6 month old with reflux difficulty sleeping

By dstankew Tuesday, November 18, 2008

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Hi! My son was diagnosed with reflux from 6 weeks old. He takes 14 mg of Prevacid/day and now takes carafate 3x/day. He used to scream when drinking from bottle. Now that he is on solids, it is even more difficult to get his daily ounces of formula. I usually give him solids first, then the bottle 1-1.5 hrs later. The bottle is usually given right before his nap because he does "dreamfeeding." I try to get him to eat during the day and he usually gets 20 ounces in before bedtime. However, he is now waking EVERY hour. He's flops and squirms and is just restless. What suggestions do you have about feeding solids/bottle and what can I do to ease him at night so that he will sleep stretches longer than an hour?

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Jan Gambino, Health Guide

11/19/08 6:06am

Hello!

Poor sleep and poor feeding...you have named two of the top concerns of parents caring for a baby with reflux. Unfortunately, there is no "one size fits all" treatment for GERD so parents and doctors need to work (sometimes really, really hard) to figure out the best treatment plan. It sounds like you have tried some medications to treat the symptoms with some success. Other treatments include diet and positioning. Let me know if you have tried any of these approaches. Have you been referred to a specialist? Sometimes a primary care doctor will try some treatments and then refer to a specialist if the symptoms persist.

I just returned from a conference and spoke with a speech language pathologist about her research on swallowing problems (dysphagia) and GERD. Sleep feeding and poor bottle feeding are indicators of a swallowing problem AND GERD so the doctor may refer you to a speech language pathologist for a feeding evaluation to sort it out.

Let us know what you find out.

Jan Gambino

The Reflux Mom

Concerned Mom - Go with Your Heart

11/19/08 9:29pm

Please provide more information:

Does he have allergies?

If yes, to what?

Does he have eczema?

Did this "reflux" just commence 6 weeks ago or did symptoms persist longer, just not diagnosed?

What formula are you feeding him?

What food is he on?

Is he gaining weight accordingly?

Did he sleep well before or always a poor sleeper?

One note- I know dreamfeeding seem like the right thing to do now,but it is not because tooth decay can occur when he gets teeth and he will need to be weened from the bottle later on. I went through this too. Weening is not difficult.

Also, what blood type is he?

Thanks,

Concerned Mom - Go with Your Heart

Lisa

dstankew

11/20/08 11:31am

Thanks for responding. My son was diagnosed at 6 weeks after persistent crying and some throwing up. He would also turn away when I tried to breastfeed screaming and latching on and off. It broke my heart, but we thought it was the position that may have been burning his throat OR that I wasn't making enough milk (I had breast reduction surgery).

He doesn't have eczema or any allergies that we know of. We tried him on Similac Advance, but he was so constipated we kept him on Nestle Good Start w/ natural cultures. He seems to digest it better. He does take solids. Our ped started him on them at 4 months because he was having so much trouble with him BM's that he thought it would help. Only switching back to the Good start helped. He now takes 2-3 tb. rice cereal and 2 tb. fruit in the am. He takes 3 tb. cereal at night with 2-3 tb. veggie. My ped wanted me to start him on lunch, but when I tried this past week, he would not take a bottle all day.

He takes about 20-23 oz/day, but never a bottle with his food. He will drink 2 oz. awake, but 6-8 oz. asleep. I'm trying to feed him dinner earlier so he can drink all his bottle before bed and have it digested better. I just think he wants more milk, but there's not enough hours in his waking day to give it with a good amount of time in between.

He has been to a GI specialist who isn't sure he has GERD. She put him on the Carafate and he did drink some while awake. We go back in December and I'm wondering if we should do a GI series to rule things out or if I'm just paranoid!!!!! He is a healthy 20 lbs. and putting on weight has never been a problem. It just seems like he's not interested in the bottle or gets full really fast.

I feel like I obsess over his eating and people look at him and say "well, he looks healthy, he'll let you know when he's hungry." But that's the problem, he can go all day without crying to be fed.

One last thing, my dad had Pyloric stenosis as an infant and my mom thinks this may be the same case for my son. Any ideas about this? I appreciate any and all feedback.

Concerned Mom- Go with Your Heart

11/20/08 1:42pm

You can almost definitely rule out pyloric stenosis as this would happen in the few weeks/months of life and a tell tale sign is projectile vomting at a distance of a few feet.

