please help

alright so we are having feeding issues, MAJOR feeding issues. they boys have totally lost interest in eating. they can go 9 hours of no food and only take 2oz then 4 hours later only take 4 and so on until 10pm. they won't sit still so i have to literally restrain them in my arms, they are biting on the nipple, chewing it, rolling it from side to side, pushing it out with their tongues or not even letting me get passed their gums. usually they don't cry before, during or after a meal unless they are moving to much and i have to restrain them - they hate not being able to move. sometimes river will cry while you are trying to get started with the bottle but once he gets it in and starts sucking the crying stops until he pushes it out and you have to start all over again. they are not really arching, gagging or displaying signs of reflux and that seems to be under control with meds. the formula doesn't seem to be the issue since this all started on soy and when we switched back to milk (over a week ago) the problem continued.

my pediatrician didn't want to deal with this problem since one of the symptoms is feeding related so he made us go up to the GI specialist and rule out reflux. we did this yesterday and they said there was nothing they could do since this doesn't appear to be a reflux or stomach/intestinal issue. so i'm going to call and yell at my pediatrician this morning for not listening to me in the first place and force them to let me come in.

the GI suggested dropping a feed and going every 5 hours instead of 4 but they aren't taking a full 5oz bottle, sometimes not even half of it, after sleeping for 9 hours. yesterday they didn't want to eat until 10:45am and that was 12+ hours without food.

the feeds are taking over an hour and after 30 minutes of fighting with them to take the bottle i give up. i'm reaching my frustration levels and feeds are becoming more of a chore then they are an enjoyable bonding experience.

we went from consistently cleaning out 5-6oz bottles every 4 hours for a few weeks to now not wanting to eat at all. so 25-30oz a day to 15oz if i'm lucky.

any suggestions? if this is teething i've tried giving them tylenol before feeds but it doesn't help.

 

I would definitely talk to your pedi again about this and tell them what the GI doctor said. The only other thing I can think of is trying a faster nipple (not sure what kind you are using). I hope your pedi is more helpful this time and you can get this worked out soon. I would be frustrated too :hug:

 

we are already using a level 4. the next fastest is Y cut and that makes them gag/throw up because the flow is too fast.

 

I agree to definately nail down the pediatrician!! Two thoughts come to mind - 1)do they have thrush?? That can definately make them not want anything in their mouths. And 2nd, maybe the nipple is too fast already? or were they doing fine with that speed before?

 

i was just looking up thrush actually. i looked in their mouths and didn't see any signs of thrush. both babies have the same symptoms and i read that thrush is pretty rare.

as for the nipple flow, they've been using level 4 without problems for awhile now so i don't think it's the nipple flow that's causing the problem.

 

are you thickening their formula?

 

1tsp per ounce and we've been doing this for a month.

 

How long has this been going on? I take it over 2 weeks. The nipple flow made sense, but if you are already on a level 4, then probably not.

Thrush is not that rare. A lot of babies get it.. white in mouth that won't scrape off. It is very painful.

 

this could be part of the problem. the same exact thing happened to us. in fact, i think i wrote a post like this when my girls were 3-4 months old. Their bellies are getting full fast from the thickened formula. Either you can give them time for their little bellies to adjust or you can stop thickening it. We stop thickening the formula as their reflux seemed to be under better control with the meds. As far as them spitting up, we just dealt with it because they were classified as "happy spitters".

There is only so much a ped can do. If they aren't showing any symptoms of anything else, the doctor will most likely send you on your way again. I would cut back the amount of cereal or just stop thickening it all together and see if that helps. Otherwise they will go 5-6 hours without eating and I think that's too long for babies that young...IMO.

 

but we've been thickening for over a month without problems. everyone said that the rice would fill them up faster and make them go longer in between feeds and that never was the case. always every 4 hours and finishing bottles in 20 minutes. why would they all of a sudden get fuller on smaller bottles?

 

I can't explain why all of a sudden they would stop eating, but the same exact thing happened to us. you can go to the ped all you want and call, but if they are gaining weight (and i'm sure they are because of the cereal) they will send you home with your happy, healthy babies.

babies go through eating strikes and you'll see this a lot more. if you don't see any signs of sickness then they are probably not hungry yet.

