I feel like there needs to be some sort of checklist created to try and make life easier for parents of babies with reflux, because there is advice all over the internet, and there are all sorts of old wives tales, and then there are the GPs and the health visitors who seem too afraid to suggest anything, in case they get it wrong.
There are plenty of products on the market that claim to help, whether it's specific formula milk, wedge cushions to keep baby from being a hundred percent flat or the somewhat ridiculous Baby Up, that is basically a baby carrier on a high chair to hold the baby so the parents don't have to. That might seem like I'm being a bit dismissive, and maybe I am, but I have a baby with reflux, I do know how hard it is, but even if it didn't have a three hundred pound price tag, I don't think I would want to have one to hold my baby, because I know that sometimes when baby's feel unwell, holding them isn't just about keeping them upright, it's about them feeling better because they need you close to them. They need the skin to skin that hospitals and midwives are teaching, because it's about comfort.
When I raised the fact that my son was struggling with reflux, which was partly in response to the health visitor saying he was dipping from the line of where he should be growing, her best suggestion was to visit the GP, and then when I visited the GP the best thing that they could suggest for a baby with constipation and reflux was to give him Gaviscon. Which makes babies constipated. Because that is clearly logical. At the time I didn't have any other ideas, so I just had to go with it, especially since I didn't have any data of when he was throwing up or refluxing things back or whatever they wanted to call it, because it also gets called posseting and exactly what you call it depends on what it is, but it seemed that no one was interested in investigating what it was, even when we ended up in A&E several times.
You might be thinking, okay, well how is a checklist going to help?
If we had had the data we would have known he was more likely to reflux when he was over a certain amount of hours for a bottle, which meant a lot of them were coming back on his early morning feeds. At that stage, yes, Gaviscon might help, because it settles the stomach acid that's built up over a longer period, but that wasn't every time. We weren't sure whether it was only the formula he was on or if it was also when he was drinking breast milk. As we realised it was far more common with formula we chose to change his milk, but just went for a different 'normal' milk rather than the special diet ones, because they all say about being used under medical supervision, though the doctors didn't seem too interested in us moving onto one of these.
Around the same time we were giving him Gaviscon - which originally cleared the problem of constipation and then made it a hell of a lot worse - we started giving him Infacol, and it took a while to realise that whilst he got better with both, that was mainly due to the Infacol, so we were able to figure out that a lot of the problem was wind, but he's a terrible burper without the Infacol and only slightly better on it. Sometimes, he'd burp when we were burping him, but he would burp with such force he'd bring back a load of milk anyway...
So checklist:
Have you tried Infacol?
I would say have you tried Gaviscon, but it doesn't stop the reflux, it just stops the pain or discomfort associated with it, so I don't know why they prescribe it. How about treating the problem, rather than the symptoms?!
Have you tried a different formula?
There are a lot of different formulas on the market, and at the time that all of this was happening for us, there were a few recalls going on and that made me anxious about what formula to give him. When we initially left the hospital, he was on Cow and Gate, but then that was recalled, so we changed to Kendamil, but that didn't seem to agree with him, and this was what we were only supplementing him with a small amount. We made the decision to go for Mamia, because when I looked into it there hadn't been a recall on Mamia formula, or at the very least it hadn't been recalled because of bacteria contamination. When we looked to change, I read that Mamia formula was most like or very similar to Aptamil, so Aptamil was obviously off the table, and with the fact that we weren't sure if the issues with Kendamil were the bottles or the formula in the early days, we didn't want to go for that either, so we decided to stick to the pre-made formula bottles by Cow and Gate, because he seemed to be mostly okay with those. When we managed over a week without spit up with those we bought the powdered version (and then had a spit up incident with the pre-made stuff), but at least he was actually gaining weight by then.
Have you tried keeping the baby upright?
We tried this so much, because it was all that we could do. We have wedge pillows in the pram, in the Moses basket, in the bassinet and one that moves all around the house in order to make sure Little Man was never fully flat. It helped a little, but at the same time we had to keep everything covered with muslims and over covers because he was still spitting up.
Have you tried either caramel or baby rice to thicken the milk?
This is basically what special formula is anyway, but you can use it in breast milk if you are combination feeding or feeding exclusively expressed milk. It's also something you can then try without committing to a whole box of formula. It gives the opportunity to try it for a few bottles and see if it makes a difference. We never got to this, or we haven't got to it yet.
Have you tried specialised milk?
Have you tried a different brand of specialised milk?
Honestly, I think I would probably stick to the same brand when changing onto a specialised milk, but if the issue was the brand of milk, that wouldn't help, would it? So surely the next bit is to change to a different specialised milk, whether this is called comfort or reflux, because it changes across different brands.
Have you tried allergy milk?
There's a few ways that this is done, whether it is goat's milk or something where the lactose is stripped out, in order to try and eliminate the idea that it's an intolerance or allergy to lactose. I already knew that if we got here, I wouldn't be able to do this for his breast milk, partly because it takes a bit of time for it to clear from your system, so I would have been pumping milk we couldn't use for a period of time, I couldn't produce enough milk to fulfil all of Little One's needs, but also because I've tried being vegan a couple of times for Veganuary and I sucked at it.
To be honest, I'm not really sure what comes after this. I know that people say 'they'll grow out of it' or 'it'll get better', but it's hard to sit and watch your child not be able to keep the only food and drink that they can have down. We've had issues with dehydration, we've had issues where I know he's hungry and I've not known what to do, because he can't keep things down, and we've had issues because I've felt nothing but guilt for the fact that I can't do anything. Even when the only thing I can do is give him small bottles of food every forty five minutes to an hour, I have struggled, because without setting constant alarms that then drive me mad, I can't keep track of time very well, and I can't stop thinking about how unsustainable some of these options that people suggest are, either for me or for when Little One goes to nursery.