Dr.'s advice… ???

[Anonymous]

Sam is almost 5 months old, and on 30mg prevacid a day, but he still won’t eat unless he is falling asleep. We’ve switched dr.’s (and we LOVE the new one) but his recent advice regarding the feeding issue has me scratching my head. He thinks that until we get sam to sleep better (meaning 8 hours or more in a row) then he won’t start to eat better during the day. He thinks the feeding issue is purely behavioral at this point since the reflux should be under control with that dose of prevacid. We got sam through about 4 nights with no feedings though he did keep waking, and he didn’t eat any better during the day. Even after 10 hours with no food he still didn’t eat much. Now he is worse than ever… he wakes up EVERY hour at night when he used to go 3-4 hours. He is still refusing to eat during the day, and hasn’t gained any weight this month so I started feeding him again at night. He is also constantly whining/fussing during the day which is very unlike him. We have a specialist appt. soon (dr. is still working on getting it earlier) on april 9 just to rule out any other possible issues that keep him from eating comfortably. I don’t think that he’ll be able to sleep like that until he starts to eat more so it seems like trying to put the cart ahead of the horse.

Dr. recommends we let him cry at the night wakings so he will learn to soothe himself, but my dh and I are very uncomfortable with that. Sam has one cry and that is the hysterical one that leads to choking so I can’t tell when something is wrong or when he just wants us.

So my question is…
Those with feeding aversions, what did you do? Did anything help them get over the aversion?
What other factors could be at play here? His diapers are normal, but he is very gassy. I did TED when he was a couple weeks old but didn’t notice anything different. I know that some allergies take time to build up though… I’ve considered doing it again.

Any advice or insight would be appreciated! I am trying to hang in there with the night wakings until we see the specialist. Like most of you, I have a hard time letting him cry if I am not sure that nothing is wrong.

[Anonymous]

What kind of prevacid are you giving him and how are you administering it?

[Anonymous]

solutabs… at least 30 min before a meal morning and night.
livalil3192009-03-24 14:09:25

[Anonymous]

I hope this doesn’t sound harsh, but your doctor is an idiot!

About the sleeping- Your son is likely waking at night because he refluxes. Letting him cry probably won’t help that. I did controlled crying with my non-refluxer and it worked great. But Hailey was like Sam- she woke up hysterical, and then ended up gagging and choking and projectile vomitting all over the place. Leaving her was not an option. I don’t see why your doctor thinks that sleeping more at night will make him more hungry in the day. You should ask your doctor if he sleeps well at night, does he eat more the next day? I can understand the thought process that if you don’t feed them at night they’ll be hungrier during the day. It’s true for typical kids, but not kids with feeding aversions.

About the feeding- It sounds like your son has a feeding aversion. Ask your doctor if he knows what that is. Babies with feeding aversions are so stressed out at the idea of feeding that many don’t want to eat at all. Others can only get relaxed enough if they are asleep or sleepy. It’s not normal, but not uncommon. Not feeding him at night won’ t make him eat more in the day. We were also told at every amount of PPI that Hailey received that her feeding problems were behavioural, that her sleeping problems were behavioural, that she shouldn’t be in pain on such a high dose of prevacid, that her reflux can’t be that bad because it was silent. You name it, we heard it. The truth is, that pain is subjective, and that’s not for your doctor to judge. Sometimes it’s not even pain, but discomfort- imagine if everytime you ate, you had vomit coming into your mouth. Even if it didn’t hurt, it would taste bad and be unpleasant. If you had no other good references for eating, then it might be enough to make you not want to eat at all. The problem with feeding aversions is that often you don’t realize that the reflux is that bad until it’s too late. By the time the med is given correctly and at a good dose, it may work to control the pain, but the expectation of pain is still there. The baby has learned that feeding is unpleasant and doesn’t want to do it.

Once you reach that stage, you really need feeding therapy to get things on track. Our feeding therapist had us keep sleep feeding until she could work on changing Hailey’s perception of eating from bad to pleasurable. She was 8 months old when we started feeding therapy. I was pretty sure that we had the meds down correctly and the pain was better. The problem with solutabs for feeding aversion kids is that they can be hard to time with a meal. If you give the med and then the baby won’t feed or won’t take in enough at the scheduled time, then the med may not work. We found that CaraCream aka buffer babies worked best for that reason.

In any case, our feeding therapist didn’t even bother to change the perception of the bottle. Hailey hated it at that point. She worked on sippy cup feeding and spoon feeding and we went from there. We also had the GI confirm that everything was looking good with an endoscopy and follow us along for weight gain.

It doesn’t sound like your doctor knows what he’s talking about. I’d try to get on a cancellation list for a GI, or ask here to see if anyone can make any recommendations for a good GI and a feeding team.

Hang in there. I found the feeding aversion to be so much worse than the reflux.

s&h’s mum2009-03-24 15:19:02

[Anonymous]

I completely agree with you… we are going to a GI soon. At least if our dr. doesn’t know how to handle a feeding aversion he isn’t being an egotistical jerk and will let us move on… At our last appt. I was in tears and said “how far does this have to go? he’s not gaining weight now, what else do you need?” since the primary reason nobody took us too seriously before was that his weight gain was always great (due to sleep feeding!) and like yours, he is a silent refluxer. Though I think mostly that he doesn’t spit up because he doesn’t eat enough at once. Whenever he does eat a big meal he usually spits a ton immediatly after or even during the feed. This is our second pedi…the first we saw for 3 months and sam only got worse, so after we saw this new dr. only once he said that if sam didn’t respond to a “feeding schedule” then he would send us to the peds GI.

We are going to either Duke Childrens Hospital or UNC-Chapel Hill…from what I’ve heard, both have top notch programs.

You are right when you say that the aversion is worse… It’s so stressful trying to feed a baby that doesn’t want to eat but is HUNGRY all the time! I even tried a little bit of cereal to see if he would go for the food a different way…he just cried. So sad. So I am not doing solids at all until we know what is going on.

So hopefully he will get scoped at least so we can see if there is anything else going on…if there’s not, then I will definitely ask for a feeding clinic referral. Not sure how that would work since he is breastfed, and will NOT take a bottle.

I’m glad that at least we are moving past the “he just needs meds” attitude at the doctors. We did try the bufferbabies and found that the quantity was always an issue and we were running out of it too soon leading to insurance arguments. The nighttime prevacid dose is no problem… He almost always eats before bed because he is tired. The morning does is iffy, but if he refuses the initial meal, then I wait till his first nap and try again. It’s so hard to know if the meds are working like they should be because Sam’s primary symptom was always the feeding issues, and they really never went away, just lessened a little with meds.

Thank you for taking the time to write all that you did.

[Anonymous]

My son actually woul dnot eat his bottle because it was so uncomfortable for his reflux.. He would cry, and would turn away. It wasn’t until we added beechnut baby ceral to his bottle..it had to be pretty thick, but it made it easier going down. If you haven’t tried that you may want to. These issues are so frustrating. Hang in there

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