 

I agree. Babies do things for strange reasons and not all of them have explanations. Are you still giving them hypoallergenic formula because of the reflux? I would think that would help.

 

Thrush is really common out this way too - mine are being treated for thrush right now. Three of 5 of my kids have had it. I didn't even know my babes were starting other than a diaper rash that wouldn't go away - the doc saw a few tiny colonies in the back of their mouths. Wouldn't hurt to have the doc have a close look in there.

I've never thickened formula so I'm no help on that one. How is their weight gain? You'll want to keep a close eye on that if they are only taking a few ounces at a time.

 

This is my opinion:

Your babies have reflux that is not being properly treated. Usually, babies with reflux cannot tolerate milk-based formula, and a lot of them can't tolerate soy either. While hypoallergenic may be expensive, have you ever had heartburn caused by a food that you didn't tolerate well, and it wasn't treated properly? It hurts, and if you have ever experienced that, it's very easy to understand why babies start refusing to eat because of it. Eating=pain.

You need to find a GI or ped that will listen to you. I went through several during our reflux battle.

 

I totally agree with Becky. If my babies were not taking the milk based formula, I would try the hypoallergenic one. There are lots of moms on here who have dealt with severe reflux & almost all of them will tell you that milk based formula doesn't work for their babies. I would definitely try the hypoallerginic one & try to find a doctor who will listen.

 

it's not a milk issue. they never did any better on the hypoallergenic formula. granted this decline of appetite wasn't an issue but they've been on milk before w/o this problem. we still had a lot of projectile throw up and general spit up with other reflux issues on hypo. since there was no real difference on the hypo, soy or milk we went back to milk. if i thought it was making a difference i would find a way to afford it but it doesn't.

as for the thrush, i will see if the ped will look at it. i looked in their mouths and couldn't see anything but they didn't cooperate that much.

and there weight gain is fine.

 

This is exactly what I was going to say. It sounds like your boys have untreated reflux. How long were you on the hypoallergenic formula? And what reflux medicine are you currently using and how long have your boys been at that doseage? Almost every one of the symptoms you listed are the same as the problems my daughter Piper had before I eliminated dairy/soy from my diet (I breastfed) and got her on the right reflux medicine. Per the GI that we went to, reflux frequently gets much worse between 3 - 5 months due to changes caused by the babies growth spurts.

 

I agree with PP about the uncontrolled reflux. One of my DS has reflux, and at 4 mos he went on a nursing strike. Just wouldn't have anything to do with eating, whether it was from me or a bottle. Changed meds and eliminated all dairy from my diet and he started eating again - but it took some time to get back to "normal". I *think* babies get smart and start to associate cause and effect or something. Like if I eat this, my belly/throat is going to hurt. So I'm not that hungry right now, think I'll pass. I know of one child who actually had to go to therapy to relearn how to eat because of really bad reflux... Just a thought.

Also, don't know if anyone mentioned it, but have their ears been checked? Whenever one of mine has an ear infection, they don't want to suck/eat.

 

I don't know, maybe I shouldn't even be responding since I never dealt with severe reflux, but maybe they just aren't all that hungry right now. Appetites ebb and flow. Some babies also only eat a small amount. Caleb would only drink 3-4 oz at a time. As he got older, it would get up to maybe 5-6 oz, but he never drank the 8 oz bottles all in one sitting like the girls would do past 6 mos. He's always been small, but stayed on his growth curve. I wouldn't force them to eat. If they are done, they are done, and wait till they cry for a bottle again.

 

I agree with this. I always thought my girls should be drinking a certain amount and I stressed about it for the longest time. After a while I realized that they just aren't big eaters. They are petite, but everyone in my family is small. I wouldn't pressure them to eat...they will definitely let you know then they are hungry. Good luck and I hope you get some answers soon!

 

I totally agree with Becky. I think that you need to find a Dr. or two that really are listening to your concerns and are putting your boys health first. And although it sucks big time, hypoallergenic formula will most likely help with a lot of these problems. I know it's expensive, but can you really continue with this frustration with their reflux and eating issues for another 6-8 months (at least)? I know you've heard my 2 cents before, but many babies with reflux just aren't able to spread their feedings out that long and take that amount without it hurting them. Smaller, more frequent meals are what was needed for us an I know it's not the most convenient for scheduling, sometimes you have to do what you have to do for their health and happines. BTW, my kiddo with reflux often only took 15-17 oz. a day, but cont'd to grow on his curve. I was in a panic and would come here so worried and always got such great advice. I would say from being there and having done that to look at their general growth curve and if they're maintaining it, don't freak about the amount of formula. I know from experience that overly worrying about it does no good and actually may have hindered the overall goal b/c he could sense my stress over it. Hang in there. It's so tough!

