we are available to chat thanks
Thank you for waiting.
It sounds like this has been going on for most of her life, is that correct?
Well unsettled all her life, 'colic' screaming only last couple of weeks
Ok. You have given a very full history in the stem, thank you for that.
I think you give a very good description of reflux.The lack of response to Losec does not preclude this.
Losec is not supposed to stop reflux, as you may know. Rather it is to make it more tolerable. The look on her face, is likely the "brash water" sour taste she is responding to.
Additionally, you describe quite well something we call Sandifer posturing, a sign of reflux. Infants will arch their back and necks, we believe, in an attempt to extend their esophagus.
It is quite reassuring to have her gaining weight and still interested in feeding. The change of formula is very unlikely to make a difference despite what the different formula makers would have you believe.Formula intolerance is a very uncommon cause of reflux although is is often blamed.
OK cheers, XXXXX XXXXX why she often screams during start of feed as if we were giving her poison, very unhappy then in 40 min or so, it's like she decides it doesn't taste that bad and drinks a lot of bottle
Reflux precautions are likely more helpful, some of which you are likely already doing: upright during feeds, upright after feeds, frequent burping, and smaller, more frequent feeds.
You can also thicken feeds with the addition of rice cereal. She should still be able to suck it from the bottle. Typically, honey consistency is helpful. A "reflux wedge" may also be useful. This is a foam wedge, with velcro harness on the front, allowing her to sleep on an incline. This works with varying degrees of success.
COuld there be a possible dairy intolerance aswell as the reflux?
The reflux does seem to be worse at times, our understanding was that it should get better with time?
Both lactose intolerance and frank milk protein allergy are frequently blamed but unlikely if reflux is the only symptom. Dry skin, blood in the stools would be more concerning for this but, alone, not as likely. Allergy to breast milk is yet more uncommon and should make you feel better that this is not a allergic issue, rather just an unfortunate result of Aisling's esophagus being very short; any burp is a "wet burp" and some children are more vocal about their discomfort.
I would be careful about changing formulas around too frequently. If you are seeing similar results with breast milk and now two formulas, the chances that she is allergic to all of them is not high. Therefore, frequent changes may be causing her additional GI upset, rather than improving it.
OK, thanks for the advice, some interesting points we have not heard before.
Colic, is also likely at play.
There are some differences in opinion on the etiologies, I'll try to explain. Traditionally, we are taught that it may be directly reflux, gas or constipation, or a GI cause. There may be an emerging opinion for a neurologic cause, not in any scary pathological sense but perhaps an immaturity. Dr Karp who wrote "The Happiest Baby on the Block" suggests that colicky babies may not neurologically be ready for life outside the womb. As such, when comforting a baby with colic he suggests recreating that environment. He recommends, the five S's: Swaddling, side position, sucking, shhhing and swinging