Reflux or Nipple confusion?

[Anonymous]

Hello everyone,

I am a first time mom of a 4month old. JK did not give any trouble for the first 2 and a half months other than a latch on problem in the beginning. I really need some advice about the current situation.

Our ped just told us that our son might have reflux problem. It all started when he was 2 and a half month old, thats when i returned to full time work. First he rejected to nurse from me unless he is sleepy, we thought he got nipple confusion. Thats what the doc also said. So i began full time pumping even at home. But 3 weeks later he got cold and from there on he started to reject bottle too and started to spit up( he never did spit up before other than one throw up when he was 1month old). Its a tedious 2 hr job to make him drink just 3 oz. First he takes abt 1/2oz then pushes the bottle away or start fussing, after that its 2-3sips and the same deal. So once the 3oz is finished about 1 hr later the whole process starts again with a fresh 3oz. We tried changing the nipple, making him very hungry, nothing worked. Only if he is sleeping he takes the bottle very good, and that too may be 4oz at a stretch. Luckily my mom is home and so she takes the patience to constantly feed him because the doc said he needs to get atleast 24oz a day to grow well.

Today for his 4 month shot the doc was also concerned since its been one and half month like this. So he suggested to feed him cereal and if JK rejects that too, get an upper GI test done and if there is something wrong take baby Zantac. But we (especially my husband) are not very keen in exposing the baby to radiation and medicine. But if there really is a problem i wouldn’t mind. Does anybody think he might be having the reflux? Do we really need to get the GI done? His weight and height gain are steady.

I don’t get to enjoy him that much. After coming home i have to pump twice and i want to atleast bottle feed him to be with him, but then since that takes plenty of time i end up giving him to my mom to be fed so i can get other chores done. Do you think he is rejecting me due to nipple confusion or is it the reflux? If its the reflux makes me wonder how come he takes the milk(breast or bottle) when he is sleeping.

Sorry for the lengthy post, but any help will be appreciated.

j’smom2006-2-28 15:44:52

[Anonymous]

Though many dont believe there is anything like nipple confusion, I feel that its possible only during first 6 weeks. You say that its all started after 2.5 months, which could mean that your ds is having some pain due to reflux. A visit to an Lactation Consultant is worth a try, incase you would wish to go back on breastfeeding.

I went for Upper GI though Ped was warning me about radiation. My main concern initially was to rule out any structural abnormality. Once that was ruled out, I could concentrate on her medication part (which Iam still doing!!!). Zantac did nothing for my dd too. I was total waste of time and she suffered first 3 months by staying only on Zantac. Why dont you talk to your Ped about an PPI? They tend to work better.

My dd sleep feeds and she has a aversion towards breastfeeding. I used to pump and feed her in bottle. But, in night, she used to breastfeed without any hitch. I know she is not rejecting me and breast feeding is definitely a source of comfort for any normal baby. Rejection of it only indicates some pain/discomfort and not rejection of mom. Please dont give up, dont take no for an answer.

Glad you found this site..its a life saver for me…

[Anonymous]

Thank you Sangeetha. Yes, i’m also glad i found this site.

I also did not believe in nipple confusion until i experienced it. Well i gave bottle once a day at the beginning (may be thats the culprit) due to latch on problem and then it continued. So he was refusing to nurse once a while even then and we never minded that thinking he is just fussy. But that encouraged my husband and my mom to ask me to bottle feed him more and i gave in once a while. Looking back i think i should have never given him bottle that early. But its after my full time work that he completely rejected me unless he is sleeping. I did go for a Laleche meeting, didn’t do any help, but thats where he got the cold from.

I know its better to get a GI done and know what really is going on. But the thought really kills us. If he really does have reflux problem how long should he have to take medication? Sorry, but whats PPI?

Incase the reflux/structural abnormality is ruled out, is there a forum for feeding questions? Or does this forum entertain regular feeding qns too?

[Anonymous]

Jaya, My dd had nipple confusion in her first few weeks which was corrected (?) by Lactation consultant help and by using nipple shields. The GERD issue came up after this. She underwent UGI at 4 weeks.

Please go thro this Intro Message fr Laura..its has exhaustive info about infant reflux:

https://www.infantreflux.org/forum/forum_posts.asp?TID=853&am p;PN=1&TPN=1

Please take time to read it as its very informative and has so much details about feeding part and PPI too. Laura had suggested about a yahoo group for breastfeeding reflux babies which is really useful for me. Also analyse MSPI issue. I come from a place where cow’s milk is considered next best to breast milk and many babies are still fed with cows milk. I did not believe my dd will have MSPI issue and till now I was in denial state. Now, she is having serious issues and an endoscopy has been scheduled to find out the actual problem. I dont mean to alarm you, but its worth giving MSPI a thought as many babies have reflux due to it.

