Baby won’t Eat!

[Anonymous]

I completely know what you ar going through! I have a 4 month old who was born with reflux. She finally got into the specialist after 2 months and got started on prevacid. She seemed to be getting better until the last couple of weeks. She started refusing her bottle, arching her back, and crying. When she does eat her intake is much less, she vomits, and she also seems to turn her head to one side to eat. The doctor ignored it until today because she had been gaining weight okay. I literally felt like i was forcing the bottle on her and she was obviously hungry. This weelk was the worst yet. I called the doctor 3 times and asked for help. The first time they said there was nothing else they could do for her. Then today I got a phone call from her GI specialist partner who scared me half to death. She told me that dehydration was a concern, but I reassured her that she had 4 wet diapers for the day and it was only 4:00. She did not seem to exhibit any signs of dehydration. They wanted me to hopitalize her and put in a nasogstric tube until Tuesday after the hoilday and then they would run more tests. We agreed to keep in eye on her and take her in at any sign of dehydration. Thankfully she has eaten better tonight. We have an appt with her GI specialist on Tuesday and they may do an upper GI to check for anything more serious. I am a first time mom and completely stressed out. It is also putting tons of strain on my marriage. Any advice would be appreciated and my heart goes out to you.

[Anonymous]

Hello and Welcome Arburchett,

It sounds like your baby is in pain from her reflux. Is she on any meds? My first refluxer was never treated properly and she was miserable until she finally outgrew it at 9 months. But, thankfully my second refluxer was treated with a good dose of Prevacid and he did great on it. His pain was gone and he began to eat without a fuss. Please read up on PPI meds and talk to the GI about putting her on one, or raising her dose if she is on one already. The right medication and the right dose really can turn things around.

You can read about PPI meds for infant reflux at http://www.marci-kids.com

Also, be sure to look at Laura’s intro link (stickied in the Introduce Yourself Forum). It has lots of valuable information that may help you.

Sometimes in addition to reflux our babies are MSPI (Milk/Soy Protein Intolerant). What forumla is she on?

Good luck and glad you found us.

[Anonymous]

Thanks for your response. My little one is already on prevacid 2x/day and the doctor says she cant take anymore. She is also on Nutramigen formula weighed down with cereal! I pray the doctor will find out why she is getting worse despite the meds and formula. Please keep her in your prayers!

[hellbennt]

you might just have to fight for higher dose…

http://www.marci-kids.com

Or, at LEAST 3mgs of PPI per kilo…

[Anonymous]

aburchett, most doctors underdose PPI’s in infants because they arent aware of the latest reserach and how quickly they metabolize these meds. read marci-kids.com and share it with your doctor.
your baby is probably not getting better because her prevacid dose isnt high enough to help her.

[Anonymous]

Aburchett (sorry I don’t know your name),

Welcome to the forum. I really feel for you. Unfortunately, we were one of the unlucky ones who developed severe feeding problems and a feeding aversion from the reflux. Hailey was always difficult to feed, but stopped eating willingly at 8 weeks old. After that it was impossible to feed her- she would arch, and scream, and cry, kick, hit the bottle away- and we got into a terrible pattern of sleep feeding b/c that was the only way she would eat. She could go for almost a whole day on just a few ounces, and even those she wouldn’t take willingly. I’m not telling you this to scare you, but I wish that we could have done something different to prevent things (if that would be possible, I don’t know).

Here’s the advice that I can offer:

1. Don’t force feed. I know that seems impossible when they don’t want to eat, but forcing them to eat while crying and refusing by shoving the bottle in actually makes the oral aversion worse.

2. Try to get her on the MAXIMUM dose of meds that she can have. Marci-kids has some guidelines and they’re definitely higher than the conservative amount that most docs like to give. How much is she getting now, and what form is it in? If the prevacid is the solutab, you have to give it on an empty stomach and follow it up with a meal 30 minutes later to make it work. I know that timing meals can be impossible with a baby that doesn’t want to feed, so zegerid might be an option for you to consider. It’s omeprazole, the same active ingredient found in prilosec, but you don’t have to time meals. If your doctor won’t go any higher, and you feel she’s still in pain, you might want to print out the marci-kids information, including the part that says which doctors are on the team, as well as the dosing memo for doctors on the left hand top corner link.

3. What kind of other symptoms does you baby have? Does she choke, sputter while feeding, vomit alot, have trouble sleeping etc.? You might want to consider other testing to make sure that there are no additional problems- some to consider are an upper GI (to look for structural abnormalities), an endoscopy to look for any damage or allergies, or a modified barium swallow- NOT the same as an upper GI- to look at how your daughter swallows and to make sure that she is not aspirating. Given the feeding problems, I would personally ask at least for a feeding study including a modified barium swallow. These are done by speech-language pathologists or OTs who specialise in feeding, and they can identify if there are any swallowing/feeding issues like aspiration, weak anatomy of the mouth/jaw, delayed bolus formation, incoordinated suck-swallow-breathe. They can also make recommendations to correct some of these things if they are identified.

