We are trying to figure out if our baby girl (almost 9 weeks old) has reflux or not. Since she was 2 weeks old, she has been spilling her feeds day and night (frequently an hour or two after a feed, not just straight after) and is getting progressively harder to settle to sleep.

When she was two weeks old she started to projectile vomit on occasion. The first time it happened she choked on her vomit as I was holding her against me and we had to call an ambulance because she was having trouble breathing. She still occasionally projectile vomits but strangely enough doesn't seem too upset when it happens and doesn't necessarily want to feed again which makes me think she was just too full. If we keep her upright after a feed she doesn't usually mind being laid down under her play gym despite continuing to spill. These two things make me doubt whether she does suffer from reflux.

However I can always tell when she is going to spill because she'll start to fuss and as I said earlier she is getting progressively harder to settle to sleep. She is actually very good at night - only wakes once and is easy to settle but is a nightmare during the day. Some days are better than others, but by 9 weeks I really thought we would have figured her out in terms of sleepy cues etc.

She is our 2nd baby and our 1st was also a chronic spiller and screamer (aren't all babies I suppose!) but we eventually worked him out after about 7 or 8 weeks. I feel like we are going backwards and of course it is even harder when you have a toddler to care for as well.

We saw a paediatrician when she was 6 weeks old and he told us he didn't think it was reflux but gave us some ranitidine to trial "just to ease Mum's mind". We tried it out for three days and looking back I think we did see some improvement but at the same time we also started keeping her awake for longer so I figured it was that and not the medicine that had helped. We have also tried Gaviscon but after a few days that didn't really help the fussing and it was a pain to administer (expressing to mix in with the powder). I'm now going to try ranitidine again because I'm kind of at my wits end.

Am I doing the right thing? I'm not that comfortable giving medicine willy nilly to a wee baby but at the same time I hate to think she is suffering. Sorry this is such an essay...

Try the Ranitidine. Then you will know. Reflux is difficult to diagnose as every baby has it differently and of course you can't ask them anything! Even my almost 2 year old can't tell me much yet. From what I remember form my 2 though it is a slowly progressing thing so the pain worsens as the irritation worsens and so can take a while for the Reflux to be noticable enough to make you feel there is something really wrong. This is why most babies only seem to "develop" reflux at about 6-8 weeks as it takes a while for the pain to happen from all the spilling and vomiting. My 2 refluxer was a dream baby for 6 weeks then slowly changed.
So I guess what I am saying is you could wait for the symptoms to get worse, til you find that you cannot settle your baby to sleep at all ( I mean even driving for an hour with a screaming Baby) or they won't stop screaming at all no matter what you do then you might be sure. But then I say that and I always second guessed the diagnosis...
Or you could try the medicine and if it works then well that is that.
The trick with the medication is to make sure you give it every day twice a day at a similar time. In 2 -3 weeks it will have built up enough in Baby's system that it then doesn't matter if you forget on or it is a bit late.

It sounds like you need to try the Ranitidine. Remember it can take 3 weeks to reach it's full effect.
Gavisvon can be mixed with just 5 ml of water and given from a spoon or syringe before a feed.

It is soooo hard to diagnose reflux. I have a 10week old. She's my 3rd refluxer, and it isn't any easier this time. You're right. Like you say, as a mum, you feel torn between not wanting to put medication into such a tiny person, and not wanting them to suffer. Ranitidine is a very safe drug tho! (I have a friend who's a doctor who thinks it should be added to the water like flouride!). I would try the ranitidine and maybe even some gaviscon too (I use the gaviscon when I can hear DD2 regurgitating, and she's all unsettled and 'swallowy'). Hopefully you'll start to see improvement quickly and then you will have your answer.

Like Roz suggested, I only ever mix the gaviscon with 5ml of boiled water. They never like the first few doses. But my kids have all got used to it quite quickly, and after a week or so literally 'lap it up'. (I reckon they learn that it helps them feel better).

Oh, and in my experience the projectile vomitting is usually related to trapped wind and over feeding. DD1 used to do it all the time. DD2 is much better at bringing up her wind, and the projectile vomits only happen very rarely when she didn't bring up her wind between sides.

Good luck! Let us know how you get on

Thank you all for your advice. So far there's not really been any improvement using ranitidine, but we'll keep going for a few weeks yet.

This is so stressful!! The odd day I think the Ranitidine is working but we are still having 2-3 bad days in between. Yesterday and today I've only been able to get her to sleep for maybe 45mins at a time, she just keeps spilling and waking up. We have been in the car a bit and every time we stop moving she wakes up and won't go back to sleep. Of course because she is so overtired she's not feeding all that well either so that may be causing her to wake too.

She has also developed eczema on her cheeks, behind her ears, neck (probably due to constant spilling), shoulders, backs of knees and on her back. The dry skin on her back is strange though, I'm not actually sure that it is eczema because it is kind of peeling like glue does when it's stuck on your skin. I'm beginning to think it is something I'm eating. If she was allergic to dairy she'd have green frothy poos right? She doesn't have that. All the same, I think it would be worth going dairy free for a few weeks - would you guys agree?

I feel so sorry for my toddler son, he's hardly had a look in this week...

Am changing doctors next week so hopefully the new one (who apparently has experience dealing with reflux babies) will be able to help us.

Okay, after me rubbing her tummy for 20mins she finally slept - for about 4 hours. I have just given her a bottle of Karicare AR formula, of which she drank about 90mls then was ready for bed again. She didn't spill a drop and was much easier to settle to sleep (I say that fingers crossed!).

I didn't find giving her Gaviscon really helped a few weeks ago but now that she is over 4.5kg I guess it might be worth trying again?