[hellbennt]

https://www.infantreflux.org/forum/forum_posts.asp?TID=853&am p;PN=1&TPN=1

hi I’m laura and the link above is what sangeetha gave you. Please do not give up on breastfeeding if you do not want to! From the link above there is a lot of information to help you!

I’m so glad you found us!

~laura

[Anonymous]

Jaya,

My son started exhibiting obvious reflux signs right around 10 wks. We knew earlier because my daughter had been through it too. She started showing symptoms around 8 wks. So, it’s not uncommon to not show any signs until this time. Our ped GI says reflux peaks at around 4 months and then starts improving. Anyway, I would try the medicine before the upper GI. Both Zantac and Prevacid are pretty benign drugs, and if you see improvement in 2 weeks you’ll know it is reflux. If not, then try the upper GI. Just my two cents… Keep pumping though because with the right meds he should return to his normal self.

Shannon

[Anonymous]

Thank you very much everybody. Laura’s article is very informative and many thanks for it. Before i was thinking if he has a problem then we can cure it and he will be back to nursing from me when i’m home and from bottle when i’m at work without any of these troubles. But after reading about gerd, mspi.. etc i hope/pray whatever he is doing is not because of any reflux problems, its just another growing phase and i am willing to take the patience to feed him. I don’t want to put him through any of these.

Shannon, do you think i can ask our ped to Rx the medicine first? What he said was to get the GI done, and if there is a problem take the medication. He said Jk doesn’t seem to have any structural abnormalities since he takes 4oz while sleeping and have taken 4 1/2oz when he was 2 month old, at a stretch.

Sangii i know, I come from there too. For us cow’s milk is the next best thing after mother’s milk. And things like mspi is unheard of even in most developed places. I’m also not ready to accept that my baby might have any of these problems, neither do my husband.

I’m really glad to be in a forum where all our questions get answered.

j’smom2006-3-1 10:55:48

[Anonymous]

You can definitely tell your doctor you would prefer to start meds right away. Do whatever you are most comfortable with. I just want you to know that it is very common to start babies on the meds first and then there is never even a reason for the radiation (if it is reflux). Neither one of my children have had upper GIs.

Have you tried elevating the crib? Try that and see if you see any improvement after a few days. Also, keep him elevated after he eats and try not to have him on his back flat much. I let him play in his crib a lot so he’s always elevated.

Shannon – mom to Chase (MSPI, Sandifer’s, 30 mg Prevacid, Neocate) and Taylor (Sandifer’s, 30 mg Prevacid)

[Anonymous]

Thanks Shannon. I’m going to try rice cereal today. I didn’t want anything but breastmilk for him until 6months. But if testing with rice cereal works i better do that than giving meds or doing UGI. If he is spitting up on that too i will ask the doc for meds first.

I elevated his crib from yesterday. Before that sometimes i used to keep a pillow under his crib sheet , so that his upper body will be raised. But both cases after 2-3 hrs he scoots to one end or to the side of the crib. Feels like i need to get a non-slip sheet. Most of the time he spits up when he is upright, propped up after feeding, while burpings or sometimes during tummy time. Only very rarely does he spit up while lying down considering the amount he is on his back. And he never spits up while sleeping. Is that a good sign?

[Anonymous]

My kids didn’t spit up when they were on the back, but you could often see the reflux (they don’t have to spit-up to be refluxing). For example, Chase will suddenly get red in the face and his eyes will tear up and when he was younger he would gag and cough. My daughter would regurgitate. You could see her suddenly kind of chewing on something and then she would swallow, all the while making a “yucky” face. Neither one spit up much while sleeping, but my son will make loud swallowing noises and then whimper or wake-up crying. Like you said, the spitting up mostly occurs when pressure is applied to his stomach (tummy time, sitting, being carried, etc). I’ve probably confused you more than helped you, but my point is that reflux isn’t always about how much they spit up. There are other signs to watch for.

If you do come to the conclusion that he has reflux there are products to keep them angled in their sleep. We bought the tucker sling and wedge and Chase went from 2hrs to 6hrs the first night. It keeps him really propped up and holds him in place. He started turning around the wrong way in his crib. We bought it on ebay, so we got a pretty good deal.

[hellbennt]

here’s from my welcome/intro( https://www.infantreflux.org/forum/forum_posts.asp?TID=853&am p;PN=1&TPN=1):

*Elimination diet (for breastfeeding): http://www.askdrsears.com/html/4/T041800.asp – this is when you eliminate foods from your diet to distinguish what foods may be upsetting your baby. It is very difficult, but it made me feel better because I knew I had tried ‘everything.’ The most common ‘triggers’ are dairy (all dairy including ‘hidden’ dairy) & soy. Jonah was born w/ an immature valve (LES = Lower esophageal Sphinctor (sp?) & while I did find items in my diet that affected him (tomato products, eggplant & tuna- weird I know), my diet really wasn’t an issue, on the whole. This diet can help you determine if your baby has MSPI (milk soy protein intolerance).