4. Make sure that your doctor understands that uncontrolled reflux is a serious issue EVEN if the baby is gaining weight. Our doctors never were concerned for this reason, and by the time we got the right medical attention it was too late.

I hope this doesn’t stress you out further. Believe me, I understand about the stress of feeding problems and the impact it has on your life and your marriage. The sooner you can get things sorted out, the better to prevent further feeding problems. Good luck.

[Anonymous]

Lori,

Thanks so much for all you support and useful info. I plan on asking for an upper GI on Tuesday this week. I a very unhappy with her care and unfortunatley in Mississippi there are presently only 2 pediatric GI specialists. I am from Atlanta and used to better medical care and options. One doctor is not aggressive at all and the other one wnated to admit by baby for 4 days, insert a NG tube for feeding and wait until after the holiday weekend to do any tests. The NG tube is not necessary due to the fact that my baby is showing no signs of dehydration what so ever and athough she is fighting us on feedings she is taking in enough to avoid dehydration. It was more of the doctor covering themselves than doing what is best for my daughter. I want a thorough GI study done this week to determine why she is getting worse.

Thanks again!

[Anonymous]

Good luck with the GI study and please keep us posted.

[Anonymous]

Just wanted to update. I’ve been offline for a while, dealing with this mess, but Ben is still struggling, though not as badly as last week. I’ve been able to get him to eat a bit longer by waving a toy in his face. He’ll eat, and wimper though the whole time. I hate it, but don’t know what else to do.

He had his 4 month check up today, and his ears are fine and no sign of teething, other than drool. So, who knows… the doctor did up his Zegerid AGAIN, so we’ll see if that helps soon.

I’ve read on here a lot of posts about how bad months 4-6 can be. I pray that’s not what’s going on here. I’m not sure I can stand 2 months of fighting him to eat.

[Anonymous]

if he doesnt improve you may consider switching to prevacid. a lot of babies do better on it than they do on prilosec (same as zegerid)

[Anonymous]

Yes, I think that’s what I would do. If he doesn’t respond the the higher dose of Zegerid I’d try Prevacid. Some babies just do better on one drug or the other even though they are both PPI’s.

I feel so bad that things are still so hard. I hope better days are right around the corner for you and Ben.

[Anonymous]

Hailey did much better on prevacid than prilosec, but I think it was also because we were doing compounded prilosec. 4-6 months was a hard time for us as well, but hopefully you can get the symptoms under control. Can you try mylanta before a feeding to see if that helps to soothe things a bit?

[Anonymous]

We tried the Prevacid for about a month before the Zegerid. It was compounded because I just can’t imagine trying to get it timed right with an infant. Anyway, I never really felt like it was doing the trick for him. The pharmacist wouldn’t compound it the way I asked either, so I don’t know how effective it was. It wasn’t flavored, but he wouldn’t use as much sodium bicarb. as I asked.

We used the compounded Prevacid for my daughter, and while she also struggled to eat and gain weight, she must have had a significantly higher pain tolerance because she never was as fussy as Ben can be. The Prevacid also really constipated her, so I would hate to have that happen again.

We’ll see. He ate great this morning. I don’t know if he was just starving or what, but he even sucked down his Zegerid too. He didn’t eat as well this afternoon, but the arching and screaming aren’t as bad. He just doesn’t seem as interested.

The doctor suggested that he might just be eating his fill really quickly which I guess it possible since my letdown is pretty fast, but he isn’t gaining weight as much as before either.

Arg! Just want this to be over!

[Anonymous]

My ped assured me from birth to age 2 months that the fact that Hailey only sucked for a minute and then pulled off was because I had an overactive letdown and the milk was “literally shooting down her throat so that she’s getting a full feeding in a few seconds”. Neither myself nor my husband could help but laugh at at that one. I did have OAL, but Hailey’s pulling on and off, and only agreeing to suck until a letdown were not due to the OAL but due to the reflux. She was gaining well, and he always used that as a barometer of how things were, but I knew that things weren’t right despite this. She was gaining because she was in so much pain that she was BF around the clock to try to soothe herself, even though she didn’t want eat and pulled off all the time. She wanted the comfort. He finally stopped with this theory when Hailey refused to nurse or bottle feed at 2 months old. Her weight gain slowed and then stopped altogether. I kept pumping, and could see that there was no way that she was getting her fill that quickly, even though I know that she was more skilled at extracting the milk then the pump.

I hope that you can get answers and help soon.

[Anonymous]

Ok, so here’s another question. If the meds. are as high as they should be, and you are doing all you can do to help, is it possible that things will still be bad for a while? Or should I assume that there is something else out there that can be done to help him?

Even though my daughter was on 30 mgs. of Prevacid, she still had the same nursing behavior as Ben is displaying right now. But it gradually got better and she grew out of it at 9 months.

To a certain extent, do we just have to wait it out?

.

[Author]

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