Another question - as their weight increases, does the dosage of Ranitidine also need to be upped?

Hi, I just wanted to comment on the eczema. Because it's over quite a lot of her body it probably is an allergic reaction to something you are eating. So I agree it's worth going dairy free to start with and seeing if that helps. With my DS3 he had quite a bit of eczema by 3 months old and craddle cap that was thick and gooey and in his eyebrows. Not every baby gets "all" the allergy symptoms (like we had no major issues with reflux for DS3 although he was much more settled once we worked out his issues). You need to try dairy free for at least a couple of weeks then if you see an improvement but then she slips a bit it might indicate other allergies (egg, soy, peanut are next most common). For DS we cut dairy, had an improvement then a flare up again because I'd replaced the dairy with soy so cut soy and found a huge improvement. So yeah, definitely worth a try and hopefully you will get some joy from your new GP.

ANd just another note on the eczema while I'm posting - while food might be the trigger in the skin other things can irritate the skin more once it's compromised including soaps, shampoos, washing powders, wool, synthetics and heat. Moisturising with a good emolient at least three times a day (at nappy changes is easiest) will help (your GP can prescribe cetamogrogol - don't let them fob you off with aqueous cream as you sound past that stage).

Green frothy poos occurs usually because of the amount of lactose in your milk. You produce lactose whether or not you have dairy in your diet. Yes, I think it is worth going dairy free for two weeks - before you decide it is or isn't working.

yes you do need to up the dosage on Ranitidine quite frequently. Check with your GP.

Thanks, I'll be interested to hear what the Dr says on Monday.

I should have thought about laundry powder being a possible culprit. My son's eczema is not good at the moment either and I'd put it down to teething.

Hi everyone, I thought I would pop in and say hi... My son who is one month old today has been having problems with reflux. It's awful when he has a bout of it - the screaming rips your heart apart doesn't it!? Doctor gave us Gaviscon a week ago, and I have used it sparingly, but now trying to use before each feed to see how that works for a few days.

Those that have used Gaviscon, do you give before, during or after a feed?

He is also quite sleepy during feeds of late, and still has some jaundice, which is possibly making him sleepy too.

I will take him back to the doctor end of this week to report on how things are going. SO FAR I think the Gaviscon seems to give him some relief though, fingers crossed it lasts.

Thinking of you all out there with reflux-y babies!

How are things now? Sorry it has taken so long to reply.

You should give Gaviscon infant before a feed if breastfeeding. You only need to mix it with five mls of water or milk rather than the 20 mls it says. Watch out for constipation. Give it three days of regular use to see if it is effective.

Oh gosh - I am reading about my daughter here!
She was 3 weeks early and very sleepy for the first 3-4 weeks - having to wake her for feed - then about 5-6 weeks she started getting very spilly.
Put it down to drinking more.
Started her on ginger mix which I have used with my other babies for trapped wind - works very well.
Then started doing these massive vomits - once choking on the curdled vomit like OP said.
Then the crying for hours in the evening started - just put it down to 'hell hour' etc blah blah.
Last week after 3 long lunchtime to 11pm crying marathons got some gaviscon off Dr. I have no experience of reflux or colic etc with my other babies.
After having a baby that rarely smiled - she suddenly got VERY happy and smiley - happy mum!
Then last night she screamed for 4 hours like she has never screamed before - very upset and stiff and wound up - I had to pat her on her bum while swinging her as I walked this whole time - she was inconsolable. Would have taken her to hospital if it continued during the night.
Got some more bottled EBM down her with gaviscon as she settled slightly - and it was enoug to knock her out for the night.

Fingers crossed it is not a regular thing.
Will persist with the gaviscon today and hope the same thing happens tonight - she really was in pain I could tell. Should I go to the dr to try ranitadine? WOuld that be better than gaviscon?
I find it hard to get down her - I was told to give it at the end of the feed - so have been putting it in some ebm in a dummy medicine feeder at the end of the feed. Noticed her stools are much firmer (was wondering if her tummy was sore last night because of this though she had bm during the day)

What a long novel - I know she is not nearly so bad as most here - but I guess from reading stuff here its a good thing to try and get on top of now.

She seems happy enough this morning which is good - has a slightly runny nose which she has had a cold a couple of days back (very mild).
Oh they keep you guessing!

It may be that she is a bit constipated with the Gaviscon. Sometimes they need to have treatment for this also. If you search Nutricia constipation guide, you will find some ideas. Gaviscon should be given before the feed and you only need to mix it with 5 mls water or ebm.

If the pain continues, you should take her back to your GP for review. It sounds like they know what they are doing.

Thanks heaps for that Roz - I will do that!

Well it's been an interesting few months for us. Turns out dairy is a big culprit - have been off it for a few months now which was working pretty well then had a wee bit at the end of my xmas holiday and bam, upset baby again. And back to spilling a great deal more. Am also finding coffee makes her spill more than usual, tomatoes and nuts make the eczema on her face flare up...I was always a firm believer that a mother's diet doesn't affect her baby but now know I was wrong!

Has anyone had any success with probiotics? Took my daughter to an osteo before Xmas and he recommended using probiotics for her cradle cap/eczema. Then I did some internet research (as you do) and read that it can really help reflux. I spoke to a pharmacist over the phone who reckons we could give our baby probiotics and iberogast and take her off the ranitidine. I'd like to believe that's possible but would to hear off other people's experiences before we do anything rash.

General question - baby has a bowel motion day every 2-3 days but leading up to it gets pretty unsettled i.e. short sleeps and harder to settle. Can someone remind me if this is normal or could it also be due to meds? She's not on gaviscon.