Tuesday, 24 September 2013

The Awfulness of Reflux in Babies - Part Four

So, now that I've shared our story of J's reflux I thought it would be a good idea to put together a post with my top tips for dealing with  it. Obviously I am not a doctor, these are just tips that worked with us and J's reflux:

1) Prop up your crib with blocks/books or use a wedge pillow under the mattress combined with a sleep positioner. Now that Josh is medicated, we decided to try and take away the wedge pillow and sleep positioner as we didn't think he would need them. This was a big mistake, within minutes he was starting to arch his back in pain. They really do make a huge difference.

2) Keep your baby sitting upright for at least 30 minutes after each feed. Longer if you can (i.e. if it's not the middle of the night). I also keep J upright as much as possible during the day. The Rock n Play I mentioned in this post is just great for giving me a break so he's not in my arms. Another option is to get a sling and carry the baby around that way during the day. I'm a fan of babywearing and have a Moby wrap that I use to carry J.

3) If you can get them to use a dummy/soother/dodie/pacifier - whatever you want to call them do it! I know some parents are against them but it is now actually recommended that they are used to help prevent SIDS. They are a great help for refluxy (and also colicky) babies to encourage them to swallow. It is also a great comfort. Luckily J loves his, I don't know what we'd do without it. Refluxy babies often gag themselves with their own fists (which J loves doing) and I'd much prefer he used a sterilised dummy if he needs the comfort.

4) Small feeds more often seem to work better. As J is pretty much exclusively breastfed and I feed on demand this can be hard to control but often refluxy babies feed more often naturally as the milk soothes their poor burned throats.

5) There is a lot of advice online about foods to avoid, most of it conflicting, in my opinion. Dairy and chocolate feature heavily though. I just couldn't face giving these up though, after being so sick during pregnancy it is heaven to be able to eat normally again. I did give up spicy foods though as that was a definite aggravator. If you have more self control than I do this could be an option for you if you are breastfeeding. I know of a mother whose baby has terrible reflux and unlike J, vomits regularly. She gave up dairy and said it made a huge difference to her baby. I could actually physically see the difference in her baby from one week to the next so it can work if your baby is slightly lactose intolerant.

If you are formula feeding try one of the specific formulas for reflux like Aptamil Reflux or SMA Staydown. Some refluxy babies are also lactose intolerant so changing your formula could be a good idea if you suspect this to be the case. Nutramigen seems to be a popular choice but of course, discuss with your GP first.

6) Seek help - there is nothing wrong with giving your baby medicine. I have heard more than once, both online and in real life women who smugly lecture me that all babies have reflux and doctors hand out prescriptions like they're sweets and you should try natural remedies. These are the women I want to punch in the face, repeatedly. It's fine if you don't want to medicate your baby, but a) in my opinion if they were as bad as J was or other babies are then you would have done anything to make them feel better, your baby probably wasn't that bad and b)how dare you be so judgemental, I'm doing the best I can and if the medicine will stop my baby's pain then he's getting it. No mother is going to jump straight to giving their baby prescription drugs without trying other things first. The reflux has been my first experience with the "judgy mummy" and I'm sure it won't be my last.

7) Play around with dosages if you need to (under your GP's supervision). Babies are different and even though there are guidelines for mg per kg of weight it seems different doses work for different babies.

8) Some medical proffessionals advise to wean onto solids as early as possible, but I have also received advice that it is not a good idea. To be frank, I have no idea. J is only 14 weeks old so too young for solids. I'm inclined to wait until as close to 6 months as possible but I really think it is up to the parents who know their babies best. I know a mother who started her son on solids at 3 and a half months due to reflux and swears by it. I'm going to see how we go. It is something to think about though if you have a refluxy baby.

9) Finally, be good to yourself.. I found the lack of sleep so difficult but luckily I have a supportive husband and we worked out a routine where he helped more at night, even though he had to be up for work. I also have a fantastic Mum who came over almost every day so I could have a lie-down while she watched J. Take care of yourself, eat well and try and sleep when you can. It's hard to see your baby in distress but remember it does get better and you are not alone, it really is a very common problem and there are things you can do to help.

