Mommy’s solution to Avin’s sleep-feeding: understanding reflux and feeding difficulties

  I have written several shareposts on this site and this one is more of a review or summary type of post. My expertise is that I am a mother of a reflux baby and I understand science (Ph.D. in Biological Sciences).  I am not a medical doctor or a therapist but when these experts explain the logic behind their treatment, I can understand it pretty well.

  Eventually, we were very lucky to find a good pediatrician and a good therapist (SLP) for my son. As for an update in Avin's condition, he is still sleepfeeding but it's happening more smoothly and every once in a while he will accept a sippy cup for smaller quantities. He is eating pureed solids but again in smaller quantities. He is still on the growth chart following a curve of lower percentile scores but he is growing into an energetic and happy child. He is happy and no longer needs his PPI medicines (Prevacid or Prilosec). He is a fussy eater but he has graduated to being a difficult and fussy child rather than a sick child. He has learned to crawl and he is learning to stand with moderate support. He babbles and says things such as mum, dad, nun-nun (for food), bha (for bye-bye) and so on.

  Along with caring for Avin, I also spoke with several dozen reflux mothers, joined many reflux and feeding forums, and met other parents who are in the same boat as us. We got many useful tips from most of them. On the other hand, I tried to stay away from folks who gave unsolicited, irrelevant or aggressive advice about medications or treatments. My logic is that all children are different and only a mother of reflux child, who spends 24 hours with the child can estimate how severe or serious her child's reflux or feeding disorders are. Therefore, I have to confess that this article is from ‘my point of view' and may have certain biases. It's also based on observations of parents of babies who have silent reflux with very little or no vomiting. You may find some things in here that are useful for your little one, and other things that are not applicable to your child's condition. You are the best judge of your baby's condition.

  Severe reflux usually causes some sort of feeding discomfort followed by a feeding disorder. Back arching is the most  common early reflux symptom followed by turning away from the breast or bottle, being able to feed only while asleep, grazing (feeding small but very frequent meals), gagging, choking and retching while feeding, and finally inability to swallow textured foods once solids are introduced. Proper medication and/or therapy are needed for babies with severe reflux. There are several good scientific articles, books, and many share posts on this website about feeding difficulties arising from reflux.

  The key to treating reflux early is selection of appropriate medicine along with appropriate dosing. It took nearly 3 months for us to figure the right medicines/dosages for my son. A good pediatrician along with a good GI finally helped us controls my son's painful reflux symptoms. Conservative dosing led to severe aversions and kept us struggling for a while. A good doctor is essential for successful treatment of all reflux symptoms. Once that was done, we introduced solids and started looking for a good therapist who could help him accept the solids willingly. It has been my experience that therapy is not very useful in infants who are less than 4 months old. A session or two with the therapist and you might realize that there is not much that they can do if your infant does not accept the bottle. Still it might be worth it to do a session or two just in case some therapist somewhere holds the key to helping a child who sleep feeds or refuses bottle.