Screaming during feeds! HELP!

About 2 weeks ago my boys started screaming with feeds. They would take an ounce or two, and then start to scream when you put the bottle in their mouth. Sometimes they would spit it out (the bottle), and sometimes they would scream then stop and suck suck away. Cruz stopped, but Aiden has progressively gotten worse. He also would spit up/vomit large quantities with feeds which he stopped doing when I switched from Similac Sensitive RS (with added rice starch) to Nestle Good Start with Comfort Proteins (manually adding rice cereal). Looking back now, I think it was that he was eating too much and too fast. I didn't figure this out until last night, but this start around the same time I switched them to a fast flow nipple. I had posted about them taking to long at feeds, and it was suggested. When I switched, I feel horrible, but I guess I didn't notice that is what it was. Aiden has a mild case of reflux, never really spit up and is on a .23 dose of Zantac from being discharged from the NICU two months ago. His weight has went from 8 pounds to 14 pounds, so I thought he might need to increase his dose. I took him into the Ped. and he made me feel bad about his weight and said immediately stop giving him the rice cereal. He checked him out and said he is full of gas. He asked if he had been gulping at feeds, and I said yes. I told him he has gradually started to eat less. He was consuming 27-34 ounces a day and now it has dropped to 14-21. The doctor said that was fine, maybe that's all he needs. He implied he was too big already, he could use a decrease in food (which is interesting after he said he needs 35 oz for his weight). I asked him what to do about treatment. He said why did you switch formulas, and to put him on regular Similac. He said stop rice cereal immediately. He at first mentioned Mylicon drops, but then decided he was going to increase his dose of Zantac to 0.6 and we will see how he does. I asked if I should do Mylicon drops too, and he was hesitant.

So, he has been on 0.6 dose of Zantac for a week. I switched to a slower flow nipple over a week ago. I stopped rice cereal a few days ago. Even though doc. was hesitant, I started using Mylicon drops every other bottle. I give it in a one ounce bottle first and then give him a regular bottle. It seems to help him drink more. And, as of yesterday, I switched to regular Similac formula. He is STILL screaming with feeds. He hasn't thrown up or spit up for over a week and a half. It is just the screaming.

I am sorry if this is all over the place, but I am all over the place. I am so concerned about this. I wish doctors could just help you. I feel like I know more than him. I don't want to make the wrong decision because I know when you switch stuff up on them, it affects them. Anyone have any advice?

 

sounds like classic acid reflux to me. for the record, zantac is pretty weak and did nothing for our boys. they didn't find any relief until we switched to prevacid. perhaps talk to your doctor about medication options, and switching to a PPI inhibitor.

 

Is there any reason to wait it out on Zantac to see if it starts to work better after time, or should I call him on Monday to see if we can try Prevacid? I read the posts on Reflux in the First Year Handbook and it seems most had to switch to Prevacid or Prilosec to see a difference.

 

My first question is: Is there any way to switch doctors? It sounds like he is giving you answers all over the place. Since they were preemies most doctors would (I would think) want them to gain weight. My preemies weren't even on their own weight chart until 6 months and it was a constant battle to get them to eat more. I was lucky if they ate 20oz in a day at 5 months (I can't remember how much earlier than that). I wouldn't be too concerned about the amount of formula intake right now since he is gaining (and not losing). I would be concerned however about the screaming. I really think you should push for a second opinion. :hug:

 

my daughter had the same problem and we switched to Prevacid and Nutrimigen AA and give her little tummys( like Myclon) drops at every feeding. She is has stopped screaming during the feedings and stopped the vomiting. It's like she is a different person now. Hope this helps. I like the idea of getting a second opinion.

 

i am with megan on switching doctors! it sounds like he is totally making you second guess every decision you make, not a good quality in a doctor. at the very least get a second opinion.

i would definitely try for a med change to prevacid. my DD was on zantac for a while and it never really solved our reflux problem. prevacid was a lifesaver for me and after it kicked in she was a totally different baby. i don't think it is worth it to try to wait it out on the zantac, it is a rapid acting med and does not build up effectivenss over time. screaming while feeding is NOT normal, and if your dr isn't taking you seriously, you need to find someone who will. also, i don't know how long you were adding rice cereal, but that will naturally cause them to eat a bit less, so without the cereal his oz. may go up again.

reflux is so hard and takes a real emotional toll, i hope you can find something that works for you and a doctor that will back you up.

 

I am so sorry you are going through this. Above is the same combo my boys were put on. Prevacid and Nutrimigen.

 

I'm going to ditto a new ped, there is no way your baby should be "dieting" or you should be cutting back on what he's eating, I don't care HOW big your baby is!!!!

My dd was born at 9 lbs 13 oz. At 2 months she was over 13 lbs. Not ONCE was I told to cut her calories or make her eat less, and by 3 months she was eating nearly 40 oz of formula a day. I started her on solids early because she was almost eating too much formula, but not once did my dr say she was too big, or to cut her back in anyway. That's crazy talk!

As for the screaming I does sound like classic reflux, and my dd also started on zantac and we switched to prevacid after 1 week. It worked for about 4 days and then it stopped helping her. Prevacid has worked wonders. :hug:

 

We have faced this with one of our boys for a while. It is clear now that he was in pain due to colic.

However, noticing that he drinks very quickly, we started taking off the bottle from his mouth after 5-6 sucking, and then reput it after 5-6 seconds or so. this has helped. but now he no longer spits up or vomit unless he has cold as happened with him yesterday.