Here is a discusion about the elimination diet- scroll through to read all about how others have done this: https://www.infantreflux.org/forum/forum_posts.asp?TID=2852&a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;PN=1

http://www.users.qwest.net/~fsdebra1/wweelim.html all about elimination diet-what to eat & more!

how to reintroduce food from elim diet:(thanksTracy):http://allergyadvisor.com/Educational/December_2.htm Scroll down to ‘C’ orange/mustard box- it’s the SECOND orange/mustard box)

a great breastfeeding resource site:http://www.kellymom.com/ there’s a ‘milk calculator’ where you can figure out how many ounces of expresed milk your baby should be getting http://www.kellymom.com/bf/pumping/milkcalc.html#calculator

here’s about thickening feeds (I personally don’t believe in it for breastfed babies, but please do your own research): http://www.kellymom.com/babyconcerns/reflux.html

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;db=PubMed&list_uids=3806288&dopt=Abstract

http://www.lalecheleague.org/FAQ/ger.html

https://www.infantreflux.org/forum/forum_posts.asp?TID=3546

here’s about starting solids: http://www.kellymom.com/nutrition/solids/index.html

[Anonymous]

Thanks Shannon and Laura. I can’t fully try the elimination diet as somedays i have to feed him the frozen milk. My daily expressed milk is not enough some times for the next day.

We talked to the doc’s nurse. She said they won’t give prescription without knowing what is wrong, so its better to get a Upper GI done. But i read in someother post by an x-ray tech in this forum that the baby may not reflux when the GI is done, so it is not the best option to find out reflux, rather its to see any structural abnormalities. So we are confused again.

I tried the rice cereal, he took it well. 1hr later when he was hungry took about 1oz milk. After sometime he spitup, no idea if its the milk or cereal. Yesterday evening i gave him 2oz similac instant formula. Don’t know if he liked the taste or if he was sleepy he took 1 1/2oz just like that. But to finish the last 1/2oz it was the old routine. And at night he took another 1 1/2oz expressed milk without any probelm. May be he was too hungry after the cooing and screaming. And no spit up. But today morning after an oz of expressed milk he had some spit up. We are really confused whether to get the Upper GI or see if he outgrow this since you mentioned it peaks at 4 months.

The thing is if we spoon feed him he takes the milk. May be he is a lazy sucker, I should try more bottles/nipples. Any insight?

j’smom2006-3-3 11:24:5

[hellbennt]

is eating the only symptom? is there pain? arching of the back, turning red, shrieking, howling, etc?

for a suck problem, I’d see a speech therapist that deals with this- maybe have a swallow study (they watch how he swallows)…

as for a GI, many doctors don’t do it- they go by symptoms…

why are you thickening? to keep the milk down?

not much will help with the spit up- the medicines only address the pain…the thickening *might* help some milk stay down-many have found success with it while others don’t see any difference- again, this is a good reason to have a swallow study…here’s about it: https://www.infantreflux.org/forum/search.asp?KW=swallow& SM=1&SI=TC&FM=0&OB=2

[Anonymous]

I also back Laura’s suggestions. You need to do something for your baby incase he is in pain. My daughter was in terrible especially during feedings and used shriek while spittings. Her first Pedi said she is just fussy and did not give any medicines for one whole month. I had to change number of pediatricians .

Upper GI is not must for prescribing medicines. I chose to have one becoz I was very scared of any structural abnormality since she failed to respond to Zantac. I should have known about PPIs then. Having said that, I do believe that these diagnostic testing are there to help you out and focus your attention to the right direction. I know its very scary that your fragile baby has to go thro’ them.

Please dont ignore if the baby is in pain. Every parent dream about raising their babies medicine-free, but sometimes its necessary to medicate to prevent any damage. There are number of OTs (Occupational Therapists) who specialise in feeding issues and Lactation Consultants who can help you with breastfeeding (including increasing your milk supply).

[Anonymous]

Jaya, I never asked if the spit-up is just milk or if it’s lumpy and foul smelling (curdled milk)? If he is spitting up the curdled stuff, that’s a very good indication of reflux. Both my kids would have bad days where they would spit up the curdled stuff. Once medicated, that doesn’t come up anymore, just milk.

I know a lot of the mom’s have had that 24-hr pH probe test done to see how severe the reflux is. Maybe you should ask your doctor about that in addition to the upper GI. We have never had any tests done, but now they’re talking about an endoscopy at the end of the month – yuck. But the other ladies are right, if these little guys are in pain we must do what’s necessary to ultimately find relief for them.

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