I think I'm going to lose it!

My boys have been wanting to eat all of the time the past day or two! I feel like I am lucky to get an hour between feedings as opposed to the two hours I "normally" get. Not to mention that, but they don't seem to be sleeping as well when they do sleep.

They suck at eating too! I don't appear to make enough milk for them so I have to supplement w/ formula. They still don't know how to latch w/o a breast shield and after breast feeding they are screaming. Unfortunately that's lead me to pumping more and hardly ever putting them to the breast. That way I can actually see how much they're getting. They spit up like crazy when they drink breast milk (breast and bottle). They also spit up like crazy when they drink formula. They have been drinking Similac Neosure since they were in the NICU and I got matistis and they had to begin supplementing. So they spit up with both. They also arch their backs when eating, they're fussing when eating. The doctors gave me Zantac to give them .03ml twice a day, but it doesn't seem to be doing any good. I have tried the NUK bottles, playtex ventaire. They don't like the straight type of nipples.

Any advice?????? Something to help w/ spit up, fussiness, etc

 

Maybe they need a different med for the reflux? Has it helped at all? If not, I would talk to your doctor, there are other meds out there that might work better. They could be going through a growth spurt that is affecting their eating & sleeping. Whatever it is, I hope it's a quick phase. :hug:

 

To echo the pp, it sounds like you have a growth spurt and continued acid reflux issues. A number of moms on here have found Zantac to not be effective and other medications to work better, so I'd recommend calling your doctor.

This probably isn't what you'd want to hear, but it's not the end of the world if you decide to just pump for a bit. I did it for the first 2.5 months. It helped build up my milk supply and it gave the boys time to mature. They're now really good at nursing and I haven't had to supplement in a really long time.

Good luck and I hope things get better soon!

 

i never breastfed so i can't help you there, at all, but it does sound like they've still got some reflux issues. zantac is VERY weight sensitive and depending on how much your twin weigh is how they determine the dosage. mine are also 3 months and are at 13+lbs and we are giving them 1ml of zantac at night with 7.5mg of prevacid solutabs in the am.

are you giving them the zantac 1/2 hour before you feed them, how long have they been on it? you should give it at least 6 days before you make the decision that it's totally not working. like some other people have said, a lot of mom's don't have luck with zantac at all and have great success with prevacid. you might talk to your pedi about switching if things don't improve. i had to fight my pedi for it. we are still dealing with a lot of reflux issues ourselves.

as for the neosure, do your twins still need that? i would be hesitant to keep giving it to them unless they haven't gained a lot of weight. what does your pedi recommend? we had a lot of success on enfamil nutrimagen with spitting up. they are on soy now and seem to be OK but it's only been a few days, they've stopped crying during the feeds, at least not as much and as often.

also, do you thicken their formula at all? you might talk to your pedi about that, it helps (at least us) a lot with the spitting up.

 

I didn't breastfeed or deal with reflux so take this with a grain of salt but it sounds to me like the zantac isn't working like it should. Excessive spit up and only going 1 hour in between feeds sounds to me like something is wrong. I would take them in to the pedi for some help figuring this out.

 

I agree with Aimee, I would definitely contact your pediatrician. It sounds like the Zantac is not working.

 

Have you looked at your diet too? I had to also supplement breast milk with formula because I was not making enough. Of course, I was eating brocolli, zuchini, and other things that give babies gas and didn't realize it because it never bothered me. I went to a very bland diet and that seemed to help until the breastmilk stopped coming. Wondering out loud and looking back to when I was doing this, I wonder if the breast milk/formula combo could be a contributing factor to the gas? just a thought..

 

I just wanted to add that we had problems with Neosure. Eve was on Zantac and Reglan and still vomiting. I noticed a big difference when switching to Good Start. When I told their ped I said I figured the extra calories from the NS wouldn't matter if she couldn't keep it down. He agreed. We've been great since (and my baby wasn't even 2lbs at birth!).

They spit breastmilk up, too, but as for a formula comparison, the NS came up way more than the GS.

 

My DS had reflux and the ped prescribed him AXID. Also, you might want to try Dr. Brown's Bottles.

 

There are a few ways to thicken formula to reduce spit up. I happen to prefer to not use cereal but a gel thickener instead.

As for Neosure, that formula seemed really rough on our boys' tummies, as was the Enfacare. They were just really sensitive I guess due to be preemies. So a few weeks after they came home we switched to Gentlease, which was better (but still caused some tummy discomfort). I've heard good things about Nestle Good Start. Been tempted to try that myself. For the past month or so the boys have been on Enfamil Premium and they seem to tolerate it pretty good.

 

They've been on Zantac for 2 weeks as of Monday. My pedi had recommended giving them the Zantac in with a small amount of milk/formula (whichever I'm using at the time), so that's what I've been doing. Maybe I'll try giving it to them about 1/2 hour before they are due to eat.

