Posted By Posting
Jul 29, 2008
aunterin
Addie and Luke's Aunt Erin
Newbie - Excessive Spitting Up
Hello to all, I am posting to ask questions about my niece, Addie, who is 3 and 1/2 months old. She has been diagnosed with acid reflux. Addie is a very happy baby, and sleeps really well, but she vomits or spits up ALL THE TIME and the volume of spit up seems excessive. She is currently taking Axid three times a day and is on Enfamil AR formula with rice cereal. She has been on Enfamil Lipil and Nutrimagin (sp?) in the past with no improvements. She spits up three to five times between feedings, and always spits up while being burped halfway through a feeding. She is very resistent to burping, during which she gets very fussy and arches her back. She is using Dr. Brown's bottles. She typically has one bowel movement every 24 to 48 hours. Our major concern is that Addie seems to be spitting up half of what she eats, and sometimes she projectile vomits. However, she does not get upset when she spits up or vomits and the doctor says she is not concerned about her weight. She also sleeps in a sitting position and we keep her upright for at least thirty minutes after feeding. In fact, we rarely ever lay her down flat. We would like to know what formulas or thickeners to try to help with the spitting up/vomiting. I have seen good things about Elecare and Neocate, but we are concerned about how expensive those are. If anyone has suggestions on other formulas or ways to finance the more expensive formulas, we would really appreciate the assistance. Thanks so much! Erin
Jul 29, 2008
mom2halleyann
Donnessa, mom to Halley born 3/10/07
Reflux (mostly) resolved at 14 months
and Addison born 8/17/09. Currently exclusively bf and on 7.5mg Prevacid
Hi and welcome! I'm glad to hear that Addie's pain is under control - that is the hardest part of reflux in my opinion. Unfortunately, unless the vomiting is related to an allergy or MSPI (milk soy protein intolerance), it's pretty much just something you all will have to live with until she outgrows it. My dd spewed like a fire hydrant for the first 7 or 8 months of her life. Once she was able to sit up and began solid foods, the vomiting slowed considerably and stopped by 9 months. As long as she is gaining weight well, then (I hate to say this) it's a laundry issue. Feel free to ask any other questions you may have - the parents here are great!
Jul 29, 2008
aunterin
Addie and Luke's Aunt Erin
Thanks for your response. I have a few additional questions. So, I guess we need to determine whether she has an allergy or MSPI? Should we try to eliminate milk based and soy based formulas and see what happens? Also, what about thickeners? Do they help with the vomiting? We have heard some good things about Simply Thick. Oh, and has anyone tried a mixer for formula? My mom said she saw something like that at Target and we're wondering if that might help at all. Thanks again. Sorry for all the questions!
Jul 29, 2008
katiesmommy
Tracey, mom to Katie diagnosed with GERD at 3 week.

Hi! Katie spits up more with rice even though her pedi. and the on-call pedi wanted me to try the AR. We buy Alimentum and it is soooo expensive too but have to avoid corn and it's the only one that doesn't have corn. Katie will often fight me during burping too and at 9 mos. she is a handful!

I know that a lot of AR babies have done really well on Elecare as that really seems to do the trick for them. It might be worth trying even if it is expensive, JMO. I had to stop breastfeeding because we think it was making her reflux worse as she would always throw up afterward and Alimentum has been a huge help for us(her food is more expensive than ours! LOL!)

Jul 29, 2008
katiesmommy
Tracey, mom to Katie diagnosed with GERD at 3 week.

You posted while I was posting! :) I have heard that the mixers help if the baby has issues with gas since they produce less gas than shaking. We buy the liquid premade since it has no corn but they are also a little thicker than the powders so that might help too.

I have heard of Simply Thick and I know it helps with swallowing issues but not sure about vomiting; hopefully you will get some answers from moms who use it. Maybe have that as a post question to see if you get any hits.

Jul 29, 2008
mom2halleyann
Donnessa, mom to Halley born 3/10/07
Reflux (mostly) resolved at 14 months
and Addison born 8/17/09. Currently exclusively bf and on 7.5mg Prevacid
Mommyto2 (Jennifer) and some others have used Simply Thick and have liked it. I'm not sure if it will help with the vomiting, but it may be worth a try.

