Baby reflux or gastrooesophageal reflux disease (GORD) was something that I had leaned about during my paediatric rotation in medical school but not something I thought we would ever have such problems with. Unfortunately our little Florence suffered badly with reflux early on.
Reflux or posseting is actually a term used to describe when babies effortlessly bring up whatever they’ve swallowed e.g a feed, in small amounts. It usually doesn’t bother babies at all and most babies grow out of it by the time they’re a year old.
It is caused by an immature sphincter muscle at the bottom of the foodpipe which doesn’t quite close properly, allowing the contents of the stomach to come back up.
There other different causes of reflux as well:
- Gastrooesophageal reflux disease – when the stomach contents rise up into the foodpipe causing irritation
- Cows milk protein allergy – may also cause a rash and diarrhoea. It is treats by removing cows milk from the diet
- A blockage – rarely, a blockage in the stomach or small intestine can use reflux and severe vomiting.
In our case, we were dealing with GORD. After a few weeks of being labelled as ‘colic’, it was evident to me that we had something more serious on our hands. Florry was an early baby so always at risk.
Symptoms of GORD:
- Vomiting feeds or refusing feeds
- Coughing or gagging whilst feeding
- Arching back during/after feeds and/or drawing up with legs
- Excessive crying or irritability
- Green/yellow/bloody vomit
- Blood in poo or persistent diarrhoea
- Not gaining weight or losing weight
- Struggle to lay flat
In our case we noticed from around 4 weeks that Florence was vomiting persistently after every feed, sometimes projectile, becoming increasingly fussy and crying a lot.
We tried to make sure she was winded really well inbetween feeds, kept her upright as much as possible and fed her little and often. By 6 weeks she was so bad that she would arch her back at the breast, fuss and thrash constantly. Feeds were a struggle, choking and coughing with every mouthful and would then be projectile vomited as soon as she sat upright. She would sometimes still be vomiting a few hours after her last feed. I spent a whole night awake whilst she slept upright on my chest because I couldn’t set her down or she would scream in pain.
It was the hardest thing for us to watch her in pain constantly. I think I went to the GP four times in the space of two weeks without any answers. Eventually I arrived, completely shattered, Florence strapped to my chest because I couldn’t even lay her in her pram at that point, and demanded that something needed to be done.
The GP, after some persuasion, rang the hospital and spoke to the Paediatric registrar who suggested a trial of a Lansoprazole. This is a protein pump inhibitor which acts to block receptors in the stomach that produce acid. We were also given some gaviscon to give with feeds.
We saw a little improvement, we were able to put her flat to sleep again, but not masses. She was still displaying reflux behaviour, being fussy, arching her back a lot and was thrashing in her sleep constantly. We had a really scary episode, when Florence actually stopped breathing, which was absolutely terrifying, but a severe symptom of reflux.
We ended up in out of hours one weekend because she was so bad, when they increased the Lansoprazole and at the hospital another time. At the hospital, her medication was changed and we were given thickeners to put in any milk she was having through the bottle. The change in medication to one called Ranitidine helped us massively, alongside the thickeners.
We’ve recently started our weaning journey too and this has seen a real improvement in her reflux so hopefully we’re on the road to her growing out of it now.
As a GP trainee, I completely understand the pressures that all members of the NHS are under and the real caseload that GPs have to contend with. That said, I really lost faith in our GP service. I was made to feel like a bit of a neurotic mother and our GP openly said they had never treated it before, often labelling babies as ‘colicky’ instead. Reflux in babies is really poorly understood. It can be really hard work and heartbreaking to deal with as a parent. It definitely makes me want to do better when I go back.
There are all sorts of support groups online and on Facebook. My advice would be, don’t just go along with what the first doctor says, if you feel that something still isn’t right, challenge them!!
Mummy’s instinct is there for a reason