Your baby's reflux symptoms worse with fortified breastmilk? - Mothering Forums

Your baby's reflux symptoms worse with fortified breastmilk?

AmyJeanneBee's Avatar AmyJeanneBee (TS)
09:08 AM Liked: 11
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03-26-2012 | Posts: 42
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Has anyone else experienced this with fortified (only to 22 or 24 cal) expressed breastmilk bottle feedings? I just have a hunch. He's taking Neosure. I'm curious if any other babies have increased acid reflux with the fortifier.
If so, well then I've got to try to convince the doc to take him off fortifier or do I??? His weight gain is excellent with the fortifier so I'm not sure the doc will budge. Anyway, let me know if anyone else has notified this. Thanks!
Bokonon's Avatar Bokonon
09:17 AM Liked: 2222
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03-26-2012 | Posts: 2,948
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Yes, it definitely made my 32-weeker much more uncomfortable and spitty.  


AmyJeanneBee's Avatar AmyJeanneBee (TS)
09:48 AM Liked: 11
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03-26-2012 | Posts: 42
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Quote:
Originally Posted by Bokonon View Post

Yes, it definitely made my 32-weeker much more uncomfortable and spitty.  


Did you take him/her off the fortifier? If so, how was the weight gain? If you don't mind me asking.

Bokonon's Avatar Bokonon
09:52 AM Liked: 2222
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Quote:
Originally Posted by AmyJeanneBee View Post


Did you take him/her off the fortifier? If so, how was the weight gain? If you don't mind me asking.


I did, with his pediatrician's approval, and his weight gain was still great!  He was on expressed breastmilk and then transitioned to exclusive breastfeeding at around 4 months old, and always gained beautifully.

 

I would definitely bring it up with your ped.  Weight gain is important but it's not the whole picture.


AmyJeanneBee's Avatar AmyJeanneBee (TS)
11:55 AM Liked: 11
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03-28-2012 | Posts: 42
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Agreed. My little guy's weight gain is good, he's happy and healthy. I would think we could get off fortifier now but we'll see.

 

So did it take you 4 months from when you brought baby home from the NICU or 4 months from his birth? My guy is getting better but I'm just hoping I can kick my pump out the door sooner rather than later.

 

Thanks for your help. I really appreciate it ! :)


Bokonon's Avatar Bokonon
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Quote:
Originally Posted by AmyJeanneBee View Post

Agreed. My little guy's weight gain is good, he's happy and healthy. I would think we could get off fortifier now but we'll see.

 

So did it take you 4 months from when you brought baby home from the NICU or 4 months from his birth? My guy is getting better but I'm just hoping I can kick my pump out the door sooner rather than later.

 

Thanks for your help. I really appreciate it ! :)



It took 4 months from his birth.  He was in the NICU for 6 weeks.  I had a crazy oversupply (was pumping about 60 oz/day) and didn't know that was a bad thing, so nursing was not pleasant for him for a long time.  Once I got that figured out, we did much better!

 

If the weight gain is good with the fortifier, could you take him off it for a week and track the weight on your own?  I don't normally recommend going against a doctor's orders, but I know that there are so many pediatricians that still think that formula is better than breastmilk, especially for preemies.  And that infuriates me.  ;)  


Cade Ryan's Avatar Cade Ryan
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05-09-2012 | Posts: 1
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Hi Bokonon,

I have a question in regards to what you mentioned about overpumping.  Our freezer is full of breast milk, we've even had to give away food to make room, but the NICU says they're stocked full and she doesn't need to bring anymore for quite some time.  (I'm a father btw, not the mother).  My wife pumps pretty regularly and I've researched high and low about fortifiers and have done some light protesting with our "Dr."  I noticed tonight while visiting that she was extremely irritable, her pulse ox would rise and fall dramatically during her feeding.  Several nurses came in and did their thing and one finally said that she was having reflux.  I noticed some bubbling out of her mouth and gurgling sounds, but no real spit up.  Then the nurse said the doc would probably prescribe zantac.  That sent me over the edge and I had to leave.

