Author Topic: 15 Weeks - Reflux? Should we move to 4 hour EASY?  (Read 1834 times)

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Offline hynygirl

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15 Weeks - Reflux? Should we move to 4 hour EASY?
« on: January 05, 2017, 18:57:16 pm »
Our baby girl is 15 weeks today.  She's been formula fed since about 8 weeks and it's been a struggle.  Her doctor won't officially diagnose her with reflux but she spits up so much and can get really fussy during a feed! I think I'm trying to force her to take more when she really doesn't want it. After reading some of the threads here about reflux signs I'm convinced this is her issue.  Yesterday after talking with her dr we decided to try a soy based formula.  She's been doing well with it but has only been a day so will need to assess again in a few weeks. 
She is doing fine with weight gain, was 6lb15oz at birth and is just over 12lbs now.  She eats very little at a feed, 3 oz is her normal but sometimes only 2oz and sometimes up to 5oz.  She'll typically take less in the morning and more later in the day. She eats best at night and will easily down 4oz because she's sleepy and relaxed. She is still waking for a 1am-2am feed and around 5am-6am as well so I don't feel she's getting enough. She's never gone more then a 4 hour stretch. Naps are normal, anywhere from 1hr-1.75hrs.  We are having issues with her soother dependancy (she wakes for her soother often) as well but I have decided to limit its use to bedtime only and will focus on smoothing out other wrinkles for now- such as sleeping longer! and good feeds.
At this point should I switch to a 4 hour EASY? She can stay up anywhere from 1hr15 - 1hr30, sometimes 2hrs and is quite content.  She's a very alert baby and fairly easy going - however when her sleep cues are missed she can be difficult to settle.
At night when she wakes I've been trying to shush pat her to sleep but usually end up giving in and giving her a bottle after an hour.  Bedtime is usually between 7-7:30pm, typically do bath or bedtime wind-down starting at 6:30pm then bottle at 7 and into bed.  I DF between 10-10:30pm.  Last night she woke for her soother at 9:30pm and then again at 10pm so I fed her. The last 2 nights I've noticed she wakes at 12:50am (will keep an eye on that to see if it's habitual waking).. the first time I did shush pat and it was a fight the whole time so I caved after 1hour and fed her.  Last night the shush pat was successful but then she woke again after 40mins and wouldn't settle so I fed her.  She will usually drink 3oz at night so it seems she is hungry but I don't know how to tank her up enough during the day to get us through the night!
Any thoughts on this would be helpful! Thank you :)  Below is our typical EASY..  she will typically have some A time before E

E - 7am (can shift by 30mins either way)
A - 7:15
S - 8:30am-9:45am (usually wakes for soother 40mins-1hr in)

E - 10am
A - 10:20
S - 11:30am-1 (will sometimes wake around 12:30/12:45pm and play until time to eat)

E - 1pm
A - 1:20
S - 2-3:45

E - 4pm
A - 4:15
S - 5pm (30min catnap)

A- Start bedtime routine at 6:30pm both girls
E - 7pm
S - 7:30
10:15 DF

Offline Lolly

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Re: 15 Weeks - Reflux? Should we move to 4 hour EASY?
« Reply #1 on: January 05, 2017, 20:24:19 pm »
I would start moving to a 4 hour EASY, you should find she takes more at each feed if you push the feeds out. Do it slowly though, I would extend her A times by 10/15 mins and hold for a few days then extend again to get the 2 hours A time and 4 hour feed times.

Apart from the feeds it doesn't sound like the reflux is too bad - did the Dr not suggest a reflux formula rather than the soy? I would have thought the reflux formula would be the better option as they are thicker formulas so it would cut down on the spilling. My two refluxers both had Enfamil AR which was great, it was a bi thicker in the bottle but thickened further in the stomach.

The other thing is have you tried a faster teat? If you are still using the first level I would try the next one up. It can take a few feeds to adjust to the new flow so you may need to keep her a bit more upright for a few days.

Laura


Offline hynygirl

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Re: 15 Weeks - Reflux? Should we move to 4 hour EASY?
« Reply #2 on: January 05, 2017, 21:27:59 pm »
Thank you for such a quick response Laura!  I will work on shifting her schedule and see if it helps.
The reflux definitely isn't terrible but it can sure be frustrating.  The Dr recommended we use Ovol drops before a feed but did not mention a reflux formula.  We are in Canada.. perhaps it's different here? I've never heard of a reflux formula.  Mind you my older daughter was EBF so we didn't deal with formula until now and I'm still learning the ropes!
As for the flow, she's on a level 2. Would moving up a level help things? I was under the impression it would make it worse. She's a pretty efficient eater and always has been, finishes a full bottle on average 15 mins.

