Your Kids Table

Today Sarah from Frugal Fun for Boys is guest posting here at Your Kid’s Table.  She is a homeschooling mom to four boys and a violin teacher.  Two of her little guys experienced acid reflux as babies. Today she is sharing their journey in discovering silent reflux, diagnosis, and treatment of the symptoms.  Reflux affects many babies and children, which can have a huge impact on how and what they eat.  Sarah has more posts about reflux over on her blog, so be sure to check it out after reading this wonderful and informative post.


Babies-Acid-Reflux



In the spring of 2009, I was expecting my third son, Owen. As a veteran mom, I figured that I pretty much knew what to expect. My first two boys were terrible at nursing at first, but we worked through those challenges, and they both went on to be chubby babies who were good eaters and grew well. I expected that my third son would follow the same path.

Well, that wasn’t what happened.


I first suspected that something was wrong at about six weeks of age when Owen would begin nursing only to pull off, arch his back, and scream just a few minutes into the feeding. If I stopped the feeding and put him down, he was content and happy. If I tried to get him to finish nursing, he became very upset. I had no idea what could be wrong with Owen, and I assumed it must be a problem with nursing. We put off going to the pediatrician because my husband was out of work and we were uninsured at the time.

When Owen was 3 months old, my husband had a great new job and insurance coverage. We went to the doctor the first week that we had insurance! By this point, I was exclusively pumping and bottle feeding because it was very difficult to manage Owen’s “snacking” approach to eating with two other boys to care for as well. With the bottle, I could see better what was going on. I explained to our pediatrician that Owen would drink 1-2 oz. and then begin arching and crying. The pediatrician suspected silent reflux (meaning that the refluxed material does not come all the way up as spit-up), and sent us home with a prescription for Axid. He said that we should see a difference after a few days on the medicine if reflux was truly the cause of Owen’s feeding troubles.


We tried Axid, and it initially seemed to work, but a couple days later Owen was back to arching and refusing his bottle. The doctor had us try Prevacid. It was very difficult to give, and Owen came down with a cold as soon as we started it, so that made us wonder if the Axid really had been helping and the poor eating was simply the result of the cold coming on. At four months, Owen began teething, and his eating was really affected. He rarely drank more than 1.5- 2 oz. at a time. At five months, Owen had an upper GI test done (normal results – did not show any reflux) and he spent a month on Axid with inconclusive results. At 6 months, we stopped the Axid, because according to our doctor, Owen was probably close to outgrowing his reflux.

Actually, he wasn’t close to outgrowing it at all!

7 months old

 

At 7 months, Owen was crying when we approached the chair where we fed him. Teething seemed to make his eating much worse, and he was constantly teething! Much of the time, he would not allow us to hold him while we fed him his bottle – he preferred to be in his bouncy seat. If anything remotely more interesting was going on, he would not eat. He would not eat solid foods, and honestly, getting him started on solids was the least of our concerns! Also, most of his milk intake was in a sleepy state before his naps. If either of his brothers interrupted us, the feeding was over! He stopped nursing completely at 4 months, so I was pumping full time while also teaching part-time at a private school, and homeschooling a 6-year-old and a 3-year-old. When I look back at the stress of that time in our lives, I realize that it was only God’s grace that got us through! Even now I am amazed at the strong feelings of stress that wash over me when I think about that stage. There’s nothing quite like wondering if your child is starving himself.
 

One night, I posted my desperation on facebook, and a friend put us in touch with a feeding specialist that she knew. She was an incredible source of encouragement and information! First of all, she assured us that this sounded like classic reflux. She gave us some tips for dealing with the reflux, such as elevating the end of his crib mattress and moving him out of his infant carseat and into a convertible seat. Because we could not “see” any of Owen’s symptoms, it was helpful to have someone assure us that reflux was his problem and that simple positioning tricks would help reduce the reflux. Owen was hoarse from the acid by this time, so we started him on Axid again at a higher dose, and Owen seemed more comfortable drinking his bottles within 48 hours! The feeding specialist also recommended that Owen see a dietician, and we eventually saw a GI specialist as well.

Owen’s reflux was ugly. And he didn’t outgrow it at 6 month, or a year, or even 18 months. But he DID outgrow it!

10 months old and sneaking a snack from the diaper bag – a moment that I was so happy to see!

Where are we now? Well, Owen is 3.5 years old and enjoys eating and snacking! Because of the feeding aversions that he developed, he did not begin to eat solid foods in any sort of reasonable quantity until he was 18 months old. He drank high calorie formula for most of his nutrition until 18 months, and didn’t give up formula completely until 2 and a half. But we made it! The formula and bottles are finally a thing of the past, and Owen loves to eat fruits, veggies (he loves carrots and broccoli), most meats, peanut butter on crackers or apples, and cheese. He had a dairy sensitivity, which he has outgrown. He has been off his medicine since age 2.


What did we learn from our reflux experience?

  • Silent reflux is hard to diagnose because the baby is not spitting up! We did not know for sure that Owen had reflux until he had a pH probe test at 10 months old. Some signs to watch for are crying and arching during feedings, screaming after feedings, frequent sour burps, and hoarseness from the acid.
  • Choking during feedings can also be a sign of silent reflux. When our fourth son was born in January 2012, I noticed that he was sure choking a lot during his feedings! I called our feeding specialist, and she said that getting choked up more than once a day is not normal. We had a swallow study done at 6 weeks of age, and Jonathan’s swallowing was just fine. But guess what the test revealed… reflux! He was having a “traffic jam” in his esophagus. Milk was trying to come back up while he was still eating. (However, Jonathan’s reflux journey was much less severe! He is 10 months old, and has always been a good eater.)
  • Reflux medicine does not stop the reflux. It does, however, make the reflux less acidic so that it will not burn and cause damage.
  • Many breastfed babies with reflux also have a food sensitivity to dairy or soy, so it may be worth it to eliminate those from your diet. Owen responded really well to a hypoallergenic formula (Alimentum) at 10 months of age. I wish that I had tried a dairy elimination diet for me when he was still nursing because it obviously would have helped.
pH-probe
Owen during his 24 hour pH probe test
  • If you feel that something is wrong, don’t be afraid to keep pursuing it, even if your pediatrician thinks there is not a problem! Our pediatrician was not concerned because Owen’s weight was in the 10th percentile at birth, and he hovered between the 3rd and 10th after that. He was growing along on his own growth curve. However, I saw what was happening at home – the refusing bottles, the never crying for a bottle, and the refusing to eat solid food. We saw a GI specialist on our own, and Owen had an EGD test done. The scope of his esophagus and stomach revealed gastritis – an inflammation of the stomach lining. A 6 week course of Nexium helped Owen quite a bit, and we would never have found that if we hadn’t gone to the GI doctor!
  • On the other hand, do your best to resolve any pain issues so that they aren’t afraid to eat, but then relax about your child’s growth. We were concerned about Owen’s slow growth, but he now eats relatively well, and is still very small for his age! Our fourth son, Jonathan, grew like a weed despite his reflux. He choked during feedings until he was 5 months old, and yet managed to hold his own at the 50-60th percentile for weight. I think that genetic differences, not reflux, has been the bigger factor in the different growth patterns of my two sons with reflux.

Infant reflux can really affect life for both baby and parents! Have you dealt with a child with reflux? If you have any questions, I’d be happy to try to answer them in the comments!

Sarah Dees is a homeschooling mom to four boys ages 9, 6, 3, and 10 months.  She blogs about inexpensive and easy activities to keep boys busy and learning new things at Frugal Fun for Boys

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