Wyatt was just back in the hospital for another hernia and a nurse had started to give him some type of enfamil, but the doctors insisted that he stays on neosure. My boys are 3 months, but only weigh 7.5lbs.

I also don't thicken on advice of the pedi saying it may cause they to choke.

I'm going to have to make a new appointment, because it's beginning to drive me crazy. I hate military insurance and always been switched around doctors even though I'm supposed to have a specific primary pedi that I picked out (she was one of the neos in the nicu)

 

I think that is more of a problem when thickening with cereals and all of those tiny particles floating in the formula. Plus the Y-cut nipples used with cereal thickened formulas are super fast. The gel thickener I make thickens the formula to the same smooth consistency as Enfamil AR. My boys have never once choked on their gel thickened formula.

 

Zantac didn't work for us. In the end the only thing that truly worked the best was probiotics.

For your b/m. your getting LOTS of water? eating enough? try eliminating dairy that could be upsetting their tummies. don't lay them down after feeding them for a few minutes.

 

did you get a syringe with your zantac prescription? you should have, if not ask your pharmacy for one. i use one and squirt it into their mouths quickly so they don't spit it out. if they can just suck on it while it is in their mouths this would be a better technique but my boys don't do that. before asking for another medicine i would try giving them the zantac 1/2 hour (at least) BEFORE you feed them. i don't know why your pedi would tell you to mix it into their formula, most GI specialist will tell you to give it to them on it's own. besides what if you make a 4oz bottle and they only eat 3oz, they aren't getting the full dose.

they are so tiny, that's no good. i'll be honest and say that i don't like your pedi's recommendations though. i agree with other comments, neosure is hard on their systems. check the calorie count on the back of the container if memory serves me right it's only 2 caloris or so more than regular formula. how much are your twins eating and how often? if they take more ounces of regular formula than they do with neosure then they will gain more weight because they tolerate it more and eat more. i would seriously consider switching. enfamil nutrimagen and similac alimentum, in my experience, is very gentle on their little bellies and also helps with constipation. have you tried prune juice, water, milk or magnesia or karo syrup for their constipation?? if all else fails you can give them a suppository on a fairly regular basis. you can find ones for kids at your local pharmacy, i forget the name of it.

really?? i have heard some people say this but i don't agree AT ALL. it's been my experience that the thicker the formula the smoother it is going down their throats and because it's heavier it's less likely to come back up. we thicken all of our formula, 1tsp per ounce with gerber rice cereal. you have to make sure you mix it REALLY good; we shake ours. what flow of nipple are they on? if you do decide to thicken their formula Y cuts are definetly WAY to fast and could possibly cause them to choke. we tried out Y cuts first and the boys sucked it down to fast and soo much came out that it just pooled out of their mouths and into their burp cloths. we use dr. brown's bottles (excellent and i highly recommend them) with a level 4 nipple. i've NEVER had any problems with choking. level 3 nipples are OK and don't really clog up to bad but with my kids they would eat 3oz and get tired of sucking and give up so we went back to level 4 and they take 5-6oz every 4 hours.


i hope things start to improve soon! reflux is so awful!!!

 

I'm gonna step out of mommy mode and let it slip that I am a health care professional...

Many of the PP's are right in that Zantac is very weight sensitive and even for your babes that sounds like a very low dose. They could be getting up to 0.9 ml three times a day. Many peds are scared of dosing small babies but there are no high dose related side effects. If that doesn't work for the fussiness then prevacid may. No amount of medicine in the world is going to stop the spitting up though. It is because of the floppiness of the muscle connecting the esophagus and the stomach and preemies have it worse because that muscle has been propped open by a feeding tube until they learned to eat. Other things that can help are the tucker sling and wedge to prop them up more when sleeping.

Unless they really have formula intolerance I agree with staying on the Neosure. Preemies need to be on an enriched formula until they are 9-12 months corrected in order to get optimal brain catch up growth. (Brain much more important than physical weight gain!!!!)

As for the nursing issues, could you try giving them an ounce before putting them to the breast so that they are not so hungry and easily frustrated? Also, there is no problem with the shield if it encourages nursing where it otherwise wouldn't happen. Mine were 37 weeks so technically term but DS needed the shield for about 3 weeks and then finally got strong enough and coordinated enough to do it on his own. I would also watch the supplementing because babies get lazy and it is much easier to take it from a bottle than from you...they learn very quickly to stop nursing so they can get a bottle. I would do one of two things. Either pick certain feedings where you only bottle and pump to keep your supply going and other feedings only nurse OR supplement only a set amount after a feeding so that if they are hungry they will demand and nurse more.

Keep trying and it will get better. Get plenty of water, oatmeal can help up your supply too.