Incline while sleeping for spitting up/reflux

I feel like I do nothing but ask you guys questions! Someday, maybe I'll have enough experience to answer a question on this forum rather than asking them all the time.

ANYWAY, here's my latest question: our twins, who are 9 weeks and four days, have had serious spitting up issues lately. We talked to the doctor about the possibility of it being reflux, but the doctor didn't have much to say about it. The worst happens while they're sleeping in their cribs, and it breaks my heart -- they wake up covered in spit up (pretty large quantities) and sometimes it's even coming out of their noses. We discovered with Emmeline that while she was sleeping in the bouncy seat she never spit up while sleeping. When Jack started spitting up in his sleep, we moved him to the bouncy seat as well. We investigated wedges for their crib but it seems like one, they're not considered safe and two, most babies end up slipping down them while sleeping. It worries me to death to have them sleeping in their bouncy seats, though, because I've been conditioned to think that a baby should only sleep on a level, firm surface with nothing in the crib with them. Has anyone else let their babies sleep in a bouncy seat for an extended period of time? Anyone have a tried and true method for adjusting the crib so that there is a slight incline? We tried putting books under one end of the mattress but the baby sort of wobbled when we put her down and it looked like she could easily roll over because of the incline...since we swaddle, that would not be good at all so we discarded that idea.

As always, thanks for any advice or for sharing your experiences.

 

I never found an effective and safe incline solution.

Are they in pain/discomfort? If not, I would do nothing. DD spit up and it never bothered her. I just changed her shirt a million times a day.

If they are in pain or uncomfortable, then I would seriously consider a new doctor. There are medications and special formulas for reflux and I would be very concerned about a doctor who was dismissing my baby's pain. DS was an a specialty formula and it made a huge difference from day 1. A lot of moms on this board have also had success with medications, such as Prevacid.

 

There is nothing wrong with letting them sleep in bouncies if it makes their sleep better. Swings and car seats aren't as good because of the way the baby sort of hunches over making the spitting worse. The bouncies let them be a bit more stretched out.

 

I let mine sleep in their swings until they were 5 months old. Their ped said if it helped them then there was nothing wrong with it. His son slept in the swing too because of reflux.

 

There was a short period that I let Alice sleep in her bouncer, maybe 2 weeks. Then we bought a wedge which worked wonderfully. We eventually had to velcro two wedges together and with the terry cloth cover, she didn't slide too much on it. A thing to remember about reflux is that the medicine only works for the acidity of what is coming back up (and comfort), the behavioral/positional changes are what keeps it down. The medicines don't keep the milk down. Only time and positional/behavioral changes can do that.

When they lay down with a fairly empty stomach, are they still spewing things that smells like stomach acid/bile? Do they seem in pain when they eat? Are they pretty fussy about food?

• 
  
  What worked for us (aka Bex's Reflux tips):
  
• tilt the whole crib, do not do this if your crib has wheels (either put something under the back legs like phone books, or put a rolled up beach towel under the back side of the mattress between the mattress and the springs)
• sleep wedge(s)
• thickening food (sometimes changing formula too)
• Try to keep their waist straight, don't be legs at the waist unless absolutely necessary
• Keep upright as much as possible, a jumperoo is good for keeping the legs straight (once they are able to sit up)
• Do not feed until full (!!) feed more frequently but less in amount. You don't want to put any pressure on their stomach.
• Invest in bibs with a vinyl backing. Lots of them. We had probably 50 of them since we went through 6-10 a day for just Alice. Royce just drooled a lot. We chagned them when they started smelling like stomach acid or when Alice had a true nasty reflux incident. At least their clothes will be dry.
• ALso invest in Aquaphor for their faces because with the wiping and the constant acid on their face, it can get very red and irritated, the Aquaphor puts a layer of good between their faces and the acid grossness.
• And last but not least, if a medicine doesn't work (I'm looking at you Zantac!) ask for a new one.

 

I had a happy spitter, so we never needed meds. Just lots of wash. Both of mine slept better in their bouncy seats and swings the first few months so that's where they were. If they are sleeping better and spitting less, that's the option I would choose.

 

You received excellent advise so far. Let me add something based on my experience. You didn't mention if your babies are breastfed or formula fed. If you have to suplement with formula I have some sugestions. Our twins were spitting up a lot around that age at every meal. They weren't fussy about it, just spitting. So we changed formulas. They started with Similac, then Enfamil, then we switched to Good Start. From my experience, Good start worked the best, they stopped spitting and it helped with their constipation issues, especially Max's. I tasted each formula, and to me Similac and Enfamil tasted like medicines but the Good Start has more of a milk taste, and it helped our twins. Of course, check with your pediatrician as well. We switched it gradually, each time we made a batch we were addig a scoop of the new formula and one less of the old one, so it took few days to switch, but it was less of a shock for them, at least we hoped so.
Good luck!

