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I’m worried that she is not having enough milk and seems so distressed at times

Hi Glenda,
My baby has just turned 4months and has silent reflux (according to myself and health nurse). I haven’t had this diagnosed by a paed but am booked in to see one end of April so if you could please help it would be much appreciated. She weighs 6 kilos and recently has been having 4 feeds of 100mls each time. She gives alot of problems to sleep during the day and everytime after a feed it sounds like the milk keeps coming up and going down and she seems very uncomfortable. I have started her on karicare thickener for the last month but not much difference and about once in 2days she does a HUGE vomit and cries hysterically before the vomit as she is so uncomfortable. I’m worried that she is not having enough milk and seems so distressed at times. If you can please let me know what else I should do, it would be much appreciated.
Thanks very much

Answer: Hi Natasha, Thanks for your question to Glenda about your baby girl. It can be frustrating to have to wait for specialist care, especially when you and your health care nurse already have an idea about what could be the problem. With ‘silent reflux’ this is where the stomach contents only comes part way up the oesophagus, and may be the reason why she is spitting up her milk some of the time and reacting in such a way as you mentioned. It’s good that you are seeking further medical advice, so that you can receive a clear diagnosis and hopefully find out what the underlying cause of the problem is, as there may be something else that are causing these symptoms, such as an ongoing infection causing the vomiting or other medical issue. In the meantime, you may find that starting a food and behaviour diary will really help at the time of the appointment, as this often can help pinpoint patterns for the doctor. Often there is such a short time to express everything that has been going on, having written notes about daily feeds and intake, behaviour, sleep patterns, can jolt your memory, and offer insight to the doctor that may otherwise be missed. Something that may be worth mentioning is that thickened formulas are not always the answer for reflux babies – while some babies seem to improve markedly on them, thickened formulas can make some babies more unsettled, so it may help to keep that in mind. You didn’t mention if you were still breastfeeding as well as using the formula however, you’ve raised a few concerns in your letter regarding her progress on feeding, and perhaps there is an underlying reason for this. A lot of babies with reflux tend to have allergies to cow’s milk protein, and as such have trouble with their feeding. For those with sensitivities, many milk or soy formula’s can cause a problem, therefore it really is recommended to mention this when speaking to your paediatric doctor or specialist who can pinpoint if that is causing the pain and vomiting. There are other specialised formula’s out there you could try, however it’s best to do this with the guidance of a dietician or specialist once the underlying reasons for the behaviour are determined, to ensure she is well monitored. While you wait for your appointment, if you are still concerned about her weight or feeding, keep in close contact with your health care nurse, local GP or other health professional, as every baby is different and they can help monitor any changes that may be occurring specific to your child. Once your have a diagnosis of Reflux, you’ll find some really useful tips and management ideas on www.reflux.org.au and RISA offers members additional support and assistance to families with Reflux as your baby grows and changes. Good luck. Best regards, Brenda
Answered: 08 Apr 2009