My 10wk breastfed little man was diagnosed with silent reflux at 5wk. We went through the process of cot tilting, wrapping and dummy, diet review, fennel tablets/tea, before Dr reluctantly prescribed gaviscon (because he is putting on so much weight) which had little effect and then progressed onto omeprazole, which we have been using (2.5mL/day) for 3 weeks. This has now (after I have also eliminated all dairy frm my diet) stopped the post feed inconsolable purple faced screaming and he will now have a kick on his back without getting upset.
The problem we now have is during the day he will not sleep in his cot for more than 40min at a time (at night he sleeps for 6hr and 3hr or so). He often wakes up crying, (after coughing, sneezing, or hiccups) drawing his knees up and when I pick him up he will often burp and take 10min or so before settling but won't go back to sleep. This means by the afternoon I have a grumpy, seemingly overtired baby. He usually shows tired signs at around 50min after being up and he gets wrapped, we have a cuddle and dummy (if he will take it) before heading to bed once nearly asleep about 15min or so later. I don't know whether this is his reflux or simply 'normal' baby behaviour?
I can see that he still gets some pain when he has watery burps and grimaces, but he doesn't scream like he used to. Do I head back to the Dr and pursue this further or am I being an OTT naieve new mum? Help!!

My second baby would only sleep 20 minutes to 30 minutes at a time during the day but slept 12 hours overnight. She had untreated, undiagnosed reflux.

It sounds like you are a fair way to having things under control. It might be useful to learn some more about tired signs and resettling. Maybe you are missing some of these. We had a session in Christchurch by www.time4bed.co.nz and found it really useful.

Also we don't recommend Omeprazole suspension. The granules are more effective. It might be worth asking for these. See the letter and instructions on this page: http://www.cryingoverspiltmilk.co.nz/medicaltreatment/medicationinstructionsheets/

Do I need to do anything special when going from suspension to granules or can I just switch? I'm going to dr next week and are going to request them. Also, has anyone noticed flareups after immunisAtions? We're overdue for our 3mth and I'm a bit reluctant as last time we had several hours of purple faced screaming,though we weren't taking meds then.

Yip we had flare up after imms i dreaded then,for miss 2 she went to have 3 month ones and was so unsettled with her reflux before she had them we ended up at hospital to see a paed.

Yeah we had a flare up with imms too, thankfully didn't last too long though and benefits have to be weighed against the negatives.

Thank you-its helpful to know what to expect! I wasn't sure if it was a reaction to the imm or his reflux though I had a suspicion it was the reflux(which I am pleased with as I would like to continue with the immunisations). I will speak with Dr to make sure.

Imms effected my sons as well. I made sure thay were very very well and delayed them a bit so they were a bit older. In fact a lot of things do seem to upset Reflux babies more. Not sure why physically but I think mentally they already have a lot to cope with and also a fair amount of pains o a bit more discomfort would make them a lot more unhappy than a regular bay. Think colds and flus and vomiting bugs but also bangs and bruises etc.
Oh and just switch straight over to the grandules. Hope they work better for you.

Yes, I think it's a threshold thing - they can cope with x amount of pain but add y and you are in trouble!
Think about when you have a niggling headache and how everything seems amplified and how things that normally wouldn't bug you do - same for these kids I have no doubt.

Thanks ladies-all of this is so new to me!! I really appreciate hearing your thoughts and advice.
I am struggling with his sleeping still,esp since his 3mth growth spurt. now screaming for 20mins or more has started to become a part of his bedtime routine. It is starting to feel familiar to how he used to be after feeding. I wonder if it could be his reflux still? He sticks his tongue out and refuses the dummy most of the time and when he is crying he won't even take the breast. He has also started waking crying in the night every 2hr or so after around 130. I'm exhausted and suffering from a bit of pnd which doesn't help matters.
He is 14wk now and has put on a kilo since first being given omep, do I ask my dr about increasing the dose or do I wait until we've tried the granules?
I'm sorry if I seem to be making a mountain out of a molehill-I have such admiration for parents of reflux children and know many have it much worse than I do.

Try the grandules first. Most people say they work much better. Keep them up as in don't miss a dose and you should see a difference by 3 weeks. I know that seems a long time. But you are right it could be something else. Unfortunately that is par for the course. Speak to most reflux kids mums and they will tell you they never really even knew knew that it was reflux causing all the problems. I found I only believed after it was gone for good and how different my child was. I thought some of it was personality or other things but looking back the majority of it was reflux. Hard to tell the difference at the time though from teething pain etc! Hang in there. Remember it will eventually be over and look after yourself.

Thank you we went to dr today and we got the granules 2 try. He hadn't heard of that means of administration and was thankful for the letter and website! We're going to wait a little while before continuing immunisAtions till I'm happy things are 'settled' a bit

Glad your GP liked the information and thank you for taking it.