My son had a barium swallow when he was 5 months and it did not show anything. My son "spit up" about 30 times a day. I own 100 bibs. No one could help me. I found out that he was allergic to milk and had to purchase ELECARE, a diary free amino acid based formula. He did worse on this. I did research and I came to the conclusion that my son could have a bacterial/fungal overgrowth. I saw a physician in Manhattan who does not believe in medications, he believes in fixing the problem. We tried Probiotics and saw a great decrease in "spitting up" but not a total cease. We did a course of Nystain antifungal for 2 weeks, and within 2 days, he stopped spitting up. With in 1 month, we never experienced another episode. My son was 7 months old and it was all better. Now he is 17 months old and is doing great. He gets a caclium supplement to strengthen the lower esophageal sphincter.

I read that your son has problems with BMs. Whether he is constipated or has diarreha, he could benefit from Probiotics. Probiotics are the natural cultures that you mentioned in Good start. You can safely give this to an infant. I gave CULTURELLE brand to my son at 1 month old. You might want to start with this route as it is the safest. I could blog on about other remedies, but it's easier to speak on the phone.

Feel free to email me at ilbacio0626@yahoo.com and we can exhange phone numbers.

It's a sad feeling when my pediatrician even said to me, I don't know what to do.

That's why I did all the research myself and I'm hoping to helps others.

God Bless,

Lisa

Jan Gambino, Health Guide

11/24/08 6:59am

Hello!

I am glad you have an appointment with the gi doctor coming up. Certainly the sleep feeding is often uses as a interim treatment as the doctor and the family work to develop a treatment plan to help your baby eat during the day.

As I talk with doctors and feeding experts, I hear over and over again that the sleep feeding is most likely related to pain from eating or a swallowing disorder. There may be other reasons too. At some point, you and the doctor may decide to explore this further. A swallow study and an upper GI test can look at the anatomy of the upper digestive tract. I know of a few babies who screamed and cried for months. Finally a upper gi test was done and there was a stricture, kink or web in the digestive tract. While this is rare, it can happen. The speech language pathologists who specialize in feeding find that many sleep feeders have feeding problems including dysphagia. Again, not every baby who sleep feeds will be diagnosed with this.

As Lisa pointed out, a few babies will have bacterial overgrowth. Again, not every baby will have this either.

That is why it is important to documents the symptoms you are seeing by keeping a journal of the feeding/sleeping, sleepfeeding, crying, etc and bring all of this important data to the doctor. Doctors really appreciate having this type of information as they look for the clues they need. I know how hard it is to bring an apparently healthy baby to the doctor and describe all of the issues I am having at home. The data will tell the story. Your son has grown because you are taking extrordinary care of him. This high level of care is the "medicine" right now.

I know the holidays are a time when relatives get together and give our much parenting advice. Try to hang in there through it all...Jan

erica

3/11/10 9:24pm

Jan,

Your last post was so helpful to me! I have a 4 month old son that constantly wiggled and back arched on the bottle and recently started refusing it awake. I can get some decent bottles in him when he is sleepy. I liked your comment about this being his medicine right now until the MD's come up with a better solution. I know that this to shall pass. I am just in the midst of it and I am concerned. He is on prevacid and I am not noticing a change in his behavior, but we are seeing a GI MD on tuesday. DId your children go through this?

Jan Gambino, Health Guide

3/12/10 6:21am

Hello Erica,

It is worrisome when a baby refuses to take a bottle while awake. I am glad you have an appointment with the pediatric gastroenterologist on Tuesday. Please let us know what you find out.

My reflux babies were not sleep feeders but they did struggle day and night to eat and drink! Over the years, I have spoken to hundreds of parents about their babies and children with reflux. Some parents like you describe a pattern of eating that has come to be known as dream feeding or sleep feeding. The parents on this site have increased my knowledge of sleep feeding tremendously. Unfortunately, the research is lacking. So the information is not research based but mommy tested at this point.

It does seem that sleep feeders may be reacting to digestive pain/discomfort and literally "shutting down" to turn off the pain and receive nourishment. While some babies sleep feed for months and seem to grow and thrive, it is a terrible burden for the caretakers. It is better to seek a treatment that decreases pain and helps the baby learn to eat while awake. Some parents have found a high dose of reflux medication was helpful. Often it is a combination of treatments: special diet, speech and language/feeding therapy and adding solids. The natural course seems to be that once a baby moves from bottle/breastfeeding to cup drinking/solids, sleep feeding goes away. Again, this seems easy but it is not unless you have a 24 hour staff of helpers.

Please keep in touch and let us know how you are both doing.

Take care,

Jan

6 month old with reflux difficulty sleeping

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