Monday, 9 September 2013

The Awfulness of Reflux in Babies - Part Three

So, at this stage in the story we were keeping J upright as much as possible and trying to get Gaviscon into him when we could. We were still exhausted and while there was a small improvement this stalled and J still had problems with spitting up, arching in pain and generally having very disturbed sleep.

I had talked to a few people who knew babies with reflux and read pretty much everything the internet had to say on the matter and it seemed that a lot of babies were prescribed proton pump inhibitors. These are drugs that inhibit the production of acid in the stomach and ease discomfort. Our GP had said at our visit that he was not comfortable prescribing these unless a paediatrician had checked him out.

Luckily, due to the previous issue J had with twitching in his sleep we had his 6 week check in Holles Street instead of with our GP. I expected the paediatrician to be quite dismissive as J was thriving in the sense that he was putting on weight and was developing normally and seemed well. The paediatrician was actually lovely about the whole thing and understood that we couldn't continue going the way we were. He prescribed 10mg a day of Losec. The sense of relief I was feeling when I went to fill that prescription was unreal. I was so hopeful that an end was in sight. I informed our GP that the paediatrician had prescribed this and he said he would do a check on Josh in a week or so to see how it was working.

The problem now was getting the Losec into him.The Losec we used was the MUPS (multi unit pellet system). The pharmacist recommended dissolving the tablet in a syringe and putting it in his mouth.The tablet dissolves quite well in water and turns in to a liquidy paste with granules in it fairly easily. The syringe didn't work as a lot of the granules got stuck in the tip. Mr HNW had the great idea of grinding the tablet finely in the mortar and pestle I use for grinding herbs. DO NOT DO THIS!!! I cannot stress that enough. The tablet consists of pellets with an enteric coating that protects the active ingredient from being destroyed by the stomach acid. I had a very bad night with Josh and couldn't figure out why the Losec was not working. Luckily, I re read the instruction leaflet during the night and realised what we had done.

The next thing we tried was placing the tablet on a plastic weaning spoon and dropping boiled water that had been allowed to cool on to the tablet using a syringe. This worked a treat, the tablet dissolves into a watery paste and it's easy enough to get it into J. There's usually a little bit of spillage but we're getting better at it every day.

After a week or so of being on the Losec, I had noticed an improvement but it was obvious that the positive effects wore off during the day, as he was being given the tablet in the evenings before going to bed.. I rang our (very lovely) GP to discuss it with him and he recommended giving him a second dose in the mornings. Since we have started doing this there has been a huge improvement. He is on a relatively high dose for his weight but it is under the supervision of our doctor and we're just grateful that it seems to be working.

While the reflux is still there and causes problems it is much more under control and we are all feeling much more human. J even sleeps more during the day now that he is more comfortable. He is now about 12 weeks old and we're starting to get into a routine, especially with giving him the doses of losec morning and evening. I think things are easier partly because he is getting older and partly because the reflux is much more under control.

If you are in a similar situation, I just want to say please don't despair, things will get better and there really are things you can do, which I'll detail in my next post.

Saturday, 7 September 2013

Autumn - The Season of New Coats and Boots

I have a confession, I actually prefer Winter to Summer. I'm not an outdoorsy or particularly active person and I'll always prefer cosy nights in in front of the fire, eating lots of food then being expected to be outside and active all the time. Also, summer clothes don't really suit me and I much prefer what is available in the shops for Autumn/Winter.

So today I was delighted that it was so miserable and cold. It was a bit strange suddenly having to think about keeping J warm enough instead of cool enough but I was thrilled to be wearing warm clothes again!

I've learned the hard way that you need to buy new coats and boots well before it is cold enough to need them, as by the time you head to the shops all the best stuff is already sold out and more of the spring stuff is coming in. So today, I was all ready to get some new items out of the wardrobe.

