My baby was born 2 months early. 31 weeks. He has been on prilosec since birth and has his dosage increased from 3 ml, to 6 ml, and now 9 ml per day. when he was a preemie he was in a danny sling, held after each feeding for 1 hour, and frequently burped while eating. His ped. thought he would be getting better now since we added food, but we had to increase dosage instead. (Food twice per day.) Since he was born he has refluxed through his nose rather than his mouth. They tested everything while in the hospital for 2 months including a swallowing test and all appear normal. I am concerned that he has turned 9 months now, should be 7 months and instead of decreased meds, we had to increase it. It does not come out of his nose much anymore, but if we say give him a bath after eating or let him layon his stomach it does come out of nose instantly. I have to hold him for at least 30 minutes upright after he drinks formula or he will reflux right away also. It is not projectile, but it is a large amount. I have gotton use to this and do this always, but night time is challenging when he wants to eat and go back to sleep. I then have to hold him for at least 30 minutes or he will be crying because it came out his nose and or mouth in his crib. He currently eats 6 1/2 oz of formulat at a time. his stomach is small and can not hold any additional volume. Should I be considered? Do you think he should see a specialist at this point? Or should I give it until he is 1? His pediatrician is the one who saw him in the hospital which is why I stayed with them, but they don't specialize by any means.
Thank you.
Sara
Hello Sara,
You are asking many good questions. While many babies outgrow reflux during the first year, some babies take a bit longer. Certainly a premature baby may take the slower approach due to an immature digestive system. A preemie may have high, low or mixed muscle tone that affects eating and digestion too. So the big question is whether he is able to eat enough to grow. If he is eating, spitting and growing, the doctor may be less concerned. If he is eating, spitting and barely growing, the doctor may want to look at the treatment plan again or refer you to a specialist.
Some treatments to discuss with the doctor include: thickening the feeds, giving him a smaller amount in each bottle but feeding more frequently. If he is gaining weight ok and your doctor is ok with decreasing or eliminating the night feeding, this might be helpful too. Some babies need the extra calories and you can't avoid a night feeding or two. It took me a long time to wean my reflux baby from her night feeds-her favorites. It was so comforting. It is easier to reflux at night when you are reclined and your muscles are so relaxed. So it is a good goal to eat only during the day.
Make sure the doctor knows how much he is spitting up and vomiting. I think it is very important to keep track of symptoms for a few days so you can bring some "data" to the doctor. Write down how often you feed him, how much, how often he wakes up at night, how often and how much he brings up. Scheduling a separate appointment just to discuss his digestive issues may help too. Sometimes during the well baby check ups, there are too many things to discuss and the worries about digestion gets lots with vaccinations, car seat safety and all the rest!
Take care,
Jan