 

 Anyway, I'm getting off point here.  My question is what is the problem with excessive pumping and whatnot?  My wife just feels she's doing her duty and even feels guilty if she's too tired to stay on schedule.  Ugh, I'm just frustrated beyond coherency right now with the fortifier and the reflux and whatnot.  She was born at 2 pds 5 oz at 30 weeks and is currently 4 weeks old and is 3 pds 6 oz.  She's done remarkably well with her feedings until recently.  I've also noticed, because I always read the label on the milk that they bring in, that they have increased the % of fortifier.

Sorry, now I'm just venting.  My main question is about the problem with pumping too much.

Thanks!


AmyJeanneBee's Avatar AmyJeanneBee (TS)
08:57 AM Liked: 11
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05-09-2012 | Posts: 42
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Quote:
Originally Posted by Cade Ryan View Post

Hi Bokonon,

I have a question in regards to what you mentioned about overpumping.  Our freezer is full of breast milk, we've even had to give away food to make room, but the NICU says they're stocked full and she doesn't need to bring anymore for quite some time.  (I'm a father btw, not the mother).  My wife pumps pretty regularly and I've researched high and low about fortifiers and have done some light protesting with our "Dr."  I noticed tonight while visiting that she was extremely irritable, her pulse ox would rise and fall dramatically during her feeding.  Several nurses came in and did their thing and one finally said that she was having reflux.  I noticed some bubbling out of her mouth and gurgling sounds, but no real spit up.  Then the nurse said the doc would probably prescribe zantac.  That sent me over the edge and I had to leave.

 

 Anyway, I'm getting off point here.  My question is what is the problem with excessive pumping and whatnot?  My wife just feels she's doing her duty and even feels guilty if she's too tired to stay on schedule.  Ugh, I'm just frustrated beyond coherency right now with the fortifier and the reflux and whatnot.  She was born at 2 pds 5 oz at 30 weeks and is currently 4 weeks old and is 3 pds 6 oz.  She's done remarkably well with her feedings until recently.  I've also noticed, because I always read the label on the milk that they bring in, that they have increased the % of fortifier.

Sorry, now I'm just venting.  My main question is about the problem with pumping too much.

Thanks!

Hi Cade Ryan,

 

I also wanted to reply to your post. I can tell you are pretty stressed. The NICU life is just as stressful for Dads who are trying to take care of Mom and baby. My husband was very supportive like you. My NICU lactation consultants told me to pump every 2-3 hours or 8x a day to build my supply. If your wife is pumping that much too, she's not over-pumping. If she is intending to have enough milk for when your baby comes home she needs to make sure her supply is up enough to meet her intake needs. I have to tell you when a Mom gives birth early I think there is a sense of guilt about it. At least for me there was. Pumping and providing milk was pretty much the only way I felt connected and needed by my preemie baby. It helped ease my mind. That may be why you're sensing your wife is a little crazy about it. My husband helped me with the pumps as he also wanted to feel like he was involved. He helped when I finished pumping. He would take the milk, put it into the storage bags, and clean the parts. Maybe you could do that also? It might make her less stressful and you'll feel involved too. Maybe you're already doing this or you're working so you can't. It is just an idea that might help.

 

As far as the extra milk goes, see if you can find someone with a deep freezer. My in-laws were hunters and farmers so that were able to clear out and clean off a freezer for my extra milk. If your family and friends are like ours, saying "let us know what you need!" then ask them for this. Space in their freezers will help your baby more than another baby blanket or onesie. I wasn't able to breastfeed my preemie after months of trying, numerous lactation consultant visits and with the help of various nursing support devices. I am now SO grateful for all that crazy pumping I did while in the NICU. I now have enough breast milk to bottle feed my baby probably until he turns 1. I am still pumping but only 4-5x a day. So he gets fresh and frozen. These preemies really benefit from breast milk. My son is 13lbs now at 6 months and was born at 1lb 12oz.