A lot of refluxers don't do very well when thickening with rice cereal (not to mention that it can cause gas and constipation). I personally would try Alimentum or giving Nutramigen another try before moving to Neocate or Elecare. You'll need to make sure you give any new formula a couple of weeks to work before giving up on it (to allow the old formula enough time to work its way out of her system). My dd was exclusively bf for the first 5 1/2 months and then we moved to Nutramigen. To be honest, I didn't see a huge difference in the vomiting either way. There was always a LOT. Burping was always a challenge for us as well - I was glad when she finally outgrew the need for it, because it was ALWAYS a fight.

Jul 30, 2008
aunterin
Addie and Luke's Aunt Erin
Thanks everyone...one more thing... Obviously, we don't care if we have to wash 400 bibs and outfits a day, so if this is just a laundry problem, that's ok with us. :) We ARE concerned about her choking though. Today, she had an episode where it almost seemed that she couldn't breathe for a few seconds. Turned out she was fine, but that's our biggest worry, by far.
Jul 30, 2008
mom2halleyann
Donnessa, mom to Halley born 3/10/07
Reflux (mostly) resolved at 14 months
and Addison born 8/17/09. Currently exclusively bf and on 7.5mg Prevacid
Has she had a swallow study done yet? If she's choking, then it may be a good idea - that will help to see if she is aspirating.
Jul 30, 2008
aunterin
Addie and Luke's Aunt Erin
No, she hasn't had the swallowing test yet. I'll tell my sister to ask the doctor about it.
Jul 30, 2008
aunterin
Addie and Luke's Aunt Erin
Mom2halleyann, Should we stop the rice formula? Do you use something else for thickening? I'll try to stop asking questions, I swear! Lol.
Jul 30, 2008
michelle&aurora
Aurora born March 17, 2007
3 years, 8 months old
Weighs 25.8 lbs
8 lbs 11 oz at birth.
Recovered Chronic Projectile Vomiter
Prevacid Free since September 08
Egg allergy diagnosed Jan 26/09
Has a Pectus Excavatum
Has an Epipen
Hi and welcome! I don't post too much these days, but wanted to reply to your post because Addie sounds a lot like my Rory. Happy all the time but constantly vomited. It got better for us around 6 months, but Rory vomited last night while burping and she's 16 months. By better, I mean, it wasn't all day every day.

It's most likely an issue of time. If she's a "good" puker, I don't think thickening will help much. My daughter just puked globs, and frankly, that was very scary. The puking and "choking" you refer to is probably her emptying her entire tummy contents. The best thing you can do is just let her puke and catch her breath, simply rub her back, no banging, jostling, that sort of thing. She should catch her breath.

The burping...to be honest, I very very very rarely burped my daughter. She didn't have issues with gas, and had the same bm's you describe for Addie. But if you find Addie is more uncomfortable by not being burped, you have to do what makes her comfortable.

I wanted to post because many of us can recall vividly the early "puke" days, and frankly, I am still traumatized. :) The ONLY thing that got me through those times was this website. I didn't have a lot of family support. I think it's wonderful that you are writing on behalf of your neice. The very very best thing you can do for Addie is to be as helpful to her mommy and daddy as you can be (assuming that is who is caring for her). This is a very difficult time for them I imagine. Sometimes looks can be decieving. Give them a break where you can. You obviously don't seem scared off by the puke (my in-laws babysat once and were terrified). Support is the most important factor in this situation, because it's a situation where there is no "answer". They have to wait it out most likely, and each day can seem like a nightmare, worrying and curling your toes at each feeding.

One more caution though, if Addie's feedings become more difficult, I would speak with your pediatrician or consult a pedi GI.....you want to nip that in the bud....my dd still has feeding issues to this day. Good luck. HUGS.

Jul 30, 2008
maiam
maia m - GERD. Nissen Fundoplication w/hiatal hernia repair.
Mom to
Son (10) GERD(aspiration pneumonias, apnea, tracheomalacia), Food allergy, Asthma
Daughter (6) GERD, Heart Murmur, Food Allergy, Asthma, Mold allergy
Have they tried smaller, more frequent feedings? My daughter threw up all the time, and she was MSPI (milk/soy protein intolerant) - and she still is! How long have they tried the Nutramigin for? It can take a couple of weeks for all the milk proteins to work their way out of her body. Thickening did *NOT* work for mine. And it could make aspiration (breathing it in) more dangerous (or that is what our Ped Pulmo told me... ) If you have a Ped GI on board, sometimes (SOMETIMES) you can get insurance companies to pay for formulas -- there are some sample letters for coverage at the neocate website. Our insurance co. would *never* cover - even if tube fed. Grrr.
Jul 30, 2008
nicholas'smom
Not a lot to add as others have more experience, but one thing I did to save a few bucks on the Nutramagen was to join Enfamil Family Beginnings (joined online). They send coupons for up to 9 dollars off the formula and will send some for a few months in a row. Every little bit helps. Don't know if you and your sister can both join and double up on coupons? Haven't tried myself-should now that I'm thinking of it though.
Jul 30, 2008
slimfast13
This is our dd, Alessandra. Dx with GER 10/07. Ran the gamut with meds and now done with them (crossed fingers). Using magnesium, probiotics and prebiotic supplements. With the exception of teething and general sassy attitude, all is well now. They really CAN grow out of it!
I can't add a whole lot to this, but even when my dd's reflux was controlled, it took a while for the massive vomiting to calm down (it slowed down as her muscle tone improved as she grew). We used a rice added formula for a while (similac sensitive RS) and even then we added oatmeal cereal to per MD's instructions. Others have used Simply Thick or ThickIt, still others rice cereal, etc...My dd has no allergies and is not MSPI either, so it was just a lot to clean. She still gurgles up some occassioanlly, esp with teething, but it's A LOT less and doesn't bother her at all.

I say as long as she seems happy and is still gaining weight, it just becomes a laundry issue. Is she a frantic feeder? That can add to choking problems and it may help when the formula is thickened further.

Jul 30, 2008
susiegal
Mom to Charlie - cleft palate and reflux. Meds - zantac, prevacid, mylanta and reglan.
My son has been on Alimentum for several months and while very expensive the GI doc says it is very easy to digest. I order it online. The website is www.babywuvinc.net. You need to order 6 cans of the powder, but it is less than $20 a can, so even with shipping you will save. They also have the ready to feed but I haven't tried that. We also use Thicken Up but I agree with the others that it is more for swallowing issues (we have aspiration problems) vs. simply keeping the food down. Good luck!
Jul 30, 2008
aunterin
Addie and Luke's Aunt Erin
Thanks everyone. To answer some questions, yes, they have tried smaller more frequent feedings, but she gets very upset with that schedule because she wants more food, I guess. She does have both mommy and daddy around but they are not exactly internet people, so that's why I'm here! As for being a frantic feeder, I'm not sure what that means exactly. She takes her bottle VERY fast and gets mad when you take it away to burp her. And no, I'm not scared of the puke. I'm much more terrified of the poop! Addie is such a sweet, smiley baby and she never fails to give you a huge smile after she pukes all over you, which makes it totally okay, IMO. I'm just so glad that she doesn't seem to be in pain...she can puke on me all she wants.
Jul 30, 2008
maiam
maia m - GERD. Nissen Fundoplication w/hiatal hernia repair.
Mom to
Son (10) GERD(aspiration pneumonias, apnea, tracheomalacia), Food allergy, Asthma
Daughter (6) GERD, Heart Murmur, Food Allergy, Asthma, Mold allergy
If she takes a bottle very fast, that is not good for reflux. She is likely gulping air, and eating fast is just not good for the tummy! Plus it can increase the vomiting/spitting up. Maybe she is eating too much (or too fast) to try to soothe her tummy? I had one who wanted to nurse *all* the time -- he was 20# by the time he was 4 mo old! LOL. He was trying to make the tummy feel better. Have they seen a Ped GI? Had any kind of testing done (like a pH probe) to see if the reflux is controlled? Tried any other meds? (Some do better on one med vs. another...). It really would probably help if she would eat slower and burp! But I know that is easier said than done! My son would *NEVER EVER* burp. Ugh. Hugs ~ reflux stinks!
Check with your
doctor first!