Re immunisations, Gem was only bad after her six week old ones, and we continued them as normal. As a practice nurse, I would say it is less likely to cause a problem if you have them on time. Younger babies are less likely to get stressed by them - especially if you have a good nurse and calm parents.

I've found the opposite with pain levels - because they have coped with pain for so long, they may react less than children who have never known pain.

Good luck with the granules - and dosage is not very weight dependent with Omeprazole. If you need dosage checked against weight, PM me and I'm happy to tell you if you need to see your GP again.

So we're on the granules-way easier 2 administer-but bubs has been sick with cold so has had a bit of a flare up. Anyways, over the past few weeks he has become quite constipated so we're trying probiotics and diluted prune juice. When he does go, it's quite green, and he has really foul gas. Does this sound like a side effect of omeprazol or do I need to assume the position in the dr waiting room...??!

Omeprazole can cause constipaton. I wouldn't expect it to cause the green poos and gas though. Maybe the prune juice or a bug???

Probiotics are a good idea.

In my experience, our dairy sensitive son reacted badly when we gave him probiotics, broke out in excema, really unsettled and foul gas. He also has green bowl motions which im pretty sure is due to dairy sensitivity - but that is just my hunch the health professionals have not been able to explain his green poos yet! So it could be the probiotics if they contain dairy?

Hope things have settled down for you. I found normally when my girl had green poos it was a dairy problem or a tummy bug, never have had omeprazole cause it, it does cause constipation though. Good luck.

Thanks we have just cut our first tooth (at 4mth!!) and are eagerly awaiting our second... No more green poo thank goodness! We're still struggling a bit with constipation-we have lactulose but I reluctantly give this only once it's been a few days. Tried prune juice but I think it was a bit acid.he's on non-dairy (ethical nutients i think) probiotics. Been on a higher dose and granules for a few weeks now. I'm assuming the teething and constipation are factors that are making the evening flareups-we seem to be back to the not laying down/only being carried in the late afternoons. We're also up 3 or 4x most nights now-gee I'm glad Hes my only one and I don't work!I'm just wondering if I should expect better control than what we have (flareups seemingly at every milestone/illness/tiredness) or should I be pushing to see the paed and exclude other causes and get the dose reviewed? Also, I'm wondering about when to start solids... From what i'v read, it seems to either improve the situation or make it worse. I have a big boy who seems to be growing well on breastmilk; my dr thinks that I should start sooner rather than later. My gut tells me to wait. There is conflicting information regarding allergies (paed dietician said start when bubs shows signs, delaying intro of wheat can cause coeliacs whereas my plunket nurse says wait to start solids and introducing potential allergens can cause allergies...!!?!) I was just wondering from a reflux perspective how your experiences with starting solids was?

yes, kayalee if he is dairy sensitive and the probiotics contain dairy then they could cause those symptoms. I haven't heard of them causing a rash.
Is your baby on a dairy free diet - including you if you are breastfeeding?

Nztas - Its important to keep the constipation under control, but often it has to be lactulose that does it with our babies. A warm bath can help relieve the pain. Teething should be able to be controlled by Paracetamol and a teething remedy.
Symptoms should be controlled enough to cover flareups at milestones etc.
Solids should be started around six months of age but take it easy on volumes increasing slowly. It is important to progress through the stages of textures at appropriate times.
Yes, the latest data shows that prolonging introduction of allergens tends to make the children more likely to develop allergies. There was a study done on Jewish children living in Israel and others living in the US. The ones in Israel were given a traditional snack containing peanut at an early age and the ones in the US were less likely to be offered this. The incidence of peanut allergy was much higher amongst these children in the US. (The study as I remember it.)
However, we would recommend that you be careful with foods that increase reflux as on this page: http://www.cryingoverspiltmilk.co.nz/food/foodandreflux/ (NB: I see I need to update the bit about delaying the introduction of allergens ...) I do agree that the introduction of gluten should be delayed until around 12 months.

Our experience was that we had to watch the total volume of solids given over a day. Their stomachs need time to get used to digesting solid food I think in some cases - but not all. We also had green poos which burnt her bottom and caused skin infections with every teething episode. After the introduction of weetbix at a year old we realised that she was intolerant to gluten and that every time she had teethed she had had gingernuts! We were excluding wheat from her diet, but she probably wasn't having a lot in general.

Thank you so much for all of the kindness, help and support x we finally seem to have things 'under control' and I'm happy with the dose we are on. I have a charming little man who likes it on his tummy and is sitting up and rolling-normal baby stuff yay!! We still have our issues - I think soy may be a problem - but its so much easier to deal with without the distress of all of the screaming! I know we will have flareups, I'm sure, but knowing there is such a fabulous support network and sound information is very reassuring. Thanks!!