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Reflux vs. OALD???  

post #1 of 10
Thread Starter 
Hi all,

I've read the responses to the thread about severe reflux and I'm still not sure whether my DD is suffering from reflux or OALD on my part or both...I'm wondering if some of you wiser mamas may be able to offer some insight. Unfortunately, my ped., while very well-meaning and nice, is not terribly savvy about bf'ing, etc. I'm in the process of finding a new one, but for the time being my LO is suffering and as a result so am I!

Here's the situation. The main problem is that after (either immediately and/or 1-2 hours later) bf'ing, DD screams and cries and stiffens and arches her back...clearly in pain. She is miserable near the end of a feeding, frantic, coming off the nipple and back on and screaming. She did this in the doctor's office at her 2 mo. exam and the doctor prescribed Zantac and Reglan, which she's been on for 10 days now, and don't seem to be doing anything. The doc's only other suggestion was putting rice cereal in pumped milk, but I won't do that after reading all the info on here (thanks, mamas!!!).

Also, for the first couple weeks of life, DD would projectile vomit every other day or so, now it's down to about once a week. It seems like she's not digesting well because she'll throw up everything she ate even hours after eating. Usually, she projectile spits-up (i.e., a lot more than a "normal" spit-up but not quite vomiting) after every feeding (without regard to how much I burp her - in fact, burping seems to make it worse). I thought the vomiting was a milk sensitivity, but I've cut out dairy and it doesn't seem to make a difference.

She also doesn't really "nap" because if I put her in her bassinet (she has the inclined sleep positioner) or our bed she gags and chokes and starts crying, either immediately or after a few minutes. She will snooze briefly in my arms or her swing or papasan chair or car seat where she's more upright. For some reason, this doesn't happen at night when she is swaddled and she sleeps great at night (usually 6-8 hours) in her bassinet or our bed. But the lack of napping is making both of us cranky!

I already met with an LC at about 3 weeks old and she diagnosed our problems as OALD and just said to keep the baby's head positioned above my breast, which I do. But, DD seems to have adjusted to the milk flow, at least as far as her latch and sucking are concerned, and the let down doesn't really seem to phase her now...she just keeps going, seems content and eats a ton and then is miserable at the end, but not in the middle.

By the way, she's gaining weight really well and otherwise is very healthy, but I can't stand to see her in such pain and for bf'ing to be such an unhappy experience for both of us. It's such a difficult experience that I can never NIP.

Any thoughts? TIA!!
post #2 of 10
I had OALD and will be back to explain how I knew we had it. it is hard though

OK my first indication of overactive letdown actually wasn't until I had ds2. and that was because every time he latched on he'd come off coughing, and my milk would spray EVERYWHERE. he had bad gas. even if I burped him as much as he could he'd still toot a lot later, and even cry from it.

ds1...exhibited no obvious symptoms of OALD. when he latched on that was IT there was no unlatching until he'd had his fill. even if it killed him. near the end of the nursing session he would arch back and cry. he would unlatch and relatch. he would nurse until he would throw up massive amounts of breastmilk. the one thing that should have told me something is that he had NO problems whatsever eating EBM. just nursing.
post #3 of 10
Thread Starter 
Thanks CalebsMama05!

Sounds much like our situation...so what do I do now? I've read about OALD online and it says to keep the baby's head above the breast (I am) and to take the baby off the breast during let down (my baby screams bloody murder if I take her off for even one second). Any other suggestions?

Thanks!
post #4 of 10
Quote:
The main problem is that after (either immediately and/or 1-2 hours later) bf'ing, DD screams and cries and stiffens and arches her back...clearly in pain. She is miserable near the end of a feeding, frantic, coming off the nipple and back on and screaming. She did this in the doctor's office at her 2 mo. exam and the doctor prescribed Zantac and Reglan, which she's been on for 10 days now, and don't seem to be doing anything. The doc's only other suggestion was putting rice cereal in pumped milk, but I won't do that after reading all the info on here (thanks, mamas!!!).
That sounds like reflux. OALD usually shows immediate symptoms at the beginning of a feed, plus sometimes you get a gassy baby with green stool. Reflux causes pain between feeds and at the end of feeds because the stomach fills up and starts refluxing. There are many causes for reflux. Zantac is only the first med to try. If you want to know if it's really reflux, try giving like 1/2 teaspoon Mylanta a few times a day and see if the baby gets better. If so, it's reflux and a stronger med is needed like Prevacid/Prilosec while you figure out what might help in the long run (change of diet, elevation, frequent burping, smaller more frequent feedings).

If you have OALD try to get some control on the milk by using the same breast for several feedings in a row, allowing the other one to get a little full. Then switch to the other breast and let the first one get full. Usually you will use the same breast for a few hours by the clock. Also let down into a towel and then after the first letdown, nurse the baby.

Good luck to you!
post #5 of 10
Quote:
Originally Posted by USAmma View Post
That sounds like reflux. OALD usually shows immediate symptoms at the beginning of a feed
That's what I was going to say.
post #6 of 10
Thread Starter 
Hmm, I'm thinking that we're dealing with both reflux and OALD since my lil peanut has symptoms of both...good times!
post #7 of 10
Quote:
Originally Posted by swtpesq View Post
Hmm, I'm thinking that we're dealing with both reflux and OALD since my lil peanut has symptoms of both...good times!
that's what I was thinking about my firstborn. poor kid. and I just got told it was colic
post #8 of 10
you can have both at the same time, can't you?
post #9 of 10
yes, you can have both at once (or even throw allergies in too! ). And to me it sounds like both OALD and reflux. Especially if babe takes pumped milk well.

If you feel like you've got the OALD under control, then focus on the reflux itself. If not, work on the OALD first and foremost, in case it's the largest contributor (just my opinion- I had reflux and allergies, no OALD with mine).

Make sure your Zantac dosage is at working levels - it's often prescribed at or below the working dosage, unfortunately.
post #10 of 10
Quote:
Originally Posted by elanorh View Post
yes, you can have both at once (or even throw allergies in too! ). And to me it sounds like both OALD and reflux. Especially if babe takes pumped milk well.

If you feel like you've got the OALD under control, then focus on the reflux itself. If not, work on the OALD first and foremost, in case it's the largest contributor (just my opinion- I had reflux and allergies, no OALD with mine).

Make sure your Zantac dosage is at working levels - it's often prescribed at or below the working dosage, unfortunately.

Dosage is KEY. It sounds like the pain isn't under control so get thee to a Dr. and get that sorted out. A quick phone call can determine if she's on the higest dosage possible, if not, try upping the zantac. Or, consider other medicines. Some babies will acclimate to zantac very quickly (can happen in less than a week) and just need different meds. www.marci-kids.org has good meds info.

ETA: To help determine whether it is still pain you can always try a few doses of Mylanta (heartburn med). If it makes a difference then you'll know that you need to go further in correcting the meds/dosage. I don't have specifics on that but other mamas can give you more specifics.
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