Do you think night time sleep might improve going forward if we are successful at switching her to the 4 hour?  I'm just so tired! What are your thoughts on trying to shush/pat through the 1/2am feed?

Offline Lolly

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Re: 15 Weeks - Reflux? Should we move to 4 hour EASY?
« Reply #3 on: January 05, 2017, 21:52:40 pm »
I think the oval drops are like our Infacol (I'm UK) which are for wind, they won't do anything to help reflux :-\  If it is what I think it's ingredient is simetihcone which helps gas collect in a bigger bubble to make it easier to shift. You do need to use it regularly with every feed though as it works better that way.

The Enfamil brand is a US brand so you will probably have it in Canada if we get it here! When my now 10 year old was a baby it was harder to get reflux formulas but they are very mainstream here now, I would be more comfortable giving cow's milk based reflux formula than soy to be honest. I'm pretty sure they won't prescribe soya formulas for under 6 month olds in the UK now - there s concern over the effect the phytoestrogens can havein later life. I've just had a quick look on Canadian Amazon - this is the Enfamil formula for example. Make sure you discuss it with a medical person or a health nurse though!

https://www.amazon.ca/Enfamil-Baby-Formula-Thickened-Powder/dp/B00DOPYJO6/ref=pd_rhf_se_s_cp_5?_encoding=UTF8&pd_rd_i=B00DOPYJO6&pd_rd_r=7E6SKR1D4F2DT2GP61G5&pd_rd_w=X4Jn4&pd_rd_wg=DGH4N&psc=1&refRID=7E6SKR1D4F2DT2GP61G5

If she is on stage 2 teat then stick with that unless you change to a thicker formula.

To be honest I wouldn't mess with night feeds just yet - she's really taking very small feeds during the day, I would expect a 4 month baby to be taking at least 6oz per feed by now so she really will be needing the night feeds. You *should* find that stretching to 4 hours helps the feeds get bigger so she will needs less during the night. Having a dreamfeed plus 2 night feeds is totally normal at this age. Longer A times should help her naps to be a bit more stable (although they are pretty good!) which will also help the night.

As a reflux survivor (twice ::)) it really is hard work = [hugs] for you both!

Laura


Offline hynygirl

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Re: 15 Weeks - Reflux? Should we move to 4 hour EASY?
« Reply #4 on: January 06, 2017, 04:40:33 am »
Thank you again Laura, very useful information!  We've used both Ovol and Infacol and they don't work, I agree - it is for gas bubbles not reflux.  I've been paying even closer attention and I see her struggle to get a burp out and when it does finally come out there is spit up with it and she cries a bit afterwards as if it burns.  She recovers quick and then wants to eat again or tries shoving her fists in her mouth - I can only assume it's to settle the pain right? She is taking in more milk recently because I have been super rigid with getting her to the 3 hours so she's hungry but I thinks he is also soothing the pain. With more milk she is more uncomfortable after a feed. 
Her Dr doesn't seem quick to put her on meds, he says they will only take that route if her weight starts to suffer.  I'll have to talk with him again and be her advocate because there is no sense in her suffering! I'll also ask about the thickened formula - he didn't mention this so thank you again for including the link!
I've referred to the book and have a plan set for switching her to the 4 hour EASY.  I hope we can eventually start stretching out her night time sleeps but for now I'll focus on her comfort with feeds.  I also plan to start implementing PU/PD to get her back to sleep at nap time rather then replugging her soother as it is definitely a case of accidental parenting. I'm feeling very confident in the plan going forward and (for now) will be patient with the lack of sleep! Our 3 year old is just full of energy so it has been very trying!

Offline Lolly

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Re: 15 Weeks - Reflux? Should we move to 4 hour EASY?
« Reply #5 on: January 06, 2017, 12:06:40 pm »
It's good to have a plan!

I would talk to the Dr again, reflux formula should help. Nobody wants to rush into meds if it can be avoided but you don't want to wait until she is loosing weight as she will have a feeding aversion by then! My two were the happiest, chunkiest babies around but they were still in pain and needed meds.

I know the soother is an issue for you but just as a thought it can help the reflux. Maybe see if you can get the thickened formula before you implement removing the soother and doing pu/pd. Actually thinking about it pu/pd isn't great for refluxer either (sorry!) as the up and down can aggravate things - think acid sloshing around. I just used to put a hand on my DD and just softly repeat a sleepy phrase and sshhh.

Laura