Advice for a confused mom

My daughter is 3 months old and we’ve been dealing with reflux since about 6 weeks. The opinion of her pediatric GI specialist, who we have seen twice now, is that she has a milk/soy protein allergy as well as reflux. Trace amounts of blood were found in one stool sample. We had a lot of problems initially with gas and although she is still a gassy baby, it doesn’t seem to cause her as much pain for the most part. Currently she is on Alimentum formula and Axid (1.2 ml two times per day). A few things have me confused lately and I was hoping for some input.

First, she has started to spit up quite a bit more. She was more of a silent refluxer initially but now she spits up several times with every bottle (and it seems like a lot to me at times) as well as between bottles. Sometimes it seems more mucousy than anything else. She is often fussy at feeding times but doesn’t seem too terribly distressed when she spits up between bottles. Within the last several weeks, she has started to sleep from 12-6 every night/morning and has even begun taking one long nap (2-3 hours) and one or two shorter naps during the day for her sitter (a HUGE improvement). I’m confused by this because if the reflux was really bothering her a lot, wouldn’t she still be restless and uncomfortable like she was in the past, and yet why is she spitting so much?

Also, about two weeks ago she seemed to develop a cold. She was really congested and her nose was running, and at about the same time seemed to be gagging on her bottles a bit more. I wasn’t honestly sure if she had a cold or if the reflux was flaring, but she had been on the same Axid dose for a month so I requested an increase to be on the safe side and gave her Tylenol for a few days to help her over her cold. She seems to feel fine but still has some coughing at night and wakes up slightly congested and stuffy some mornings. Can this be a result of the reflux? I am just getting over a cold myself so I felt fairly certain that she had one as well but can’t really be sure. I guess I’m also not sure if this is something to mention when I see the GI doc or if it’s just a coincidence. Around the same time, she also started to eat less, going from about 26-30 oz. of formula a day to as little as 18 or 19. I chalked that up to her not feeling well from the cold and continued to monitor it, and we’re getting back up to about 22-23 oz. now. I recently changed her to a Level 2 nipple and it seems to help her eat a little better as she was taking forever to eat and seemed to lose interest half way through. This morning when I fed her she was fussy and my husband suggested that she was still hungry so I offered her more and she did take about another 1.5 oz and then settled. I wonder sometimes if I am so concerned about the pain of reflux or other issues that I miss the obvious signs of something simple, like she’s just still hungry. I worry about over feeding her at one feeding though because of the excessive spitting.

So, I guess my questions are these: Does anything I’ve said seem to indicate that she needs a stronger medication like a PPI? Is it common for babies with reflux to begin spitting up a lot more? Also, do you think she could be helped by adding a small amount of cereal to her bottles? I know that practice gets mixed results but I’m wondering if a tiny amount would help keep the liquid down and also help her to feel fuller without loading her belly up on more liquid, which she can’t seem to keep down. I’ve done research and I know that I’d have to use selective cereals given her allergy.

We see her GI specialist on Tuesday and I’m hoping to get your advice on what to ask/request of him. He’s fairly conservative in his medication dosing and will not prescribe a PPI without a formal scope. I’m hesitant to do a scope on my daughter at this point since she seems to be gaining weight and growing well in spite of some of her challenges. I do believe that Axid gives her relief because I can notice a difference when she is outgrowing her dosage or if I am late in giving her a dose for some reason, but as I’ve said, I’m just often confused and overwhelmed by the different behaviors and symptoms she exhibits. I worry and think (or “over think” as my husband says) so much about the reflux and gas issues that I end up just confusing myself more!! Thanks so much for your input – this site has been a great resource for me!

JulyMom2008-10-24 13:16:55