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The only way to get him to settle and sleep is walking with him in a sling upright

Dear Glenda,
Jack is now 5 months old and suffer with reflux. The last month has just been really rough and the screaming when trying to get him to settle and sleep, unbearable! The only way to get him to settle and sleep is walking with him in a sling upright and sometimes in the stroller, but also after a big scream. We have tried the routine to put him on his side and patting when he cries, but he just arches his back so far back that he makes it impossible. We tried the silent night cd and book, which work for a day because it was something different.

We are currently giving him Zantac 2x a day, but he started again refusing his bottles and then an hour later he is hungry. Please help, because we just don`t know what to do anymore! The GP`s just don`t understand when you explain the bub is screaming his head off and nothing helps!

Kind Regards,

Answer: Hi Rentha, It sounds like things are getting worse at home, rather than better. Unfortunately, this can happen with reflux!! Unfortunately, it can also be difficult to get your doctor to understand what it is like – particularly as when you go to the doctor the baby is distracted and often sits there quite happily, smiling at the doctor. As I said in the previous response, it can help if you write down everything that is happening - including everything you have outlined here – record details of all the feeds (including when he refuses), sleeps (and settling), screaming, dirty nappies and anything you consider relevant. It can help the doctor understand the situation much more than you telling them (I don’t really understand why, but this often works). Alternatively, I would suggest taking a family member or friend with you to the appointment – someone who can back up what you are saying; or videotaping him so the doctor can see for himself. It may not work, but you could perhaps also try timing it so the doctor can watch a feed (though in a new surrounding he may just feed well). Do you see a paediatrician or paediatric gastroenterologist? They may have more experience dealing with reflux, and it may be worth getting their opinion too. They may also understand the enormous stress you are under. There could be many factors involved – is he teething perhaps? Or at a stage where he is trying to crawl? Constipated? Has he recently had vaccinations, or has his routine changed? Any of these factors can flare reflux, so they may be worth considering. Also, Zantac is a weight based medication and the dose often needs to be increased as bub puts on weight – sometimes quite often (while my son was on Zantac, the dose was increased every 2 weeks). (if the dose remains the same as bub puts on weight, the effect is that the dose is becoming smaller/kg as they grow). While it isn’t necessary to increase the dose for some babies, it is for others, so that may be something you could talk to your doctor about. Even if it has been increased, it may need to be increased again. Sometimes too, Zantac isn’t enough, and other medications, or combinations of medications, may be required. Even though he is on medication, it is worthwhile also following conservative therapies too e.g. keeping him upright for feeds and for half an hour following them, giving him tummy time before feeds rather than after, making sure his nappy is not tight, not putting him in a seated position immediately after feeds. There is no ‘one’ treatment that works for all reflux babies, and it often involves a lot of trial and error. There is more information on our website, (at www.reflux.org.au) so you may like to go there and take a look. Please keep trusting your instincts, and keep pushing for answers. Best regards, Glenda
Answered: 15 May 2009