 

IF you aren't able to find space for her milk, you can donate it to Mother's Milk Banks. They would be so grateful to have preemie Mom milk. It is like 24k liquid gold.

 

Oh and regarding the reflux. Acid reflux doesn't always cause vomiting or spit up. There is such a thing as silent reflux. How you may know it's reflux- Your baby's breathing will be all funny after eating. She may arch her back and cry. My son's ox. levels got very low one day because of reflux and he had to go on Previcid. I struggled with it too as I'm a crunchy, hippy Mama. I felt when it came to his breathing and nutrition, I would allow him to be on this medication. It is very common in the NICU when baby's have an n.g or o.g tube keeping their esaphogus (sp?) open. So far the prevacid has not had any negative effects on my baby, ONLY positive. Zantac is a faster acting reflux medicine and prevacid takes a few days to kick in.

 

I hope I've helped your question. If you have any others, feel free to send me a message. You sound like a great Daddy! Best wishes to you and your family.


Ratchet's Avatar Ratchet
11:00 AM Liked: 485
#9 of 10
05-09-2012 | Posts: 617
Joined: Mar 2011

In reply to Cade Ryan-

If they increased the amount of fortifier, I see that as likely meaning she really needs it.  If she still has an NG tube in place, that can be a big contributor to reflux, as is prematurity on its own.  Our DD (born at 27 weeks, home at 39 weeks) came home with medication for reflux and an NG tube, but once we took out the NG we stopped the med.  It could be the neosure, but not necessarily.  These babies have such increadible nutritional needs, and it's so much work for them to feed, that I think for most really early preemies fortifier is needed.  One other option is throwing out foremilk (which is more watery) and feeding just the high fat hind milk, but it's less predictable and I don't know if that accomplishes their goals for vit d, iron, etc. 

 

I have a chest freezer in my garage filled with milk, and have already donated many gallons to Mothers Milk bank in Ohio.  My daughter finally caught up to how much I was producing by about 7 months (4 mo past her due date) and now I appreciate having a little extra although I don't have to use it often.  But it was all the pumping early on that made it possible.

 

Everyone is different with their needs for pumping.  I ALWAYS allowed myself a 6 hour stretch at night [and I think EVERYONE should allow themselves that, unless their supply tells them otherwise], but still kept my total at 8 times per day.  I gradually decreased frequency, checking in on the total volume to make sure that didn't decrease.  There was a while I could pump only 4x/day and still get the same amount as when I was pumping 8x, but I can't really do that anymore so I try to stick with mostly every 4 hours.  My daughter is getting just pumped milk in a bottle, so that changes stuff too... baby at the breast works better than a pump. 

 

The closer we got to discharge, the crazier I got.  DD never had any BIG ups and downs, just the usual, and early on I could tell myself that none of these setbacks were making us stay any longer anyways.  It was all stuff that wasn't life threatening, was common NICU stuff, and was fixable.  Once it was the last few weeks before discharge though, every failed feeding attempt, every time they had to increase the oxygen for her nasal canula/ cpap whatever, everything was a delay in leaving and it killed me.  So, you may get crazier before it gets better.  But then you get home, and she's all yours, and you can fortify or not, give meds or not, and only have to explain yourself to your Dr at your appt's every few weeks/ months/ whatever. 

 

Good luck.  I'm sorry.  Just survive.


mom2tig99Nroo03's Avatar mom2tig99Nroo03
10:47 PM Liked: 13
#10 of 10
10-24-2012 | Posts: 9,343
Joined: Apr 2003

mine was on hmf and then neosure for fortification in the beginning, and it made his reflux quite a bit worse (not silent reflux, we're talking  throwing up a LOT of the feed reflux) he didn't not do this with straight milk.


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