Just want some thoughts please, having a problem with my 4 yr old, lol. When her reflux flares up she doesn't want to eat because her tummy hurts and then she won't sleep because being hungry gets the acid flowing nicely also being hungry doesn't help sleep anyway but she doesn't want to eat and gets really fussy because it hurts, ends up a vicious cycle. I started giving her a sandwich, piece of fruit or some rice milk just before she goes to bed if she hasn't eaten dinner well just so that hopefully we can actually get some sleep but I have had a hard time about it and been told I am not to do that because I am teaching her not to eat her dinner and she will get something later anyway. Do I push the hard line and say if you don't eat your dinner theres nothing more and end up with no sleep or do I let her get away with it and give her something light later just to try and get her comfortable enough to sleep?

I think with refluxers,you do what you have to do.People who have not had a refluxer find it hard to understand that the normal rules dont apply and you do what you have to.Is she on any meds ? Does she eat at all during the day ? Small and often is another way to try .Im not to much help as mine have all been pretty much ok,after about 2 even so miss 2 and half can be a bit picky and shes a tiny wee thing at just on 10kg but i dont stress to much now and just go with the flow.

The thing is - is it a medical problem or a behaviour?
You wouldn't expect a baby in reflux pain to sleep through the night and leave them to cry it out and just learn to deal with it - so if there is a medical reason she isn't eating well then you have to run with what you have I think!

But I wouldn't give her something JUST before bed but give it a good 30 mins beforehand because food in the tummy and then lying down can add to the vicious cycle too.

With the older refluxers who are difficult eaters I think you need to do the little and often thing, just as you would with a refluxing baby. Tempt them along with nice bits and pieces and possibly even treats - depending on her normal eating/weight/growth.
Does she eat fine in between bouts or is it slowly impacting that too?

All of my boys have had extensive feeding difficulties due to reflux so I take a different - just getting something in/cals are good - kind of attitude.

I'd also say this is a pretty good reason to try and get things back under control and poss go back to meds for her.
When Thomas had his reflux surgery the surgeon commented there was no wonder he didn't want to eat - his oesophagus was actually ulcerated from the reflux!

Thanks and yeah when I say just before bed I should have said just before we start getting her ready for bed, would be a good 1/2 hour before bed by the time we have a shower, find pj's, have some stories etc, lol.

Normally she is a small but good eater, ie small amounts but eats pretty healthy. Just a comment someone made to me on another forum made me think, being holidays she is out of her routine and would normally have a lunchbox at kindy with plenty of fruit and a sandwich and crackers and then would eat when she got home from kindy about 3.30 and just a tiny bit of dinner. With having all the kids home there is no fruit in the house because they eat it so fast and because we aren't just getting home from kindy/school they aren't thinking about eating then so by dinner she is feeling extra hungry and maybe an upset tummy before dinner. She does normally eat fine in between bouts, I know when she gets fussy or doesn't want to eat that she is not feeling good!

Also this has been going on since about xmas, I put it down to the foods she got at xmas which things like that she normally comes right again within 2 weeks but hasn't. I am wondering if it could be the change in her eating pattern with the holidays?

Also we got a new prescription for her the week before xmas and I didn't think about it at the time but there was a note that said they had changed the brand of it but it was the same thing and worked in the same way. Could that have anything to do with it?

I just want to find an answer, for her sake and for the sake of me getting some sleep!

I am not finding an problems with the new brand. Hope it isn't that. It should be working by now. Is her dosage right. if she had it a long time ago she may need it increasing. I have a rule no food in bed but if you are hungry after dinner you can have fruit, bread, crackers and milk. I think especially if a child hasn't eaten dinner maybe due to it being something that hurts them or even if it is something they don't like as long as you keep offering it to them and don't give them treat food it is ok. I am just happy if my refluxer eats anything for dinner and happy to fill him up after on bland food. Routine out is right on the money for all our children's behaviour! Wow do kids love routine.

Well we have an appointment with the doctor next week to look at her meds to see what they think.

