Posted By Posting
Feb 21, 2012
helendema
baby not eating enough and only sleeping while being held
Hello. Thank you in advance for reading my post and apologize for my babbling. My daughter is 10 weeks old. She was diagnosed with reflux at her two month checkup. She was actually good for the first month, eating 4ozs each time (formula and breastmilk) and gaining more than 3lbs. The only thing abnormal I noticed was her squirming and making loud noises (like she was straining) during the early morning hours (from 5am to waking up) but her eyes were closed and she didn't spit up. she has been fed breastmilk exclusively since about three weeks of age. After her one month checkup, it became more and more difficult for her to eat. She eats much less each time (2-3ozs) and sometimes cries or pulls away during feeding or when offered a bottle or when there is a letdown. She spits up milk but sometimes she spits up liquid that is almost clear. With all the spitting up, she still managed to gain 2lbs during the second month. Her sleeping is getting worse by the day. During the day, she can only sleep in her infant seat or on me. During the night, she used to have stretches of 4-5 hours of sleep, but now she can only sleep in her crib (one side elevated) for 20,30mins, sometimes an hour, or wakes up immediately when I put her in the crib. She wakes up usually not crying but obviously swallowing stuff, sometimes spitting up. Since she can sleep for hours and seems comfortable when I hold her, I end up holding her all night now. Is there any negative consequence for her in terms of development and sleeping habits if I hold her all night? Her doctor prescribed nizatidine (2ml twice a day). She has taken it for 5 days. I feel like her symptoms are getting worse. After reading other posts here, I am kind of scared that my daughter might have a severe case of reflux and we have to deal with a lot of other issues for a long time. Do I need to request a medication change? Do I need to request a referral to a specialist? It is terrible to be so sleep-deprived but worse to see my baby in pain. What else can I do to help her?
Feb 21, 2012
dcd
You are doing all the right things. There is no negative consequence for her development or sleeping habits if you have to hold her all night. If that's the only way she'll rest, do it and don't feel guilty. Mamas do what they have to. It won't last forever. All of us on this forum have been there. We know how tired you are and that it is so hard!

My suggestions: get her on a PPI (proton pump inhibitor) like Prevacid, Prilosec, or Zegerid ASAP. Make sure the doctor prescribes a high enough dosage and that you are administering it correctly (on an empty stomach, 1 hr before a meal). Also research the possiblity of a milk-soy protein intolerance (MSPI). Reflux and MSPI often go hand-in-hand and the symptoms can mimick each other. My daughter had both reflux and MSPI and it took us a long time to sort things out because we weren't sure which was causing the problems (it was both).

Feb 21, 2012
helendema
Thanks, dcd, for your support and advice. I will talk to her doctor about it asap.
Feb 28, 2012
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.
Just adding my support for doing what you have to do to help your little one sleep. There were times when I literally thought I might die I was so exhausted, and for my son it lasted for years. People gave me so much grief for giving so much of my own sleep to help him, but now, five years along on our adventure, I am absolutely certain that it was my willingness to do so that PREVENTED developmental problems. Every minute of sleep for an infant is valuable, and for those who have difficulties sleeping, for whatever reason, all the more so.

I do want to encourage you, however, to seek help in getting some rest yourself from any source you can -- partner, family, neighbor, anyone who can be with your baby for short periods of time to allow you to get some sleep (or at least some rest). When a baby wakes frequently, sleeping when baby sleeps is useless advice -- you need to sleep when she is awake, which requires the assistance of someone else. It is unlikely that your daughter's challenges will go on as long as my son's did, but I really wish I had understood then just how long it might be before I got a full night's sleep (it was two years and happened just once, and it has only been in the past couple of months -- he's almost 5 -- that the frequent night waking has really dissipated). I might have been more proactive about seeking help in getting help from others to allow me to get some sleep.

Feb 29, 2012
helendema
Thank you, Lorenzomama, for your kind support. I really appreciate it. My daughter has been on prevacid for 7 days now. She is given 2.5ml once per day. Her eating has improved. It is not as much of a struggle as before and she doesn't spit up or swallow stuff as often as before. However, her sleeping has been pretty much the same except one stretch of 4 hours in her crib two nights ago. So what result can I realistically expect from the medication? Is what I have seen the extent of it? As for the prevacid, it only says "taken before meal", the pharmacist says 30 minutes before meal, but people on this forum say 1 hour. Which one do I follow? Or does it have to be that exact? Thanks again for your help.
Mar 01, 2012
dcd
Lorenzomama - Awesome that after five long years you and your boy are finally starting to get some decent sleep! I hope the trend continues!

Helendema - 2.5 ml seems EXTREMELY low to me. What is the mg/ml concentration? I haven't heard of a dosage that low...I believe the "max recommended" dose is 15 mg/day at your daughters age - often in a split dose (7.5 mg morning & night). But because babies metabolize the PPI so much faster than than older kids and adults, doctors often prescribe an even higher dose than the "max recommended" - my daughter saw relief at 27 mg/day (split dose).

How do you feel about your physician? Do you get the impression he/she is well-versed in treating infant reflux? (Many regular pediatricians aren't.) I personally would want to trial a significantly higher dose of the PPI. Have you considered getting a referral to see a pediatric GI?

Mar 01, 2012
helendema
It is 3mg/ml. We have only seen this pediatrician twice so I am not sure how experienced she is in treating reflux. I thought I would request a referral if this round of medication didn't work. Do you have any tips on administering the medication? My daughter doesn't like it and would push it out with her tongue, and it is not always easy to squirt the medicine between her gum and cheek, so sometimes she doesn't get the full prescribed dosage.
Check with your
doctor first!