Saturday, 24 August 2013

The Awfulness of Reflux in Babies - Part Deux

So, in my last post about reflux we had just started on the road to managing J's reflux and attempting to make him (and us) a little more comfortable. We started by putting a rolled up towel under the mattress in his crib and putting telephone books under the legs to raise the head (actually I tell a lie, they say to use telephone books but who has them these days? Honestly, I used big thick trashy Jilly Cooper novels!). You can buy these if you want to be fancy:

They are little blocks to go under the legs of the cot. However, we have a gliding crib so it doesn't have defined legs (it has bars instead). The Jilly Cooper novels would have to do for us!

Propping up the legs of the crib really didn't make much of a difference to J's reflux, he was still sleeping terribly and was obviously in a lot of pain. We had a few horrendous sleepless nights. We had huge problems getting him to sleep in his crib.Quite a few nights he slept in his rocker. My friend who lives in the States sent J a Fisher Price Rock n Play (see picture below) and it was a lifesaver.

I'm not sure if it is available in Ireland or the UK, I had trouble finding it online or in stores here but honestly we couldn't have done without it. Some nights when J just couldn't or wouldn't lie in his crib because of reflux, he would sleep in the rocker for an hour or two relatively peacefully, as it puts them in a kind of supported sitting position. Many nights I got myself into a tizzy because I know babies are meant to sleep on their backs and I was worried about him sleeping any other way. There are a few articles online about how it wasn't safe for them to sleep in the rock n play which I read with growing horror, in this case Google really was my enemy. Also, many nights when even the rock n play failed us J would sleep on my chest for a few hours. Again, I would tie myself in knots worrying about this thinking I'd wake up to find him not breathing. In hindsight, if that's what we needed to do to get through the night and we were being careful about things then I think it is ok. J needed a mum that wasn't a complete mess and could actually function during the day. As the days went on I got a bit more relaxed about it.

One night during this period I was so sleep deprived I started hallucinating. I took J out of his crib and placed him on the bed while I got ready to feed him (or so I thought). When I went to pick him up off the bed he wasn't there. I was scrabbling frantically in the bed looking for him, pulling back the covers and throwing the pillows off the bed getting more and more freaked out by the minute. Then I turned around and he was still in his crib, I had never taken him out at all. I was so tired I had lost the ability to distinguish between dreams and reality. It sounds so over the top, but it was one of the scariest things that has ever happened to me.That was when I knew we couldn't go on like that for much longer.

The hallucination incident happened on a Friday night so on the Saturday morning we took J to the out of hours GP in St Michael's Hospital in Dun Laoghaire. I had read online that infant Gaviscon was the thing to get for babies with reflux. This is an over the counter medicine but pharmacists are reluctant to give it to babies under one year old unless a doctor had told you to use it (I had been to the pharmacy to try and get it!). We went to the doctor with me hoping he would give us the Gaviscon so we could get J feeling better.

The doctor, after asking lots of questions and ruling out anything more serious said it did indeed appear to be silent reflux and suggested Gaviscon after every feed, but no more than 6 in a 24 hour period. I was delighted thinking it was the solution to all our problems but my optimism was a bit unfounded as it turns out.

The problem with infant Gaviscon is that it is really not compatible with breastfeeding. Gavison needs to be given after a feed mixed with either water or milk in a bottle or a syringe. If you are formula feeding you can mix it with the milk in the bottle before giving it to the baby so it's much easier. You can also get specially thickened formulas for reflux, but you can't mix Gaviscon with these. Anyone who has breastfed a baby will know how unresponsive they are after they have been fed. How on earth do you get more liquid into a full, sleepy and milk drunk baby? It was impossible to get him to take more milk when he was already full.I was very reluctant to give up breast feeding and switch to formula for a number of reasons so wanted that to be a last resort.

Mainly we gave the Gaviscon to him mixed with some breastmilk in a bottle before his feed. Usually this didn't work because it's not designed to be given before feeds and our boy loves his grub and making him wait while we prepared the Gaviscon was not alright with him at all! He'd be hysterical by the time I was ready to feed him, making the reflux worse because he would gulp his feed down really fast which actually aggravates reflux. Sometimes we would wake him up an hour after his feed to give him Gaviscon but it really wasn't an ideal situation at all. If he woke up crying out in pain it was easy to get the Gaviscon in to him but mostly he'd just be groaning and thrashing about in his sleep and waking him up for Gaviscon meant it took a long time to get him back down again, as well as making him very upset.

It did help a little bit but it really wasn't nearly as effective as I hoped. We used the Gaviscon in conjunction with continuing to prop up his mattress and also keeping him upright after a feed for at least 30 minutes before putting him down. This was fine during the day but a right pain in the ass at night when all you wanted to do was to go back asleep. I bought a wedge pillow to prop up his mattress more effectively. There are a lot on the market but I just bought this basic one from Mothercare:

The problem with propping up the mattress was that it would cause J to roll to the side and he'd wake up screaming with his face rolled into the bars on the side. Obviously not ideal - bad mammy territory! To combat this I bought a Clevamama Sleep Positioner (also from Mothercare although many places stock them):

This has bumpers at the side to stop the baby rolling over. It's only suitable for young babies as once they have learned to roll over it's not safe. It did solve the problem of him rolling to the side although he does slip down it during the night, meaning you have to wake up and move him back up every so often. It's also not suitable if you swaddle your baby and we found it didn't really work while using a gro bag so we had to retire that temporarily.

There are also specialist reflux wedges for babies that look like this:

The baby sleeps in a little sling attached to the pillow. How clever is that? They are extremely expensive (about €200) but there was the odd night I'd be sitting holding J up and browsing on my iPhone were I was thinking screw it, it's only money, if it makes him feel better just get one. I would have done anything. In the morning I always saw sense though, to the immense relief of Mr HNW!

So we tried all of these methods over a two or three week period and while there was a small difference in J's reflux we were still struggling. During the day J was a very happy little baby and luckily, we never had any problems feeding him. Some babies with reflux start to associate the pain with feeding and refuse to feed. J has always been a good grubber and was putting weight on well. Still, we were exhausted and we felt like all we talked about was J and how he was. It became a full time job feeding him, trying to fit in the Gaviscon and constantly sitting with him upright in our arms.

To be continued......


If anyone is out there I would love to hear any thoughts you have after reading this blog!