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Mar 31, 2009
alicesmama
Mama to Alice, May 08, Prilosec 10mg
Night-weaning an all night nurser with silent reflux. Any advice/ideas?
DD is 11 months tomorrow and feeds through the night next to me. She can ONLY go back to sleep if she's feeding on the breast. We have co-slept pretty much since birth on 2 twin beds, as sleep has always been such an issue. She wakes every hour, groans, rolls onto her front, groans and puts her head down and her bottom in the air. She stays like that for a few moments and then crawls over to me to feed back to sleep. At 4 months we mistakenly put her in a crib and tried to get her to cry it out for a week. It didn't work, she cried relentlessly. She started on 6.6mg Prilosec at 5.5 months when we finally got the diagnosis and meds right. Within 2 weeks she'd stopped screaming through the day, but the night-time waking continued. I haven't had more than 2 hours sleep in a row since she was born and I am so tired, so my questions are 1) Is this feeding back to sleep helping or making it worse? On marci-kids it says empty stomach with lots of acid makes it worse and it sounds like they are saying babies should be fed. But my Mum has a reflux and says the thought of feeding through the night would mean she would be unable to sleep a wink, she would feel so sick. So who is right??? I am so confused. I have been feeding her relentlessly through the night because I thought she needed soothing. But when I lie down to feed her to sleep in the evening, often I have just eat (like she has) and I can feel the food rising in my esophagus and I sometimes feel a bit sick when I stand up after, so how can this be good for her? 2) If anyone has night-weaned, what age did you do, how did you do it? Was it very hard? I have withheld the breat a few times a night and she has screamed very hard for hours. I've looked at Dr Jay Gordon's website and plan for 12 month old babies, but do they understand this new plan? If anyone has any advice or experience I would be so grateful as I am at a loss her as to what to do. I know for co-sleeping babies it's normal to wake up every hour, that's just what they do so my baby is no different in that sense but her reflux means she could be better off being night-weaned. Thanks so much, Sarah, very very tired Mum of very very tired Alice
Mar 31, 2009
alicesmama
Mama to Alice, May 08, Prilosec 10mg
I should say I have withheld the breast at night only a handful of times, maybe 3 or 4 times, since she was born and she SCREAMS! Sorry, it looked like I'm doing this every night in my opening post, but this is not the case, just wanted to correct for sake of clarity. I'd love to avoid more screaming - anyone any ideas? Thanks again.
Mar 31, 2009
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!
Adult GERD and infant GERD, though similar, doesn't mean that how one feels, the other will as well. Many of these kids "comfort feed" to soothe the throat. It's not right or wrong, mama - it's just what works for you and your dd.

It may be the meds aren't enough for at night, and I'd ask the MD about splitting the PPI dose or adding an H2 blocker or Maalox/Mylanta. We had the best luck with the PPI in the evening and the H2 in the morning, since sleep was always a problem for us. We did "dreamfeeding" where the baby is asleep but eating, but that was to get her to sleep longer and that was only when the reflux was under control.

Has she had any testing? Have you tried propping her during and after feedings?

Mar 31, 2009
mallory'smom
Shawna: First time Mom to Mallory (10/07/08). Silent reflux diagnosed at 2 months. Alimentum formula fed. Trial of Losec (minimal effect). Now Prevacid 1x/day plus Zantac 2x/day.
My personal feeling is that if the reflux is under control then the night feeding has become habit and that sleep training is possible. My daughter is almost 6 months old and I have read every sleep book out there until I found a way that I was comfortable trying. She is now sleeping through the night for 11-12 hour stretches. Obviously sleep training in reflux babies is harder because if they cry they reflux and it hurts! There are a lot of different methods from no cry to cry it out and we found that an inbetween balance worked best for us. I became very 'tuned in' to my baby's cries and decided that when she was comfortable, fed, dry, warm etc. that I would start putting her in to her crib just slightly awake. If she cried some, I let her cry for 10-20mins, whatever I was comfortable with (and YES, this is hard to do!!!!). If she really screamed or sounded like she was in pain (rather than just protesting the change) then I would pick her up, console, rock, feed, do whatever to re-settle her and then try again. This cannot be accomplished in one night or maybe not even one week so if you try it you should have some help. But I can honestly say it was soooo worth it. (I don't know what it would be like with an 11 month old because this is my first baby but I'm guessing the same principles might work.) Just my two cents. By the way, I also have reflux and having a full stomach all the time is just not comfortable. If you are on the right meds then you should be OK. My favorite sleep book so far was 'Healthy Sleep Habits, Healthy Child' by Weissbluth. It is really blunt, a little disorganized and some of the suggestions I didn't totally agree with but it was the most informative and to the point.
Mar 31, 2009
abbysmom
Andrea: Mom to 3 crazy girls!
Jackie (3/01)
Payton (9/03)
Abby (4/06) Prevacid 7.5mg (evening), MSPI, goats milk (currently trying to wean off Prevacid)
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I guess you really have to know if her reflux is what is causing the wake ups at night. First when anyone new posts that is on a compounded medication I always give them this link to make sure that the med is compounded correctly http://www.infantreflux.org/forum/forum_posts.asp?TID=4505

