reflux mamas: need ideas

we've been dealing with reflux since day 1, it seems. the boys have slept propped up in their bouncy chairs from the very beginning. just recently jacob gave us very clear signs that he wasn't comfortable sitting up anymore and wanted to sleep lying flat. we transitioned him to the crib and now he won't sleep any other way. he even resists naps propped up now. we let owen go at his own pace but this week he started giving us the same signals so last night we transitioned him, too.

they're active sleepers so they roll, rotate, and move around a lot. i think they've been craving this freedom of movement, frankly. because they're active we can't prop one side of the mattress up. they turn around and face the other direction several times throughout the night and i don't want them to end up with their heads on the downhill side.

here's the problem: while we've got pretty decent control of the acid problem with meds (depending on the day) at night they're clearly experiencing reflux in their sleep. it's more of a silent reflux situation because it's rare that i find moisture on their clothes or sheets. what makes me think they're getting that washing-up-the-throat action is that jacob coughs in his sleep. and in the morning he coughs during his first bottle. it gets better as the day goes, but when we tried unsuccessfully to transition meds last week i noticed he coughed a lot more on a bad acid day. so i'm thinking the night coughing is related to acid during his sleep. he has no other signs of illness.

with owen the problem is a little less clear. he slept like a rock for the first time in weeks, rolled over almost onto his tummy. i think he was a lot more comfortable lying flat than he was propped up in his chair. but then he woke up at 3:30 crying like he was in pain. we got him up and his voice was hoarse. he seemed hungry so we offered him a bottle, which he lunged for, but then it was like he couldn't suck without pain. his reaction to the nipple was almost like he was scared to swallow. i finally soothed him through it and he guzzled 3 ounces with hardly a pause, and we put him back to bed (this time in his bouncy chair) with a dose of baby motrin. when he woke up this morning his hoarseness was gone and he seemed a lot more chipper.

i'm just afraid lying flat is causing them some pain from reflux in their sleep, but they're resisting sleeping propped up. reflux mamas who have BTDT, can you help? i'm looking for any creative ideas for how we could find a happy medium between being propped and letting them have the sleep freedom they're enjoying in their cribs.

 

I haven't really found a happy medium...baby girl is the one with reflux. But, she liks to sleep in her crib, on her tummy, and there's not much I can do about that. She takes prevacid and I split her dose (after talking with ped) giving one in the morning and one in the evening with cereal. I've found that seems to have helped her with the nighttime stuff. Not sure when you give your meds or what meds they are on or if this is even an option for you...just thought I'd throw that out there.

 

The meds for reflux aren't to cure the spitting part (for the most part), just to cut the acidity of what does come up and make it less painful. I would ask your doctor for either a stronger dose of the medicine, or start moving it back until they're taking it at night.

 

Do they sleep on their tummies? I found that they were much more comfortable on their stomachs with the reflux. There is lots of research to suggest that tummy sleeping helps put gentle pressure on their stomachs which seems to soothe them. I wonder if they are ready for this?

 

With DS, I found that it worked the best if I gave him his meds at the 2-3am feeding time rather than in the evening before bed. He got his second dose mid-day. We are finally able to do once a day meds now (he's on Axid), just starting this past week. I hope yours starts getting over it soon, too.

 

my guys were on meds in the morning and then before bed..as well as a bottle with cereal in it before bed..this helped them. once they start rolling around there isn't much you can do to keep them "in position".

 

Have you tried tummy sleeping? My refluxers seem to do better on their tummies. Are you thickening at all? You could try to thicken their last bottle so that it might stay down better. But if they are spitting up acidic stuff and are in pain that is definately a sign that meds need to be increased.

 

I agree with the others, maybe their dosage needs to be changed on their meds? The coughing can definitely be caused by the reflux. Once they start rolling/scooting around in their cribs, there isn't much you can do to keep them in place unfortunately. Although like pp said, tummy sleeping does seem to make them feel better sometimes.

 

thanks for all of the responses. a couple of additional bits of information:

they're on prevacid, one 15mg solutab twice a day. that's a pretty high dose already. we experimented in the last 2 weeks with moving them to nexium based on the GI specialists' recommendation but they were in pain as though they'd completely missed their meds within 24-48 hours of the switch. we tried transitioning twice and both times they had the same reaction. the pain improved as soon as we moved back to prevacid.

we dose them once at 6:30 a.m. and again at 6:30 p.m. i'm wondering if shifting their medicine to different times would help. what makes me hesitate, though, is that they can be a little resistant about their meds and we do daycare, so we would be asking the daycare ladies to struggle with their meds. i'd rather oversee that myself just to make sure they take it all. additionally, they mostly STTN so there isn't a middle of the night feeding most nights. so i think we're stuck with our current schedule.

they won't tummy sleep because as soon as you put them on their tummies they think they're supposed to push up and try to crawl. :lol: owen is sleeping almost on his tummy, he rolled from his back so that his legs are all the way over but his bottom arm is still in front of him so it's not a complete roll. jacob sleeps on his back and his side. if i tried to put them on their tummies they would try to push up and they wouldn't settle until they rolled onto their backs.

if i could be sure they would at least keep their heads pointed towards the same end of the crib all night i would just prop one side. but i just went up there to check and jacob is already pointing the other direction.

 

Hmmm. Has your GI doc or ped given the ok for Mylanta? Maybe you can give that in the mornings when you notice the cough. Still though you would think the Prevacid should be doing a better job. The times you are giving the Prevacid sounds fine.

As far as the sleep positions go, I don't think there is a good answer when they start moving around, and why the meds are so important to keep it under control.

I know sometimes they add Zantac or something along with the Prevacid. Have you gone that route yet?