reflections on reflux

Disclaimer: Please remember that we at Baby Bunching do not have medical degrees and we would never, ever suggest that you take our medical advice (especially that involving medication for your child) without the knowledge and support of your pediatrician.  So read the following advice...and then consult your doctor.

Recently, I had a park play date with a Baby Bunching friend whose youngest child (at 5 months old and CUTE as a button!) broke my heart because I think he may be struggling with reflux (gastroesophogal reflux disease, or GERD, in the medical world).  

I say *may* because I feel as though reflux is the mystery ailment of the baby world.  Linda is convinced that EVERY baby has reflux. This is a theory I would support, but for the fact that my eldest child was literally the happiest baby on the block.  After three children (and half a dozen pediatricians along the way), I'm convinced that even pediatricians don't know definitively.  If it looks like reflux and smells like reflux, they'll encourage you to give the reflux meds a try and see if it IS reflux.

My third baby was "diagnosed" with reflux after a particularly high-stress trip to urgent care over Labor Day weekend when he was a little over a month old.  My husband, who had had just about enough of the constant crying, laid down the law and insisted that there MUST be something wrong with the kid and it was inhumane to "wait and see" until regular doctor's hours on Monday morning.  With little reflux diagnostic technology on hand in urgent care on a Saturday night, the pediatrician on call suggested that we give the medicine a try.  I resisted the idea of medication at first, being the type of person that will walk around for 4 days with a  headache before taking an Advil, and I certainly didn't like the idea of a daily dose of anything for my newborn.  But the doctor insisted that the medication was so safe that it was used on preemies and that we should just give it a try and see if it worked.  

It worked.  Just a few hours later, we had an entirely different baby on our hands, and silence that was music to our ears - for the first time in a month.  

Although my mother had previously suggested the possibility of reflux, I poo-pooed the suggestion because the symptoms didn't "match."  Although the baby was fussy, he wasn't projectile vomiting (and in fact, barely spit up), slept in decent stretches, and was appropriately gaining weight.  He nursed ok (although not great, and did better from a bottle once I introduced it around the 3-week mark).  He was just fussy and fidgety every waking hour. It turns out that reflux has a stealth mode - otherwise known as "Silent Reflux" - that doesn't involve any projectile vomiting, but hurts just as much.  And while most babies grow out of it around the 6 to 9-month mark, it makes for a VERY long 6 to 9 months if not diagnosed and treated.  In addition to medication, we were under strict instructions to feed the baby sitting up (as opposed to reclining), leave him sitting up for 30 minutes after each feeding, and put his mattress at an incline.  As you can imagine, these instructions make for some tricky nursing acrobatics, but we made it work (although now I can barely remember how, in all honesty).

In retrospect, I believe that my Baby #2 had undiagnosed reflux.  To this day, I'm overwhelmed with guilt at the notion that not only was he in pain for months, but I let it mess up nursing.  After going dairy-free myself, and then finally moving through soy and the full range of "sensitive tummy" formulas, we finalIy settled on the uber-expensive Alimentum because it was the only thing his little tummy could tolerate.  With him (and his 18-month old older brother in tow), I was in a Baby Bunching haze, quite honestly.  He could've projectile vomited in my face 10 times a day and it probably wouldn't have raised a red flag.   When I stumbled upon a solution that "worked," I didn't question it - I just went with it. For these reasons, I am on a one-woman mission to save all of my mommy friends and their precious darlings from the hell that is reflux. If your baby fusses all the time or never seems "settled,"  consider this friendly advice to ask your doctor (or an objective friend, or a grandma) about the possibility of reflux.  

You can absolutely try going dairy-free, eliminating other gassy foods from your diet and sampling a variety of formulas, but it can take weeks for dairy to work its way out of your system and in the meantime your baby is fussing his way through the "wait and see" approach.  I will admit that I am normally a big proponent of "wait and see" parenting, believing that kids progress differently at different developmental stages and in their own time, and also that some conditions clear up on their own if left alone.  However, this is one situation where if your pediatrician agrees that your baby may be a candidate for reflux medication, it's worth taking a shot at seeing if it works - for your own sanity and the baby's!

Comments

[Cassandra]

I completely agree with this post. My son had reflux and literally cried the first 6 months of his life away. It wasn't until I had my second child that I realized what a settled, content baby looked like. I do believe all babies have reflux to some degree - some are 'happy spitters' and some appear to be in so much pain it breaks your heart.

I am a Registered Nurse and very uneasy about what I feel is over-labeling/over-diagnosing/over-medicating in pediatric care. But that day at the Emergency Room back when my son was 5 weeks old - after 36 hrs straight of him crying - I literally begged the pediatrician to give us something to ease the pain - for us, and for my son! For what it's worth, we didn't see an instant cure with the medication. We tried three difference acid blocking medications and put him on a specialty hypoallergenic formula and while he settled somewhat, he still was a fussy, pukey baby. Once he learned to sit and then stand, the reflux improved quite a bit. At 22 months old, he still "regurgitates" his food from time to time but diagnostic tests say there's nothing surgical to correct. He's just destined to be a barfy, allergy prone kid. It's a good thing he's so darn cute :)

Having a newborn is hard enough as it is and my heart goes out to any parent of a colicky, reflux baby. If that's you and you're reading this - hang in there! It does get better.

[Amanda]

Thank you for posting this. I still feel guilty that I did not advocate for my son (babe #1) more because in retrospect, I think he was suffering from reflux to the max. We too tried new formulas, change in my diet, special bottles but he still had ongoing reflux symptoms. The non-stop crying was chalked up to Colic by our "new age" pediatrician and we were encouraged to SWADDLE and SHUUSH until the cows came home. None of it worked.
Along come babe #2 less than a year later and from day one when she let out a burp so loud it rattled the hosptial, I knew we were on the same path (babe #1 was still urpy burpy at this point). After a week of notstop projectile spit up, I demaded that our peditrician (we switched by this point)do something. It took a few tries but eventually a compounded version of proton pump inhibitor worked...for both babies. It took nearly a year for my son to get some relief of his reflux. :(

[jespond]

Our daughter was a violent spitter...probably/definitely had reflux...but she was so happy even when spitting out a whole bottle that we never bothered with anything. My son though was happy as a clam, never spit, nursed well, etc....until he started rice cereal. He went all FTT on us and for months barely ate, barely drank. Every dr known to rural Ohio (heh) told me he was fine, some kids are slow eaters, on and on...as I was forcing (LITERALLY) food down his throat as he choked to keep him alive for the first year and a half of his life. Finally around 2 I got someone to let me try reflux meds (after weight checks, high calorie diets, supplements, going off milk (which he is also allergic to), and after developing all sort of behavioral issues. He turned into a different kid--not that it saved us admission into Early Intervention and continued issues even at age 3.5. Because he was in constant pain (and was probably genetically prone anyway) he developed some severe sensory issues. If any of the doctors had listened to me when I started asking for some prilosec or prevacid, he'd likely have not needed as much help as we've had to get him. Including an upcoming scope because he screams that his stomach hurts even still.

In short, don't trust anyone but yourself, even if they hold a medical degree! The kid that doesn't need reflux meds still takes two doses a day.

[Amy]

My 3 month old has silent reflux. It's heartbreaking when we forget his meds. Great post!

[Audrey]

Thank you so much for posting this! I just wish I'd seen it in Dec., my youngest has silent reflux and just got on the meds in feb (at 3 mo age). I gave up nursing and went through all the formulas too. were on soy with a hefty prevacid dose. I hate that she was in so much pain, that it ruined nursing and that we spent so long wanting to stuff ANYTHING in our ears to block out the crying. I mean ANYTHING. I hope others lean from this and dont go thru what we did!

[Sara]

I wish I'd seen a post like this a month ago! My second baby was just diagnosed with reflux at 8 weeks. We had no idea what was going on with her before that -- she was just constantly fussy and unhappy. Our first baby was colicky (aren't we lucky?), but she only screamed from 6pm-midnight and slept and ate normally during the day. I never knew two babies could be so different. Anyway, once we got some baby Prevacid, our little girl has finally been able to get some sleep, and so have we. Seems like a miracle drug!

[Daina]

I am a newbie to this blog, and I am soooo grateful to have found it (thank you to Rookiemoms.com for the link). I have 2 kids, 7 months and 29 months, and have read every post and past post religiously. Thank you!

My youngest has reflux and, like you, I did not know. It was my SIL who heard her after 2 day crying marathon and told me to get the doctor,stat. We started reflux meds the next day and within 3 days, my daughter was a different baby. I'm not a doctor and offer the same disclaimers as you, but I also tell new moms with crying babies to at least explore the reflux possibility.

Again, thank you for your blog. You make a BIG difference in my life!

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