If you don't think that her reflux is under control then I wouldn't suggest doing any sleep training until it is. The waking at night could be reflux or it def could be out of habit. I have never co-slept with any of my kids so I don't have any advice with that but I am sure that it will make sleep training harder. She has to learn to fall asleep on her own and not be fed to sleep.

Have you tried any other reflux meds? How many times per day is she getting the Prilosec? Abby def did best on the Prevacid twice per day.

So first I would ask 1. Is her reflux under control. If not look into a new med, higher dose or givng it twice per day. 2. If her reflux is undercontrol then I would work on weaning the night feedings. I am sure that this won't be pleasant. I would maybe start by decreasing the time you let her nurse unless you think cold turkey is best. I know that I had reflux when I was preggo and I could never eat within an hour or so before going to bed. It was horrible, the acid would just burn my throat and I would have to eat some bread or milk to help soothe it so I know how it feels. 3. You might want to get a referral to a pedi GI. Maybe some testing would help determine how bad her reflux is.

HUGS to you! Reflux really SUCKS!

Apr 01, 2009
lorenzomama
Lorenzo b.4/25/07 1 week in NICU w/ aspirate pneumonia from a reflux episode; diagnosed GERD at 9weeks; Used Zantac for 5months. Currently using Chinese Medicine and Craniosacral Therapy. GERD, Obstructive Sleep Apnea, Sensory Processing Disorder. Ask me about breastfeeding a refluxer! Pic: day 5 in the NICU.
I have struggled with this question of night nursing for a long time. I haven't slept more than 3 hours in a row (and usually a lot less) since I was 6 months pregnant, over two years ago. At times I feel so exhausted and touched out that I all I can think of is night weaning. And I have also wondered about the potential problems of a stomach full of breastmilk all night long. In other words, I have no confident and definitive answers for you, just a lot of empathy, support and a few points I have considered/things I have learned.

I have read Dr. Jay Gordon's night weaning approach, and the main thing that always holds me back from it, as with every single other approach to sleep training and/or weaning, is that NO ONE recommends doing sleep training when a child is ill, hurting or suffering from an underlying medical cause for frequent night waking. I find it so hard to know for certain how much of my son's night waking is due to medical issues, and how much is habit, that it just doesn't ever feel right to me to take the risk that I am depriving him of something he really needs to soothe him through the difficult nights.

We also discovered, after many months of extreme night waking (every 10-60 minutes) and after I observed him not breathing while sleeping several times (and overcoming the skepticism of his pediatrician), that he has sleep apnea. I mention this in part because there is a correlation between reflux and sleep apnea, and in part because you mention your daughters position with butt up in the air -- while this is not an uncommon position for little one's, it is also a very common position for little one's with sleep apnea. (Here are a few links you might want to check out related to sleep apnea:

http://www.sleepapnea.org/ http://www.bcm.edu/oto/grand/121996.html http://www.stanford.edu/~dement/childapnea.html I don't mean to freak you out with this information, but I wish so much that we had known that it is not all that uncommon for babies with GERD to also have sleep apnea. Unfortunately, sleep studies, which are the only way to confirm that apnea is present, are expensive and not often authorized by pediatricians.

I guess what I'm trying to say is, I think it is wise to follow your instincts about what your little one needs. It is also important to keep in mind that night weaning does not guarantee fewer night wakings...it only guarantees that you won't be nursing during them (you may want to explore the La Leche League Forums, for more information about night weaning experiences -- if you haven't been there, it's a great resource for all breastfeeding related issues, as well as many others). It's so complicated, because there's also your need to get some rest -- it can feel like a real catch 22. There are several of us here who are in your situation, and have been for a long time -- we are here to support you in whatever ways we can, in whatever approach you choose to take. Best wishes to you, feel free to email me anytime at cristina@mothersupportnetwork.com, and keep us posted on how things are going. ((HUGS)) and wishes for sleep to visit you home soon...

