The dreaded reflux

nikkiuk · May 2014

Hi ladies,

I could have sworn there was a thread on reflux in here somewhere but I seem to have lost it. Anyways, I was talking with one of our primary care night nurses last night and she mentioned that she thinks LO's reflux needed to be watched. Not in a scary OMG kinda way but she thinks it's a little worse than the doctors realize. She said she spoke up yesterday about it but wasn't sure they took much notice of her. Two hours or so after a feed yesterday, he spat-up and it was yellow which, she said, must be stomach acid as he is on formula and yellow spit-up would only be normal if he was being fed breast milk. She has elevated his crib so he isn't lying flat and puts him down to sleep on his tummy or side.

I know reflux is super common in preemies but I wondered what doctors have said to other mom's? All that has ever been said to me (other than last night) is that he will grow out of it, probably before we leave the NICU.

Also, I take Omeprazole for GERD every day and have done for years after my stomach was wrecked from taking Chantix when I stopped smoking. My OB said it was fine to continue while I was pregnant but I wonder if LO's tummy was used to that drug and now it's gone the acid is building - as it does if I stop taking it. Obvs I'm no doctor but that was just a thought that crossed my mind.

nikkiuk · May 2014

Ah see nobody told me that sucking on the bottle and paci will help nor that the feeding tube makes it worse but that totally makes sense. Man, I hate that feeding tube so much. We haven't had any real success with bottle feeding and he while he sucks like crazy on his paci, he only lasts a minute or so before spitting it out and then he won't take it again for a while.

nikkiuk · May 2014

Totally. We have a care meeting next week so I'll certainly be raising it then. I'll speak to some other nurses in between now as then as there is little chance we will see a doctor before next week. It's interesting that only one nurse has seen this as a potential issue so I really need to see if she's being overly cautious (which is fine) or she's absolutely right and there is a little issue there that needs to be addressed. It's nice to know that babies can take a simple med like Zantac or Omeprazole to relieve the reflux as it really does suck.

nikkiuk · May 2014

Great advice ladies, thank you

Mcsweets · May 2014

DD is on omep as well - she was in a lot of pain before taking it. She is 5 months now and still hasn't grown out of it. We just stick it in a level 2 nipple and she sucks it right out!

scubagirl81 · May 2014

So common in preemies! DS (7 months actual/5.5 adjusted) has reflux too, they told us he was just a spitty baby, but it turns out he has milk protein intolerance in addition to his reflux. We kept asking them in the NICU and they said it was normal. After we got out, we started working on getting some better answers (we were only there 8 days), and now DS is on soy formula, gas drops (they do help with the spitting too), thickened feeds with rice, and zantac. If you think something is wrong, trust your instincts and keep pushing!

nikkiuk · May 2014

@scubagirl81 - I've been thinking about some kind of intolerance for a few days. He seems uncomfortable when he feeds and I seem to be the only person who notices it. My instincts are ringing alarm bells and while I generally trust them, I'm kinda aware that I may well be working this up into a far worse situation than it really is.

I had an absolutely horrible evening in NICU last night and I was seriously on the verge of just bringing LO home. The nurse wasn't one of our usuals and I found her to be less than friendly, there were a stack of new babies in with alarms going off constantly all around us. Then they brought in a really tiny very sick baby and worked on her for the entire time we were there. I was a crying mess by the time I left and ended up arguing with my DH - so a bad night. It's times like that I can have a knee-jerk reaction so I'll see how things are today and calm down a bit.

And, breaaaaaaathe....

nikkiuk · May 2014

Little update - the doctors put Zach onto Prilosec this morning. Fingers crossed we are now getting some kind of resolution on this matter.

scubagirl81 · May 2014

I'm sorry you had a bad NICU night, I know sometimes it can be so frustrating. Don't be too hard on yourself! I hope the Prilosec gives him some relief!

Nita14701 · June 2014

Reflux/GERD mom here- we're hopefully be weaning LO of her meds (Prilosec and zantac) soon with the help of her GI dr. I know LO's can be picky about which bottle/nipple they will use- but if you're using formula you might want to try Dr. Browns. We found they helped with less gas/air getting trapped (less wet burps). And the standard keeping upright for 20-30 min after a feed, and sleeping on an incline in something like a RNP.

Also be "persistent" with your dr, if you don't think the meds are working see what else they will advise like a dietary change or something. LO ended up having a problem digesting cow milk protein so once we switched formula we noticed a drastic decrease in reflux symptoms.

nikkiuk · June 2014

Thanks again, ladies. Another little update - he is just 1oz away from the magic 5lb mark and he's almost 34 weeks so those milestones are coming faster now. They increased his caffeine for a few days as the Bradys were increasing and they thought he'd outgrown his dose, but they are taking him off it again next week as it's almost certainly aggravating the reflux, which they think (although they can't be sure) in turn is also causing the Bradys - but of course, that could also be just his age. So right now we're caught between a rock and a hard place. He still isn't feeding from a bottle but sucks like crazy on his pacifier and they are seeing that as a positive sign that he might 'get it' soon. So, we plod on

nikkiuk · June 2014

Zach was doing so well until last night. He was on cue-based feeding, his weight is hovering around 5lb 14oz, his alarms had stopped and when his heart rate dropped, he pulled himself out of it without stimulation.

To check his heart rate drops are reflux and nothing else, he was put on a different monitor on Monday and was to be on his back, flat, for 48 hours. What an absolute disaster. He was spitting up, could not settle nor sleep, was in pain and generally had a very rough time. The Primary Care nurses couldn't bear to watch him so uncomfortable and after 24 hours they complained to the doctor that it was causing him too much discomfort and pain and that he needed to be elevated again. So they did. Last night he had his first 'true' brady in a long time while I was feeding him and he also choked a few more times before and after that. He seemed very angry and totally confused about how to feed, like everything had gone back a week. He only took around 25ml before falling asleep.

Plus we found out he'd had a Grade 1 IVH brain bleed at some time over the last four weeks. It has corrected itself and won't be an issue but that has freaked me out. What with the big brady and the brain bleed news, last night was just horrible.

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