 

We used something similar with http://www.onestepahead.com/catalog/product.jsp?productId=424758 . Helped my DS with spitting up.
Good luck!

 

You guys are so awesome. Thanks so much for the advice and reassurance -- I just wanted to make sure that others had used bouncy seats in this way with no repercussions. Now I feel much better.

Cat mommy, Emmeline seems to have no pain when she spits up -- she often smiles or laughs afterward. Jack has more trouble and wakes up screaming when he spits up in his sleep. I'm assuming that means the acid content in what he's spitting up is high? In defense of the doctor (though I'm not really that enthusiastic about her) when we asked about acid reflux only Emmeline was spitting up so we told her there was no pain associated with it.

becasquared, thanks so much for the comprehensive list of suggestions -- especially the Aquaphor. I had never heard of that and Emmeline's face is already getting red and chapped. We will definitely be getting some of that.

monica77 -- we do 8 feedings a day, and three of those are formula (the 12 am, 3 am, and 6 am feedings -- I'm pumping) -- Emfamil's formula specifically for premature babies. The problem is there doesn't seem to be any difference in amount they spit up, whether they're taking breast milk or formula. We will soon be going to all formula, though (I'm having some health issues with the breast feeding) so I am going to ask my doctor about Good Start. Thanks for that suggestion!!


catalina - that looks awesome -- just what I've been looking for and haven't been able to find. I'm ordering two today!

Thanks again to all of you for your suggestions and for sharing the way you did things. I don't know how people had twins before the Internet. These are the first babies for my husband and me and the learning curve is very, very steep. I appreciate each and every one of you.

 

My girls (one with diagnosed reflux) slept in their bouncies for several months, actually. Night and day. I don't think they were out of the bouncies at nighttime until around 3 months, and longer for daytime naps.

 

DS had reflux, he was a happy spitter but when I laid him in the crib he would grunt and groan and I would sleep with him elevated on my chest so we could both get some sleep. Our Ped put him on Rinaditine (sp?) and I bought a wedge for him to sleep on. It had adjustable supports on the sides to make sure he didn't slip down. We bought it a toy's r us.

Once he started sitting up we have had no issues. I notice that DD spits up more than he does now...I guess we just never noticed spitting up her spitting up LOL

 

I think they have reflux. My son uses to spit up through his noses when asleep. And he cried alot. Burp burp burp them alot before you put them down. It will get better after 6 months

If it starts bothering them talk to Pedi for med. The best is prevacid. It. Works wonder

I went through 6 months with my dd puking vomittimg 3-4 x/ day. It broke my heart so I understand your feeling. But don't worry too much. They will be fine. My baby girl is healthy and happy and active now.

 

There are safe wedges out there... just not the kind you can buy at Target or Babies R Us. My daughter Piper had severe reflux (she still does at almost 4 years old) and slept on a wedge for the first 7 months of her life. Our hospital NICU recommended the Tucker Sling/Wedge combo. It's a hospital grade foam wedge plus a sling/harness thingy that keeps the baby from slipping down. It really works.

We bought one for each of our girls -- they're expensive, but we're still using them so I feel like we got our money's worth. At first, they were for sleeping on, then they were awesome for tummy time, then great for climbing and exploring. Now my girls use them to lean against when they want to sit and read on the floor. We even tie-dyed the covers so they look cute.

Here's a link to the website: http://www.tuckersling.com/

 

We fitted our twins for pediatric wedges- referred by our pediatrician- fitted by a physical therapist. Insurance paid for the fitting, we ended up paying for the actual wedges- I think it was $70 each?? They were great!! Safe because you strapped them in plus they were made for each baby. Very helpful with the reflux too. We had them in them until about 4 months.

 

Oooh, thank you guys! The other sling posted upthread is out of stock all over the internet...thanks for the other options! Looks like we will be able to get them back into their cribs after all!

 

My babies slept in bouncers/the swing until 2.5 months, then they went to bed in their cribs. I have one spitter and one who rarely spits. Then we started thickened formula, and sleeping flat in the crib was no longer a problem. My spitter still spit, but she was a happy spitter, so we did not modify anything. She is now 8 months and spits occasionally, but it is not a problem.

I would say that yes, it is important that babies learn to fall asleep on their own in their bed, but at 9 weeks, you can delay worrying about this for a little while until you find an acceptable solution to your problem. Everyone's experience is different, but this was mine... Good luck!