Lots of issues

[butrfly462]

My ds will be 6 weeks on Tuesday and we are having some issues overall. 

The main one is he has reflux and spits up ALOT!!  So that being said, he doesn't always make it a full 3 hours from E to E.  it's more like 2.5 hrs the past few days.  I also ebf, but have had mastitis, clogged ducts, and overall lots of discomfort, so I'm supplementing with formula and planning to switch to formula.  He downs bottles...he's a hungry boy!!  And I question if he's getting enough breast milk...although he is gaining lots of weight...almost 11lbs and was born 7lb15oz. 

He loves his pacifier and its the quickest way to soothe him, especially when he's sleepy.  If I give it to him he goes right down.  However, if the pacifier pops out in an early stage of sleep he immediately wakes up and screams!  I'm beginning to think its a prop and its causing more harm then good.

As for his EASY he wakes around 7 or 8.  He goes down pretty easily for his first nap (pending he falls asleep w out the pacifier or he doesn't realize it falling out).  This nap ranges from 1 hr to 2 hrs.  2nd nap is usually in carseat or carrier when we run errands and is about 1-2 hours also.  3rd nap is usually short and in my arms, and catnap is just a hot mess bc from 5ish on he is overall awnry.  After we put his brother to sleep, we do bath, pjs/lotion, swaddle, sing, eat, rock, sleep by 7/730.  I try to dream feed but he's comatose and either takes nothing or very little.  He would go 5 hours, but now is back to waking 3-3.5 hours after his bedtime to eat.  I'll go in and feed him w minimal distractions and I put him down right after.  Usually within 10 minutes he wakes and cries so I have to go resettle him.  Usually he will go back to sleep until about 230, and he then is up constantly, probably every 1.5 hrs until he wakes for the day.  Last night I brought him in our bed for the simple reason he will sleep if with me and bc I am just so tired!!!

Is it ok to have him nap in my sling/Bjorn for the two naps that aren't so good?  Any ideas how to remedy any of this?  Thanks so much!!

[Ima shel Alon]

Is it ok to have him nap in my sling/Bjorn for the two naps that aren't so good? 

Of course it is! He is still so young, at this stage most mommies just do whatever is possible to get LO to sleep. Don't worry about props and AP so early on.

Could you post your day in an EASY format, I would just like to have a look at his A and if there is anything you can do to get better afternoons.
Is he getting any meds for the Reflux? I think a lot of your issues are because of Reflux, but I am not a Reflux expert so I am going to ask someone with more experience to come and have a look at your post.
Till then, have you seen the Colic, Reflux and crying board? Colic, Reflux, & Crying there is a lot of info there that could be helpful.

[Ima shel Alon]

Also forgot to say about the paci, that I read here a mommy telling that she had the same problem, as soon as LO lost the paci he woke up. So she went in 10min after LO fell asleep and gently took the paci out. She did it for a few days and then she forgot to do it once and he slept through the nap even though lost his paci.

[butrfly462]

Great idea about the paci!!  He did just start medicine last week for the reflux.  I honestly think my breast milk isn't sitting well with him for some reason.  He constantly spit it up.  He does fine with the formula.  Today he mostly had ottles of formula and only nursed once and he was so much more content and he napped well!  I'm thinking hunger might of been a lot of our problem.  Here is our EASY

Wake 745
E 8
S 9-10

E 10:15
S 11:20-1

E 1
S 215-345

E 345
S 5-550

E 6 and topped off at 650
Bed for the night at 7

Today was really good and I think it's bc of the formula.  His 2nd morning feed came so quick bc he spit up so much of the 8am breast milk that he was hungry early.  I'm curious to see how tonight goes!!

[Ima shel Alon]

That does look like a very good day and I think there is only a very small change that you can try and that is to up his A in the morning by 10min and see if you are getting a full (1.5h) nap out of him. But like I said, it looks great!

Have you tried ED? Perhaps you are eating something that makes the Reflux worse? I think many mommies stop with dairy when BF a baby with Reflux.
I will ask again for someone to come and have a look at your thread WRT the Reflux.

[butrfly462]

I have excluded dairy...didn't help.  Only thing that helps is formula..he keeps it down and doesn't scream!  He was still up a lot last night . I didn't dream feed...and he was up at 1146, 224, 446, 6, and 715 for the day. I'm going to try the dream feed again now that he's on a bottle. 

[Ima shel Alon]

It does sound like discomfort Do you think you have an over active letdown?

