerance thing as I have only been off dairy 1.5 weeks, had a couple slip ups. I will continue on a strict dairy elimination diet for another couple of weeks and then evaluate the results. I chose to do only dairy first (instead of soy and egg also) as I wasn't convinced we could do all 3 top food offenders without cheating. If I'm going to do it, I need to do it right (to be scientific enough to draw accurate conclusions)....but will probably try eliminating soy and possibly eggs next, depending on how things go....
Now...the GERD or GER (reflux): dd has been a big spitter since birth. multiple times after every feed, often an hour or two later (and the spit up sometimes smells like vomit). The only positioning that seems to help is being completely upright (in Ergo or wrap...which she ONLY likes when already sleeping!). Tummy napping on top of me helped her sleep more deeply, but she still did spit up on me a few times. I think tummy sleeping would help...but I'm too afraid to try it yet, as dd doesn't seem to be able to fully lift and turn her head when on her tummy )she often just squishes her nose into whatever she's on, instead of turning her head to the side.
Other symptoms include: silent reflux and coughing, often followed by stridor and wheezy/gurgly breathing. At night (co sleeps with me on her side) will sound congested in her upper respiratory tract....although she can still breathe through her nose fine. We sleep on a waterproof pad/cloths so I don't have to change the bedding 3 times/night! After a spit up or silent reflux (especially the ones that have been sitting in her tummy a while), she will often (but not always) look upset and even start to cry. She frequently arches her back, especially when being picked up from a seat, bed, etc. and will take a while to settle over my shoulder. Throughout the day, she will fuss, worse when on her back....though she is generally consolable. This gets worse in the evening. Wants to nurse all the time it seems...but after the feeds is not settled. Yet sometimes she is perfectly happy to play on her back (until she starts spitting up it seems...). She seems to enjoy diaper changes.
Also has mucous in her stool and the colour is normal mustard colour. Some BM's have been looking like runny yellow snot! No blood though. Again, my midwife said some mucous is normal....unless it is in big globs separate from the stool. I'm thinking the mucous is from all the re-swallowed regurgitate?
Sleeps poorly when alone in bassinette that is elevated (swaddling helps a bit)....although when with me she will sleep a 3-4 hour stretch (have had an occasional 5 hour stretch), followed by another 2...and occasionally another hour or 2 - though she won't stay asleep later in the night unless latched on. Not stellar...but definitely better than some babies!
Have also done some feeding modification (I have a fast letdown and ample milk supply) including feeding positions to decrease choking on milk and ensuring breast fully emptied (so she gets enough hindmilk). This has made no difference whatsoever in her reflux...but has made her less gassy (not gulping so much air or lactose in the foremilk).
She is obviously experiencing some distress (but then I wonder if this is normal fussing/fatigue as it's not all the time....yet she doesn't seem quite as happy a baby as my dd1 was). It's just a "gut" feeling that she's in pain from the reflux as her fussing does seem to be worse after spitting up or a silent reflux episode.
Now the BIG question. Do I medicate or not??????? I'm not certain I can wait for the results of elmination dieting....nor am I convinced that the eczema and reflux are related - I suspect 2 separate issues as there has been ZERO improvement in reflux since being dairy-free, yet an improvement in eczema. In fact, the reflux has gotten worse. I think her LES is simply immature/malfunctioning. I'm so afraid of this progressing and causing permanent damage to her esophagus and airways (we have a family history- my dad and brother, with GI problems, diverticulums, IBS, h pylori infection, etc....but fortunately I don't have this....I was breastfed 11 months - long back in the day!). Yet I'm equally afraid of the medications permanently altering her gut flora and putting her at risk of other problems, including autism, GI illnesses, pneumonia, etc.
Wise ladies with GER/GERD babies- please share your insights! What would you do? Is it bad enough to medicate? My appointment with GP is next week....around the time I will have been dairy free for 3 weeks (long enough to evaluate results I think). Thanks for reading this far :-)
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