I recently did a bit of shopping to prepare myself to Autumn/Winter 2013. The first thing I needed was a new coat. I frickin love buying new coats, I think because in the Winter you wear a coat all the time, meaning a decent coat will always make you look good easily. They cover a multitude of sins. I have three coats currently that I still love and can see myself wearing for years to come, a beige wool skirt coat from Topshop that I got on sale 4 years ago and am going to wear until it falls apart, a brown parka with a furry hood from Zara and a short Superdry navy windcheater. Being very practical, I decided I needed a short peacoat type of jacket to wear with jeans and boots. I did a lot of online research before heading to the shops and found the perfect coat. This burgundy number from H&M for €40:

It is also available in beige, black and khaki green and it just fab on, a great fit for the price. The funnel neck can be done up as in the picture or worn down like a normal collar like the below: For that price it's obviously not made of wool but I reckon I should get a few seasons out of it.

Even though I had decided I needed a short coat it was a tough choice between that and this H&M trench coat:

This is €50 and to be honest, I haven't ruled out a trip back to Dundrum to get my hands on it. It was heavier than other trench coats I've seen and also fit very well.

I also considered this boyfriend coat from Topshop:

I ultimately decided it was not a good reason to two reasons, the first being that it is navy. I love navy but I have very strong feelings on wearing navy and black together. I just can't do it, I think it stems from having a navy school uniform. I have two pairs of black winter boots and I knew I just couldn't wear a navy coat and black boots together. Secondly, I think the boyfriend fit would just hang funny on me, I think it's more a look for tall, slim women and would do nothing for a big-boobed shortarse like me.

Last winter I bought an expensive pair of black knee high leather boots so I don't need a new pair now and probably couldn't afford it if I did! I did buy a pair of ankle boots. I'm not a big fan of ankle noots normally, I just don't like how they look with dresses or skirts and I've never felt able to pull off ankle boots with jeans. Looking online recently I decided it was time to give it another try, I like how ankle boots look with the currently popular super skinny jeans and jeggings.

I purchased these from Asda for £18

I figured they were cheap enough that if I didn't wear them much it wouldn't be a huge loss. I wore them today and they are ridiculously comfortable. Mr HNW did say I looked like a pixie but I think I can live with that.

I'm on the hunt for a pair of flat, beige/stone coloured ankle boot with no decorations at all (i.e. studs ands things) but having no luck at all. I did find this pair in New Look:

but they are in their wide feet range so they would be massive on me. The search continues anyway!

My final winter purchase I am sadly excited about. I bought a pair of short Hunter wellies direct from the Hunter website:

Bring on the snow, I am ready! They are having a sale on certain colours in their short boots so these were reduced from £75 to £48 with free delivery to the UK, meaning I only paid €3.50 for delivery using parcel motel. Since I ordered them they have released their new Autumn/Winter 2013 range and there's quite a few pairs that I want. However, I am being sensible. Realistically, how many pairs of wellies can you really wear?

If you are on the hunt for some Hunter wellies I realised recently that in the kids range they do up to an adult size 5. The boots are about 10cm shorter but still, the kids short gloss boots are only £38 so could be a great bargain if you're feet are on the smaller size.

So, I'm off to get in to some fleecy pyjamas and get into bed with my electric blanket on - bliss!


Tuesday, 3 September 2013

Cloth Nappies - Baba and Boo Review

I have a confession to make, my name is Niamh and I am a cloth nappy user! While I was pregnant I did a little research on types of nappies and realised how funky, stylish and practical cloth nappies had become. When you say cloth or reusable nappies to people their first thought obviously goes to terry cloths and safety pins and imagining me up to my arms in soapy, pooey water. Cloth nappies have moved on in a big way since then!

The reasons I was interested in cloth nappies was a) to save money and b) because I wasn't comfortable with the amount of waste using disposable nappies produces. I'm not really the hippy, environmentalist type but in Ireland 600,000 disposable nappies are used everyday and 94% of these end up in a landfill. It just seemed like a lot of waste to me and if using cloth nappies also saves money in the long run, it made sense to give it a go. One thing we are not short of in Ireland is rain so I wasn't worried about using extra water. I know parents in drier areas often have to weigh up the environmental impact of sending nappies to landfill versus the increased water using washing the nappies causes. 