I have also been a bit more watchful on what she is eating and when and making sure I give her snacks and mostly fruit and less bread which is how she normally eats and we have had a slight improvement. Apples especially seem to help settle her tummy, both fresh apples and apple puree.

Try some gaviscon when they don't want to eat. If they get hungry within 20-30 minutes, that's a sure sign that they're having a little flare up and then they'll eat much better. My girls are going thru this at the moment as we test foods and change medications ..... gaviscon is my instant saviour. Of course convincing them to have it is not always easy, but they know that it will make them feel better, so we get there in the end.

Weight is a major issue for us, all due to eating issues. We've been told if they want to eat, let them. Those calories and energy are the most important things, and eating habits are something that we can deal with later when they're older. At this age, it is just toooo vital to get food and energy into them.

I would suggest her reflux isn't being properly medicated... If she is experiencing pain then she will have some acid burn, Back to the doctor to review medication choices!!!

If she is on Omaprazole, then I have found my daughter is TERRIBLE on anything Dr Reddys or losec branded capsule suspension. (doesn't help that most pharmacist crush the tablets to make it dissolve quicker... a big no no.)There is an omaprezole powder which when made into a suspension is BRILLANT. Also the LOSEC branded tablets sold over the counter are the best... but they cost $$$$

Also gaviscon will stop the omaprezole from working

That is interesting about gaviscon stopping the omeprezole working, never heard of it before, when my daughter was really little they had her on both gaviscon and omeprezole.

I haven't been able to convince her to take any gaviscon for a long time, gave up trying because she just wouldn't but I actually managed to get her to take some yesterday! She got worse again and had a really upset afternoon so gave her some late afternoon and seemed to be a lot happier and the thing I still can't believe is she cleaned up evey last thing on her dinner plate and asked for more!!! I gave her some more before bed, and apart from a few grizzle sessions in her sleep she is still asleep now, hasn't slept in this long for a very long time! She told me at bedtime though she never wanted any of "that yucky stuff again" though, lol.

That is the hard thing with medicine isn't it. If it doesn't taste nice it is so hard to get them to take it, even when they know it will make them feel better. I know I am this way myself!

You can take both Gaviscon and Omniprezole but they should be 2 hours apart. It is written on the label usually. SOmething like don't take iron calcium or Antacids within 2 hours of taking the product. Good to hear the gaviscon worked.

Ok, thanks that makes sense, I had been told not to use them together but hadn't heard why, although it doesn't say it on the bottle.

We were told if you need gaviscon then the reflux really isn't being controlled properly ?! So hard so many doctors have different ideas. We only ever took advise from a paediatric gastroenterologist... they are the experts

Gavison and Omeprazole do not interact so no problems giving together. Ranitidine and Gaviscon do interact though.

Our paediatrician's suggestions around eating, was to offer food five to six times a day - breakfast, lunch, dinner, and inbetween and maybe supper/dessert. Give them the food to eat for 20 minutes, then take it away and make them wait until the next meal time. Means the stomach isn't always digesting and making acid. Also means that they are likely to be hungry for a meal rather than grazing. Hope that makes sense.

You are right of course Roz. Sorry my brain is always sleep deprived and Arlo takes both Ranitidine and Omniprezole so mixed them up.
Oops. Hope I didn't cause you too much trouble.

LOL, thats ok, always interesting to find out these things, I don't normally give them together anyway but hadn't heard that.

Roz, that is what we were told with her eating too and it has always worked well until she just didn't want to eat at all again!!!!!!!! It seemed just dinner was refused but looking back I don't think she was hardly eating much at all, just seemed so because she was actually accepting the food earlier in the day but then leaving it or giving it to the dog after only taking a mouthful.

Thankfully we now have our happy/hungry girl back again!!! I guess she was feeling pretty awful and that the increased dose helped because she is now having her proper meals and snacks and eating better than she has in a very long time, let alone just better than lately when things came to a head!!!!!! She is cleaning her plate and happily showing me its all gone and sometimes even asking for more!!! It's so great seeing the improvement!!! And the sleep too, we are back to only the 1 wake up at night and then not even every night!!!

Thanks everyone for all the suggestions and help!