HELP!!

rnfsuper08

it's been a rough night! DS has been on Ranitidine since 1/31 for acid reflux and this was helping to ease the pain but in the last week he has been very fussy and vomiting more at night. I emailed our pedi yesterday and he suggested we just up the dosage slightly (most likely to accommodate his weight gain) and to give it before his feeding (we were giving it to him during his feed) so we did this last night and it was a complete FAIL. The cries he has are awful and I can tell he is in pain and nothing I did could soothe him. He is ok during the day but his last feed he would take, then fall asleep for 30 min-hour before waking up in pain and then this would continue for a couple hours. I would hold him upright for 15-20 minutes before laying him down. He is still in his bassinet and it is elevated. I also started the level 2 avent nipples earlier this week but I went back to the #1.  Does anyone have any other ideas or advice? DS gets BM during the day and formula in the evening and all night feedings. Before he was diagnosed I used to alternate BM and formula at night and he still had the AR. DS will be 11 wks tomorrow. Sorry for writing so much but I wanted to include as much info as possible.

andoolittle

Breastmilk has a natural antacid in it. He is probably in more pain at night since you are giving him formula which lacks the natural antacid. Can you breastfeed at night or give him a bottle of pumped breastmilk? Switching back & forth is really not good on their stomachs/digestive systems. I dont mean to sound like a know it all....but I am a neonatal ICU nurse so I've got quite a bit of experience with newborns.

rosiemomma

I agree with PP is there anyway you can up your pumping to try and wean off the formula?

from kellymom:

What can I do to minimize spitting up/reflux?Breastfeed! Reflux is less common in breastfed babies. In addition, breastfed babies with reflux have been shown to have shorter and fewer reflux episodes and less severe reflux at night than formula-fed babies [Heacock 1992]. Breastfeeding is also best for babies with reflux because breastmilk leaves the stomach much faster [Ewer 1994] (so there?s less time for it to back up into the esophagus) and is probably less irritating when it does come back up.The more relaxed your infant is, the less the reflux.Eliminate all environmental tobacco smoke exposure, as this is a significant contributing factor to reflux.Reduce or eliminate caffeine. Excessive caffeine in mom's diet can contribute to reflux.Allergy should be suspected in all infant reflux cases. According to a review article in Pediatrics [Salvatore 2002], up to half of all GERD cases in babies under a year are associated with cow?s milk protein allergy. The authors note that symptoms can be similar and recommend that pediatricians screen all babies with GERD for cow?s milk allergy. Allergic babies generally have other symptoms in addition to spitting up.Positioning:Reflux is worst when baby lies flat on his back.Many parents have found that carrying baby in a sling or other baby carrier can be helpful.Avoid compressing baby?s abdomen - this can increase reflux and discomfort. Dress baby in loose clothing with loose diaper waistbands; avoid ?slumped over? or bent positions; for example, roll baby on his side rather than lifting legs toward tummy for diaper changes.Recent research has compared various positions to determine which is best for babies with reflux. Elevating baby's head did not make a significant difference in these studies [Carroll 2002, Secker 2002, Craig 2004], although many moms have found that baby is more comfortable when in an upright position. The positions shown to significantly reduce reflux include lying on the left side and prone (baby on his tummy). Placing the infant in a prone position should only be done when the child is awake and can be continuously monitored. Prone positioning during sleep is almost never recommended due to the increased SIDS risk. [Secker 2002]Although recent research does not support recommendations to keep baby in a semi-upright position (30? elevation), this remains a common recommendation. Positioning at a 60? elevation in an infant seat or swing has been found to increase reflux compared with the prone (tummy down) position [Carroll 2002, Secker 2002].As always, experiment to find what works best for your baby.If your child is taking reflux medications, keep in mind that dosages generally need to be monitored and adjusted frequently as baby grows.

https://www.kellymom.com/babyconcerns/reflux.html#help 

rnfsuper08

Before the meds I would give BM at night and he would still be in pain. Pedi wanted DS on some formula and I only make about 2/3 of what he needs even on fenugreek, oatmeal and those milk teas. However I will save some BM for the next few nights and see if this works.