I did a bit of online research about the different types and brands of cloth nappies and read reviews of different brands. I decided to start with pocket BTP (birth to potty) nappies. BTP nappies do what they say really, they are adjustable so they can be used as your child grows. Each nappy consists of an outer nappy shell with pockets and then two microfibre inserts that go in the pocket. 

Baba and Boo Cloth Nappy

This seemed to be the best all round option for me and I chose to order from a company called Baba and Boo. They offer a more affordable range than other companies as well as having a starter kit that interested me. Also they have some fab designs which really appealed to me (pic of some of my stash below!):

Baba and Boo Cloth Nappies

I bought a starter kit of 20 nappies, 40 microfibre inserts, two wetbags (for transporting dirty nappies home with you), a nappy bucket and two mesh bags to put the dirty nappies in to. This cost £168 plus delivery. They really are very simple to use, one insert gives you three hours of dryness and two inserts gives you six. The nappies have poppers on them to adjust the size. The nappies are advertised as being suitable from 8lbs to 35lbs but I found that although J was 8lbs 1oz at birth the nappies did not fit him well enough to use until he was about 3 weeks old. 

It took a little bit of experimentation to find the right combination of poppers to fit him but we got there in the end. We do have leaks occasionally, mainly if he has a dirty nappy and I don't change him quick enough after it. We have found that the disposables we use occasionally actually leak more often then the cloth nappies which I found surprising. We do occasionally get some "wicking" on the legs (this is when the edge of the nappy at the legs gets wet and then soaks through to the vest/babygro) but this is mainly at night. There is the option to "boost" your nappies (for instance for keeping baby dry all night) by adding hemp, bamboo or charcoal inserts into the nappy to make it more absorbent. We use charcoal inserts for this and they are great.

With regards to the dirty nappies, we rinse them with the shower head, either in the bath or down the toilet (luckily our shower head stretches to the toilet) then they go in a mesh bag in the bucket which is kept in our bathroom (this is called dry pailing). Once the bucket is full I pull out the mesh bag, put in the washing machine on a cold rinse and then wash at 40C using a small amount of washing powder. You can add napisan or something similar into your wash but the best stain remover is actually the sun. Even though we live in an apartment and therefore don't line dry our nappies the sun can still remove stains through the windows if we place the clothes horse in the sitting room window. 

Using cloth nappies really works for us and I would recommend it to anyone. I like that I don't have to buy nappies (apart from an up front cost) and that our waste hasn't increased. Also the cloth nappies seem to agree with his skin more, when we were using disposables he got an awful nappy rash that we needed prescription cream to clear up. Now, when he wears a disposable nappy it gets stuck to him in exactly the same place that he had the rash so really I think they are so much better for his skin. Yes, it is more work but really not a huge amount  especially if you consider the benefits we get. 

If you are interested in using cloth nappies I'd recommend checking out the Irish cloth nappy library. You can trial nappies from here to see how you get on before purchasing. In hindsight I should have done this as the Baba and Boo nappies might not have suited J and us. Luckily they did but if they hadn't fit him very well I would have been stuck with twenty nappies I couldn't use. There is also a cloth nappy users group on Facebook where you can chat to other women who use cloth nappies. Another option is to buy second hand or "pre-loved" cloth nappies if you want to try any out. Cloth nappies do hold their value well and there is a good market for second hand nappies. There is also a Facebook group for that here. 

Be warned though it can become addictive, there are so many brands of nappies with fabulous designs, styles and structures. It's easy to get caught up and just keep buying more and more! I have my eye on a wolverine one for J at the moment. Mr HNW is a big X-Men fan. There also seems to be a limitless amount of brands and styles so I'm currently trying out some other kinds to see how we get on. 

As you can see J is pretty happy with his fluffy bum: