Reflux Help

[2moms2b]

Both boys have reflux we are trying to treat but so far no relief. Sam is a happy spitter as in he spits up almost his whole bottle at least 3 of his 6 feedings. He doesn't get too upset but refuses to eat anymore once this happens. Jacob appears to be in actual pain from it and screams through his feedings. Plus he seems to spit up and swallow it in between feedings then screams.

We have tried meds from week 8 to yesterday with no luck so now the ped wants to try cereal. I am not sure I want to introduce cereal in their formula at 10 weeks. Anyone have any thoughts and/or experience?

[ssg73]

Ella had silent reflux (silent as she didn't spit but boy did she scream). Things that worked for us were feeding her sitting up and facing us it is how we were taught in the nicu since she refluxed so badly it caused her to spell (stop breathing/drop heart rate). I will see if I can find a picture of what it looks like. It also allows you to watch their feeding cues and pace them so that their feeding is more organized. We also had her in her bouncy seat after feeding and she actually slept in it for a long time (months) because she could not sleep on her back with out being pain. She was o n meds and it helped quite a bit. What are they on? Did it seem to help at first? If they worked at first they may have outgrown their dose so if they have gained weight and the dose has not been adjusted. Also most pedis are very conservative in dose and type of meds for reflux. Since so many preemies have reflux (due to having feeding tubes for so long) they treat it more aggressively for the most part. If the med you are on is not working there are others to try. I would guess that they are on xantac but many babies need a stronger medication such as Prevacid. Also have you tried switching formula. It could be a food sensitivity issue as well. Several of the preemies on my preemie board have corn sensitivities which is in many formulas. There are quite a few choices in formulas so check with your pedi to see if they think a change might help.

[2moms2b]

Thanks! We do feed them both sitting up and try to pace them the best we can and moved them to gentle ease 3 weeks ago from similac advanced. Jacobs is definitely silent so harder to "see" other than the screams. They have us on Zantac and while I feel like it may have worked the first couple of days Sam would still spit up and Jacob would still scream just not every bottle. Now I see no difference. They also sleep in rnp and we keep them upright for at least 30 min after feedings. While I love our ped I feel like she really is anti meds if there are other ways such as cereal. My issue with cereal is while yes they are almost 10 weeks their adjusted age is only just over 5 weeks and I am worried it will mess with their digestion. When I brought this up she said its such a small amount 1tsp per 2oz that they should be able to digest it easily.

I might ask about the dose and weight as I know Jacob has gained a pound since we have seen her while Sam is pretty much still at the same weight. My biggest concern is Sam as he fell percentages on the adjusted chart and spits so much up each day. I just don't want to have an issue with weight gain with him.

Is there a better formula for them based on your experience? Our ped said gentle ease should be fine but the first ingredient is corn syrup.

[ssg73]

let me talk to the preemie mafia. I pumped for E so I was using fortified bm. I did see a change in E once we stopped adding formula to my milk though. Oh the rnp is awesome. It came out after E was a baby. I saw it and was like omg I so needed that.

[ssg73]

What gestation where they when they were born? Late term preemies often have issue kind of pop up later since they don't have big ones when they are born.

[ssg73]

From Trish who knows reflux like the back of her hand (son had horrible reflux and ended up needing get a g-tube)

Usually the first stop is to switch to something not-milk based. Usually soy.
If that doesn't help, they'll go hypoallergenic (usually nutramigen or something similar.)

I would also encourage her to try Good Start because it's not corn based.


She also needs better reflux meds. Zantac is a pretty wimpy med. I'd ask for prevacid.

Also if you would like to join us (we have late term to micro preemie moms in various stages) go to thepreemiepalace.com and say Sam sent you. (it is a private board and we screen)

[ssg73]

I am just copy/pasting their comments

Parent 2: (twin mom) We used Good Start. It was a HUGE improvement for us. The proteins in it are broken down so it's a lot easier to digest compared with other milk-based formulas.

Also, Zantac isn't a very strong reflux medicine. They will probably have better luck with something more potent, like Prevacid or Nexium (we used Prevacid). Of the 2 Prevacid is easier to administer, so I'd suggest it over Nexium if it works and/or is better covered with insurance.

Mom 3: FWIW Evan's x-pedi said that if babies have a problem with dairy protein, there's a 70% chance they'll have a cross sensitivity to soy. I'd try the good start first as trish said. Not only does it eliminate corn, but it also gets rid of caesin which is the harder to digest of the dairy proteins, it uses 100% whey, the easier to digest dairy protein.

first line hypo allergenics are nutramigen and allimentum, I don't know why, but just an observation that I know more kids who've been successful on nutramigen.

Evan couldn't handle any of the formulas but pregestimil, it was corn and dairy free. He wouldn't drink it by mouth though due to the taste. Of course he was hard to get anything in his mouth at that time, so maybe if he were an infant used to eating orally he would have??

I can't remember how long it takes for zantac to start showing help. I'm pretty sure prevacid is 2 weeks. Just so she knows to not look for improvement right away.
oh, and Evan couldn't handle the fortification, nor the poly-vi-sol they wanted him to be on. All they did was make him puke more and retain less nutrition over all. He did do better on dividing his poly vi sol dose into smaller bits given throughout the day. If they're on it they could try that.

Keeping upright for at least 30min post meal.

If they're twins, I'd wonder if they're being held while being fed, gulping air will creat more trouble too. Burp often during a feed. Smaller feedings more often can help too....none of which is easy on the parent though : (

[2moms2b]

This is awesome info! Thank you soooo much!!!!!

[2moms2b]

Oh and they were born right before 36 but I had steroid shots at 33 so they didn't need assistance at birth other than with temp and sugar.

[twomoms2twins]

2moms how early were they again ? I second everything SSG said and the post she refereed you to while in the NICU we learned a lot and we are still friends with our NICU NURSE we lover her. We did not have reflux issue but know a ton of preemies and micro preemies who do. Good luck and keep us posted and the cereal is recommended a lot

[quinny]

N had horrible reflux for over 6 months. He never slept longer than 20 min. All day and all night. We went to children's gastroenterologist, were in meds, tried cereal, no BFing, every type of formula and I restricted everything I ate. The only thing that worked, the only thing that calmed his purple faced, back arched screaming and allowed him to sleep for a whole hour was Colic Calm. It's a homeopathic mixture. We went through gallons. Both my pedi and the GI dr said it was fine (though I'm sure they had no idea we were single handed keeping them in business). It was an honest to goodness life saver. He was on Zantac and the next med up. They did absolutely nothing for him.

It's the only FDA approved gripe water. It's worth it's weight in gold, in our case www.coliccalm.com/

[hensmum]

You've been given awesome advice here - just wanted to add more encouragement to stick to your guns about the cereal. It can be a choking hazard. Good luck!!

[2moms2b]

Thanks Quinny for the colic calm tip. I didn't know that existed! And thanks for the support Hensmum! This is getting so frustrating.

[2brides]

We went through gallons of Gripe Water (sounds similar to the colic calm.) It really really helped both kids.