 

How long did you try the hypoallergenic formula? And how do you know it wasn't helping their pain? It may not have affected the spit up but it may have helped with the pain of reflux they may be feeling. My oldest son was a happy spitter, he'd go through several changes of clothes a day, he'd soak right through bibs and burp pads (the lined ones with waterproof backing), we would have to change our clothes several times a day, and we always carried at least 2 receiving blankets (not burp cloths but blankets) and a wet wash cloth in a ziploc bag in the diaper bag. I have been there done that and it sucks. But, my son wasn't in any pain, and was still eating good, so we didn't have to try different formula's.

Are they on any meds? How much, and how often? If it's zantac then it may not be working anymore, and if it's prevacid they may need the dosage increased.

 

we were on the hypoallergenic formula, both alimentum AND nutrimagen (at different times of course) they spent over a week on each one with little improvement, both still arching their backs, gagging, coughing and spitting up/projectile vomitting, lots of regurgitation, and pain during feeds. we switched them to soy and things started to improve slightly but not enough to continue use of the soy so we went back to milk based (similac advanced) and will transition to similac sensitive which is milk based but lactose free so we will see if that improves.

currently their meds are 7.5mg prevacid solutabs in the am which i give them a half hour before they eat and zantac 1ml at bedtime which i also give them before bedtime. since the zantac started to kick in we noticed a damatic decrease in the reflux issues and all seems to be under control. we've been on the prevacid for over a month and the zantac at night for over 2 weeks.

i did call the ped and they just recommended that i continue with the 4 hour feeding schedule and hopefully get as much into them as possible. i thought about the over feeding issue too, it has crossed my mind. this morning river took 5oz after sleeping for 8 and alex would only take 2oz also after sleeping for 8. they aren't very concerned since they have gained over a pound in a month and are now in the 50th percentile for weight measured up against full term babies.

i checked their mouths for thrush but couldn't see the white bumps but then again they fight me to get their mouths open. the ped didn't think this was the case but then again they haven't done an oral examination. i'm starting to lean more and more to this being a teething issue since we seem to see white popping through their bottom front teeth but not breaking the surface yet so i don't know.

lately, after the dreaded morning feed, they are doing a bit better with the rest of the day feeds up until we do the "dream feed" at 9:30-10pm where we are lucky to get 4oz in them.

as for finding a new ped and new GI, right now it's pretty much impossible. flu and this swine scare has every parent in the county rushing to their ped for shots or thinking their child is dying. so i can't schedule a new patient appointment until this passes. it sucks.

but thanks everyone for the advice/tips, i really appreciate it!

 

Haleystar, I wonder if your ped would consider increasing their prevacid daily dose to 15mg? Our ped prescribed a 15mg dose for Brandon, who only had moderate reflux, nowhere near as severe as yours. When I saw you and others post that their dose was 7.5mg I was worried that my guy was being given too much. So I emailed a friend who is a pharmacist and asked if I had anything to worry about. He replied with "I really would not worry about it. You really can not take too much Prevacid. All proton pump inhibitors do is reduce acid. At the twins age I think a trial of 7.5mg may have been more prudent but usually with those drugs a prescriber will just go with what they had success with." Still yet I wondered if Brandon would do okay with only half that dose, since so many others were having success at 7.5. So for a few days I reduced his dosage, and then he instantly sounded really hoarse again, which is a sympton of acid irritation of the esophagus. After a few days of that I went back to 15mg and the hoarseness immediately went away. So I guess we'll stay at the full 15mg dose. And I am wondering, that given your boys' severe reflux, if they shouldn't be moved up to 15mg too. Might be worth another call to the ped at least. You probably have their number memorized Good luck!!

 

oh believe me i tried this route both the pedi and the GI said no, that's why we are on the zantac and prevacid. :/