[Fiver]

You seem to have already made a decision to FF, but FWIW, it's not uncommon for BF babies to feed every 2.5h at 6w of age and it sounds like he's been doing great in terms of weight gain, so supply is obviously not an issue.  I just wonder whether there's an issue somewhere with the way LO is latching on which is resulting in him swallowing more air when BF and so having more wind which would explain the spitting up and discomfort.  It could also go some way to explaining the mastitis and clogged ducts you've had, especially if there is something like a tongue tie causing issues.

Obviously if you're happy switching, please feel free to ignore

[ENMS]

Hi there, sorry you're having issues

What meds is he on for reflux and what is the dose? Are you seeing any improvement to the reflux pain since starting them?

How long have you been off dairy? Are you also removing hidden dairy from your diet, or just obvious dairy? Lots of LO's that are intolerant to milk are also intolerant to soy, so it could be an idea to remove soy as well from your diet?

How long has he been having formula? Is it regular formula, or hypo allergenic formula? I agree over active let down could be an issue if he does much better on the bottle than with breast feeding - usually breast milk is much gentler on the tummy and much easier to digest than formula.

and he was up at 1146, 224, 446, 6, and 715 for the day

did you feed at all of these?

[butrfly462]

Fiver...we are still doing both!  I thought his latch or my letdown might be causing issues, too.  I don't believe he's tongue tied but I will have the doctor check tomorrow at his appointment. 

Elise...he is .3 ml of Zantac.  I'm not sure if its helping or not, but he's spitting up a lot less and isn't grunting as much or having wet hiccups.  I'm not sure if that's due to the med or more formula.  I've only stopped obvious dairy, like milk.  It didn't seem to make a difference.  He is on Similac Advance and does well with it.  And yes, I did feed at all those times...alternating formula then breast.  I know I shouldn't have but I've been going n little sleep for a week now and am delirious at the wee hours!  However...this may be doing more harm then good.

Thank you so much everyone...I love this board...you are all always so helpful!!

[ENMS]

The zantac dose seems a bit low - see this link. Keep it for 2 weeks and then if you're still having issues I'd ask the dr for an increase.

http://refluxrebels.com/Acid_reflux/Acid_reflux_medication.html

It's hard to tell which is working - the formula or the zantac. It's up to you to wait and see if you want to continue to BF or not. But if you think he's milk protein intolerant, the similac advance would eventually make him uncomfortable. sometimes though when LO's react to breastmilk it can be things like coffee, chocolate, acidic foods that bother them rather than just milk or dairy.

Re: the exclusion of dairy, if you don't remove even hidden dairy from your diet, LO can still have symptoms. if you think dairy is an issue I'd try to remove all traces of dairy for a few weeks and then re-assess.

How are his poops?

I know I shouldn't have but I've been going n little sleep for a week now and am delirious at the wee hours! 

oh hon I wasn't asking to make you feel bad - it was the opposite I wasn't sure if you were feeding him and so was wondering if he was waking out of hunger! I totally get it how tired you must be!

[butrfly462]

His poops are good...they were constant when ebf.  They are fewer now with incorporating formula.

When he wakes at night and it is not time to eat...what's the best way to handle that?  Pat/shhh without picking him up?  If so, where should I pat him??  He's in a rock n play sleeper so it's hard to get to his bottom or back.

[ENMS]

When he wakes at night and it is not time to eat...what's the best way to handle that?  Pat/shhh without picking him up?  If so, where should I pat him??  He's in a rock n play sleeper so it's hard to get to his bottom or back.

with my DS I'd turn him on his side and pat his butt, sometimes I'd just lay a hand on his stomach, it's really about finding what he likes. it's not easy at first but I think the key is to be consistent. I'd pick him up sometimes if I felt it would help, but sometimes it would do more harm than good.  my rule (which I know lots of people on this site use too) was not to feed more often than at night than during the day. so if he was feeding every 3h during the day, and he'd wake after 2h30 at night, I'd hold him off and try to resettle.

[Zeusthecat]

For the reflux, have you tried hazelwood necklaces? My LO had some reflux, not as bad as yours, and we had him in ranitidine for a few weeks. We took him off at 6 weeks or so and put the necklace on and had no more reflux. Not sure of it was maturity or the necklace, but I'm going with it.  The necklace works to
Absorb extra acid from the body.

Good luck

[Ima shel Alon]

with my DS I'd turn him on his side and pat his butt, sometimes I'd just lay a hand on his stomach, it's really about finding what he likes. it's not easy at first but I think the key is to be consistent. I'd pick him up sometimes if I felt it would help, but sometimes it would do more harm than good.

I agree, you will find out what works best for him. For us it was a hand on the shoulder but no patting and the shh.