Apr 01, 2009
alicesmama
Mama to Alice, May 08, Prilosec 10mg
Thanks for all your responses. The night-wakings are very common in babies that have no reflux but are co-sleeping. They all do it. If you go to mothering.com website and look at night-time parenting and the family bed section, you will see thread after thread of mothers who are at the end of their ropes, with all-night nursers, absolutely exhausted, just the way I am and this goes on until kids are 3 years old or more sometimes. It's definitely a habit but some like Dr Sears say the fact that they get sooooo attached to the breast means it's more than a habit, it becomes a very good need. I'm just worried about her teeth - the acid and the sugar means she could end up needing a lot of dental work if we don't sort it out by the time she's 18 months. Some of these kids do end up with heaps of dental work needing to be done. But she is very very reluctant to give it up. I am quite down at the moment. I started working on day-time naps with a view to stop her feeding to sleep at night, all night. All I have now is an 11 month old who is very tired all the time, rubbing her eyes, won't sleep until the evening when she is allowed to feed to sleep - she has decided she won't nap anymore during the day. Even when I offer her the breast to fall asleep on, like just now. I tried for one week to stop her feeding to sleep on the breast for naps, and now I have no break myself in the day. It's a disaster frankly. I was going to get going on the night-time feeds too, but now she has a rash everywhere and obviously isn't well. So we are back to square one, or perhaps even worse now she won't nap. I just feel so tired all the time, every day is a grind, nothing ever seems to get better, she groans all day long. No she has had no testing done. Only an ultrasound which was conclusive to reflux but didn't show how bad it was. We may go down the barium swallow at some point. We are going back to the Ped in 4 weeks so hopefully then we can get an increase in the medication. She takes Prilosec in tablet form so no worries about compounding. I do think she needs an increase, she's smelt acidic for weeks but I'm never sure if that's because of teething or the stomach acidity. I hope she'll be walking very soon and then she'll be properly upright for most of the day. She's still on all fours most of the day which can't help things. I just wish there was some end in sight. We hoped around sitting up, we hoped around crawling, we hold out much hope for walking and yet she's upright some of the day now with cruising but still no sign of the reflux going and with it, no sign of any sleep for me either. She's on 10mg now, she takes it all at once, I just changed to the evening but after giving it to her last night, she still smelled acidic on the breath. It just doesn't seem to be working anymore and they want me to stop it when she is 1. I feel like tearing my hair out over it. Sorry for the rant and thanks again for all your replies. It's great to know I'm not alone.
Apr 01, 2009
abbysmom
Andrea: Mom to 3 crazy girls!
Jackie (3/01)
Payton (9/03)
Abby (4/06) Prevacid 7.5mg (evening), MSPI, goats milk (currently trying to wean off Prevacid)
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I wouldn't wait 4 more wks to see the pedi. I call and either ask about an increase (explain everything that is going on) or make an appt to take to him/her about an increase. Also ask about splitting the dose am and pm.
Apr 01, 2009
emibug
Kathryn, Pager Volunteer and mommy to Emily Mia 02/04/07. 3 years old with GERD. 30mg Prevacid and Pepcid AC. Mylanta needed for flares. Failed prilosec med switch. Tried and failed many med weans but GERD and pain are well controlled. Functional constipation. Reoccurring SBBO. Suspected IBD or autoimmune disease. Resolved issues: MSPI, CSID (acquired), Stage 2 kidney reflux, Chronic diarrhea.
Audrey Meadow 06/20/08. born 34/35 weeks. Still b/f and eats everything! ftt and chronic constipation.
i just wanted to say my audrey does not have reflux and is up all night to eat at the breast too. we used to co-sleep but b/c she was up all night and crawling around i decided crib is the safest (b/c i was soooo tired i couldn't take the chance she would fall off)

it is my understanding that refluxers who nurse throughout the day and night might be doing it to soothe a sore throat. it is generally accepted that small frequent meals are the best. I don't think that anybody is really right when it comes to how reflux effects, my reflux caused me to no want to eat at all, but with my Mil, if her stomach was empty it felt the worst.
Apr 01, 2009
momma of 2 refluxers
My daughter had infant reflux and night fed every 2 hours up until I weaned her from the breast (11 months). She still woke up at night so I would take her downstairs and give her a snack and a cup of milk. Within a week she stopped waking up at night. These babies are smart, I think she figured out she wasn't going to get the breast so she finally gave up.
Apr 01, 2009
lorenzomama
Lorenzo b.4/25/07 1 week in NICU w/ aspirate pneumonia from a reflux episode; diagnosed GERD at 9weeks; Used Zantac for 5months. Currently using Chinese Medicine and Craniosacral Therapy. GERD, Obstructive Sleep Apnea, Sensory Processing Disorder. Ask me about breastfeeding a refluxer! Pic: day 5 in the NICU.
Oh, I'm so sorry you're little one has given up the daytime naps! I know how hard that is to not ever get a break. She is a little young to understand this now, but you may want to begin laying the foundation for "quiet time." For little one's who do not nap, it can be very helpful to have them accustomed to a period of time during the day when they are in bed (or at least in a limited space) and can look at books, or play quietly, but are expected to play quietly. I know it can sound impossible at this age, but if you start doing it with her now, the odds are good that later on she will be able to do it on her own. In the meantime, even though it isn't a break in the sense that you get time to yourself, it is a time when you can slow down and teach her how to relax. You may not get any immediate gratification, but my experience and observation is that it is a long term investment in a happier mama and child.

Also, our pulmonologist recommended cranio-sacral therapy for our son, who has slept about half of what is recommended for his age range most of his life. It has made a small improvement in his overall sleep, but it made a massive improvement in his ability to relax. Sleep had become such an anxiety producing state for him that he resisted even being near bed, or lying down. Shortly after starting this therapy, he began accepting gentle massage while lying down and would even lie down on his own at times. We co-sleep, too, and I feel like it is worth it in spite of the exhaustion factor, but it is always a balance of needs. If an arrangement is not working for you, perhaps it would be worth trying another. You can always go back if it doesn't feel right to you.

Do you have a network of friends and/or family that could perhaps relieve you for short periods of time to get a bit of rest or a break? I really hope things improve for you and your little one, but from someone for whom things have not improved much in two years, I urge you to take advantage of any help you can get, just in case this goes on longer than you think/hope it will...

Apr 01, 2009
debbieb
Debbie, Mom to:
Derek,10/29/02 GERD,Can't have any legumes(soy, being the worse), allergic to PN/Tree Nuts, struggled to gain weight for years, my "picky" eater,Takes Zegerid. Johnny, 12/05/99 GERD, managed by diet, allergic to cashews/pistachios.
Another opinion...my 1st son co-slept with us, and I nursed him to sleep, and he didn't wake up to nurse at night(rarely), so I don't think they all do. He did nurse a LOT during the day, though. My 2nd son, the one with worse reflux woke up pretty much every hour around your sons age. Turns out he was milk and soy intolerant, and improved after we removed those things from his diet, I figured out that after switching Ped. I finally weaned him at 16mths onto Enriched rice milk, by them he only woke about 2-3 times a night, and that never stopped until we got him on stronger reflux meds, 3x a day. You should see a gastroenterologist and an allergist.
Apr 01, 2009
debbieb
Debbie, Mom to:
Derek,10/29/02 GERD,Can't have any legumes(soy, being the worse), allergic to PN/Tree Nuts, struggled to gain weight for years, my "picky" eater,Takes Zegerid. Johnny, 12/05/99 GERD, managed by diet, allergic to cashews/pistachios.
Oh, and regarding the dental work, there is NO proof that breastfeeding causes that, I think it is coincidence. Both my sons have great teeth. I nursed my first until he was 3, and my 2nd until 16mths. It isn't the same sugars as in juice or formula.
Apr 01, 2009
debbieb
Debbie, Mom to:
Derek,10/29/02 GERD,Can't have any legumes(soy, being the worse), allergic to PN/Tree Nuts, struggled to gain weight for years, my "picky" eater,Takes Zegerid. Johnny, 12/05/99 GERD, managed by diet, allergic to cashews/pistachios.
If you ever need someone to talk to, feel free to e-mail me at 4pas@sbcglobal.net and if you haven't already, see if you have a LaLeche League meeting near you, they are a great support system for breastfeeding, they helped me a lot.
Apr 01, 2009
ahousat
Lost my 33 yr old most physical fit husband 1 year ago, I miss him and his help! Feels so shitty and unfair. My baby getting better is the only thing that would bring my sanity back.
I still nurse my son at 31 months and know that he does not wake out of habit. Follow what you feel is right for you and your babes. Also we just had dental surgery, removal of 4 front teeth, from which dentist told me from breast.. as we do not do sweets, juice, bottle, ect. Advice they had for me was if I am to continue breast throughout night.. to wipe his mouth out after with wet cloth. Best to you and yours, it isn't an easy one :(
Check with your
doctor first!