Finally, I wouldn't trust a Dr. that seems guessing and hesitating in what to do.

Good luck :hug:

 

I know this may sound over simplistic but my girls did the same thing around that age (3-1/2 months) and it was because they didn't like being cradled anymore while they ate. Now what we do is hold them with their backs against our chest and then feed and it has worked for us. If your LOs try to lift their heads up while being cradled maybe they just don't like laying down that much anymore???

Let us know if you find a solution and good luck!

 

It sounds reflux related to me. I would switch to Nutramigen and try to get the Zantac switched to something else like Prevacid. I had problems getting the doctors listen to me re:reflux, and kept switching until I found one that would listen. It took 4 months. :hug:

 

We saw no results after being on the Zantac for 5 days and the Ped said it could take up to 7 days. But she went ahead and switched us to Prevacid and thickened feeds with Alimentum. The Prevacid help within about 48 hours. I would definitely try and get a medication change and maybe try and get a referral to a Ped GI.

 

He did ok the earlier part of yesterday, but the last few feeds of the day were horrible. Last night he even had some wet burps, which he hadn't done in a while. I felt so helpless, and was questioning the switch to regular similac. After reading some of the replies last night, and the section in the First Year Handbook, it sounds like alot of people switched their formula, and used prevacid. I will call doc. on Monday to see if he can switch to Prevacid (and probably start looking for a another doctor) but in the mean time, I was debating if I should switch his formula. I looked on Similac's website for information on Alimentum (similac's version of nutramigen) and it said for babies who are both allergic to cow's milk and soy milk. So I felt like I should try soy first. The doctor mentioned trying soy. The only thing is I have read some stuff on the computer about studies and side affects of soy, such as early puberty, infertility, low sperm count. I even read it is banned for giving to infants in some countries. Knowing that alot of people use it, I decided to try it last night, but I am second guessing my decision.

Anyone have any thoughts on soy?

 

As stated in my PP, do you think I should try the soy first or go straight to Nutramigen/Alimentum??? I don't trust ped.'s answer, I know it will take a while to get appt. with another doctor, and feel like I need to make the decision, but not sure if it is the right one.

 

I would go with the Nutramigen/Alimentum but be prepared for it to take several days to get better. I've heard some babies take a few days to get used to the taste. With this switch, make sure you give it at least a week (and a week from when you finally get Prevacid).

 

Hi..definitely sounds like reflux to me. We were on Neosure and are still on that, but changed from Zantac to Prevacid and that worked immediately--but make sure you do solutabs and shoudl put you on 1 tab a day (taken 1/2 at a time)--the 1/2 tab a day didn't do anything. We also see a GI who has helped us, b/c one of my twins boys had silent reflux and now is refusing to eat....dramatically decreased his intake of food. So not to worry you, but I would definitely stay on top of it as much as you can, b/c if reflux gets really bad then it can lead to refusal of food (rare but possible). Sounds like yours is still taking plenty, but mine is curreently down to 10 1/2 ounces a day and we are having all kinds of issues.

My other one...the screamer--prevacid by itself helped. I also asked about switching formula. mY GI said...unless he has an allergy, he woudl not switch to alimentum...it doesn't taste that good...and it's crazy expensive. He did a stool test to make sure there was no blood...which is a sign of allergy. Other signs of allergy is hives and rashes....so I wouldn't really switch to that kind of formula unless absolutely necessary.

After being on prevacid for a while the screaming did start back and so we added mylanta supreme--1ml 4 times a day.right before a feed...also has worked, in combination with mylicon.

HOpe this helps..good luck. Reflux has been a nightmare for us...so feel like I have learned a lot about it.

 

would your health insurance cover a visit to a pediatric GI specialist? pediatricians are generalists, and while they're very knowledgeable about almost everything you need to know, a GI specialist may be able to more accurately assess the problem and prescribe the right medication ad the most appropriate dosage.

 

My DD had a similar problem, she sometimes will still have an off day here and there. We were on Zantac as well but that didn't help much after a while. She had a bowel problem (or so we thought) and we went to a gastroenterologist who switched her to Prevacid 1.3 twice a day and told me to supplement with Nutramigen. It helped her out a lot, (the Nutramigen doesn't have a plesant smell!) At two mths teh gastro dr told me to add 1/2-1 tsp. of rice cereal to 'weigh down' her milk. The gastro dr. also told me not to use Mylicon drops with her, instead to give her 1mL of Mylanta regular strength. Also for some reason I'm think that my DD was taking a higher dosage of Zantac and she was much lighter than your DS....she just got to 10lbs 2 weeks ago. I also agree with PP my pedi is all about them gaining weight, I don't know why he would tell you to cut back & a pediatric GI may be able to better diagnose, with my insurance I just had to have my pedi refer me to one and they covered it. GL, reflux is hard to deal with.

 

Thank you all for your advice and words of encouragement. After MommyMeg's suggestion this morning, I went out and got Alimentum. I wouldn't say he is 100% back to normal, but I would say about 80%... a HUGE difference. It actually got better after the first bottle, but I wanted to wait the day out to make sure. He just went down to bed. Thank you for the suggestions. I am going to call my ped. tomorrow to ask about Prevacid, and I also found a Pediatric Gastroentoligist locally that my insurance covers that I am going to make an appt. with as well.

Thank you, thank you, thank you to you all for your support. I don't know what I would do without this forum! :hug: