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OT: Pains Post Partum/Feeding
Since I have two questions, I'm just going to post them both at the same time. First, I'll start with the pains I've been having. I'm 4 weeks post partum and starting at 1.5w pp I started having terrible stomach cramps, vomiting, and diarrhea. It was so bad that I became dehydrated and couldn't eat for several days which caused my milk supply to dry up. So, no more bf'ing for me. :( It went away at 3w pp and my midwife said it was probably my ibs or a virus. After that I got a sinus infection. It's nearly gone and last night I was having these terrible pains in my lower pelvis and back and it seriously felt like labor pains. I tried to go to the bathroom and didn't have much luck there. I woke up this morning and felt fine. What is this? Is it probably just my ibs?
Secondly, Lexi is now on zantac and we have to add rice cereal to her bottles per her ped because of her bad reflux. We were doing 1tsp/oz of formula but today she was back to having her entire bottle come back up, so I upped the rice cereal to 2tsp/oz of formula and she hasn't had any problems with it coming back up. At 4 weeks how much formula should she be getting at a time. She'll take anywhere from 2-4oz...usually closer to 2 and if she's still hungry I'll give her another ounce or two. But, then she doesn't want to eat at the 3 hour mark. Her ped said to give her 2-3oz every 2-3 hours but he said that at her 2w appt. If she eats 3-4oz she won't want to eat before 4-5 hours. Last night I thought I would let her wake me up for a feeding because she's been doing that. I woke up 5 hours later (she'd only eaten 2oz) and I had to wake her up and keep her up so she's eat another 2oz. Is this okay? How much/often should she be eating?
Secondly, Lexi is now on zantac and we have to add rice cereal to her bottles per her ped because of her bad reflux. We were doing 1tsp/oz of formula but today she was back to having her entire bottle come back up, so I upped the rice cereal to 2tsp/oz of formula and she hasn't had any problems with it coming back up. At 4 weeks how much formula should she be getting at a time. She'll take anywhere from 2-4oz...usually closer to 2 and if she's still hungry I'll give her another ounce or two. But, then she doesn't want to eat at the 3 hour mark. Her ped said to give her 2-3oz every 2-3 hours but he said that at her 2w appt. If she eats 3-4oz she won't want to eat before 4-5 hours. Last night I thought I would let her wake me up for a feeding because she's been doing that. I woke up 5 hours later (she'd only eaten 2oz) and I had to wake her up and keep her up so she's eat another 2oz. Is this okay? How much/often should she be eating?
Well we're currently in a state of emergency here in TN. We have 8" of snow on the ground right now. I'm so glad I went last night and bought two cans of liquid Nutramigen. I called her ped's office and got some other dr who told me to put 1 tablespoon of rice cereal/2oz and continue with nutramigen since I have an allergy to a cow's milk protein. So far, I actually cut back on the rice cereal to 1 teaspoon per 2 ounces and put her on the Nutramigen and so far no projectile vomit. I really hope this works for her.
I totally understand your frusterations, especially with your mothers intervention-however well intentioned it may be. Trying the soy formula is an excellant idea. If that does not help I would definately talk to the doc about the upper GI. It's a very simple test and when my DD had it done, it didn't bother here in the least. I consider projectile vomiting anything that comes our forcefully regardless of how "far" it goes.
poor baby :(
If you have only been on zantac, keep with it a while longer. It takes time to build up in the system. Also, the doses often need to be adjusted. There are also other options that can be explored if after 2 weeks, the zantac doesn't fully help. We ended up on prevacid. Unfortunately, it's a process of trial and error. And the meds won't lessen the spitting up, just the pain with it. We ended having to see a gastro when my ped admitted he never had a baby that still had severe symptoms with both the standard doses of zantac and prevacid.
You can try other formulas, but know in the trial and error process that it does take a while for the meds to build up in the system and be effective. You can also educate yourself further by looking at the MARCI-kids website. It is tremendously helpful.
I hope things get resolved soon. I remember just sitting there crying as my baby screamed in pain, arching and shrieking and nothing comforted her. I begged DH to find something, anything to give her relief. There are OTC meds that can be given in flair-ups, but I wouldn't give someone the names of the meds or even speculate the dosage over the internet. Just persist with the ped, and if he doesn't have answers then see the gastro. I didn't feel like DD's reflux was being managed until almost 8 months when we finally got the meds right. Despite the severity of her case, we were able to wean her off the meds by 12 months.
If you have only been on zantac, keep with it a while longer. It takes time to build up in the system. Also, the doses often need to be adjusted. There are also other options that can be explored if after 2 weeks, the zantac doesn't fully help. We ended up on prevacid. Unfortunately, it's a process of trial and error. And the meds won't lessen the spitting up, just the pain with it. We ended having to see a gastro when my ped admitted he never had a baby that still had severe symptoms with both the standard doses of zantac and prevacid.
You can try other formulas, but know in the trial and error process that it does take a while for the meds to build up in the system and be effective. You can also educate yourself further by looking at the MARCI-kids website. It is tremendously helpful.
I hope things get resolved soon. I remember just sitting there crying as my baby screamed in pain, arching and shrieking and nothing comforted her. I begged DH to find something, anything to give her relief. There are OTC meds that can be given in flair-ups, but I wouldn't give someone the names of the meds or even speculate the dosage over the internet. Just persist with the ped, and if he doesn't have answers then see the gastro. I didn't feel like DD's reflux was being managed until almost 8 months when we finally got the meds right. Despite the severity of her case, we were able to wean her off the meds by 12 months.
No, she definitely has reflux. She arches her back and screams and throws her head back, draws her knees up to her chest and screams, I mean it gets pretty bad. I didn't even talk to the ped about it until her 1month appt because I figured I was over reacting, but then it started getting to where nearly her entire bottle was coming up. It comes up with force and will come out about 2-3" past her mouth before it starts falling. My mom told me if it was projectile it would be going across the room and hitting the walls, which I don't necessarily agree with. I've seen babies with spit up and it really doesn't look the same.
I tried everything before bringing it to my peds attention. I tried having her sleep at an incline, giving her smaller more frequent feeds, burping her (and some times she won't burp at all no matter how long I try), I feed her at an angle so her stomach isn't bunched up, and once she slows down on feeding or falls asleep I remove the bottle so she doesn't overeat. So wednesday her ped said to try zantac and the rice cereal to thicken her feeds. It worked great for like a day or two an she didn't have reflux, then it started all over again. She was gaining weight before we tried adding the rice cereal, but it was a very slow weight gain.
I have a cows milk allergy and am lactose intollerant. I asked him if maybe she had it as well, and he said that it was possible, but my mom was at the appt and spoke up and said she knew she didn't. I mean she acted like she was around Lexi enough to know how she acts at a feeding and she's not. So he overlooked the possibility that it's reflux and maybe a cow's milk allergy. I know that the cereal is a choking hazard and isn't meant to be given to a newborn because it fills them up. But I feel like I've tried almost everything. Today I'm going to go get a can of soy an see if that works. Then I guess I'll try nutramigen. This is just getting frustrating because after an episode she acts like she's starving and then it's just a vicious cycle.
I tried everything before bringing it to my peds attention. I tried having her sleep at an incline, giving her smaller more frequent feeds, burping her (and some times she won't burp at all no matter how long I try), I feed her at an angle so her stomach isn't bunched up, and once she slows down on feeding or falls asleep I remove the bottle so she doesn't overeat. So wednesday her ped said to try zantac and the rice cereal to thicken her feeds. It worked great for like a day or two an she didn't have reflux, then it started all over again. She was gaining weight before we tried adding the rice cereal, but it was a very slow weight gain.
I have a cows milk allergy and am lactose intollerant. I asked him if maybe she had it as well, and he said that it was possible, but my mom was at the appt and spoke up and said she knew she didn't. I mean she acted like she was around Lexi enough to know how she acts at a feeding and she's not. So he overlooked the possibility that it's reflux and maybe a cow's milk allergy. I know that the cereal is a choking hazard and isn't meant to be given to a newborn because it fills them up. But I feel like I've tried almost everything. Today I'm going to go get a can of soy an see if that works. Then I guess I'll try nutramigen. This is just getting frustrating because after an episode she acts like she's starving and then it's just a vicious cycle.
I don't have any suggestions on the first one but for the reflux....
Typically 2-4 ounces is find for a baby of a month old. But keep in mind the cereal is going to make her fuller so she will take less formula. This actually isn't a good thing becuase she needs more formula for the nutritonal value. The cereal doesn't have that. I have had 4 kids who were ALL on reflux meds..but having learned something from them I was able to keep my last baby off meds and cereal. These are just some things that I"ve learned and maybe they will help you:
1. Many parents have the tendancy to want to make the baby finish a bottle. DON'T. When your baby starts giving cues that s/he is full...STOP. Overfeeding is a big reason for reflux issues.
2. Keep your baby at an approx. 45 degree angle during feeding but ensure that her abdomen isn't bent too much causing pressure on her stomach. Also ensure that her diaper and clothes aren't too tight around her waste causing pressure.
3. Burp her after every ounce. Too much air built up can cause the food to reflux as the air tries to make it's way out. Frequent burping can help to prevent this.
4. Once she is done eating, pick her up to burp her one last time then put her in a bouncey/swing or something else that is inclined. Don't lay her flat. Try to keep her inclined for atleast a half an hour after each feeding. Also, don't move her around too much.
5. Keep in mind that spit up is NORMAL. All babies are going to spit up some. Up to a few table spoons. HOwever if she is spitting back her entire bottle and/or it's projectile spit up. You may want to speak with her pediatrician about having an upper GI done. My oldest had one due to severe reflux. We found out that the flap that closes off the esophogus wasn't fully developed yet, in addition the muscle going from the stomach to the intestines was spasming. These two combined were causing severe episodes of projectile spit up. She was put on a med to calm the spasms. This was a pretty extreme case of reflux though.
6. Honestly I think 1 tsp of cereal per ounce is a bit much. Honestly I would talk with your ped about switching her to a formula like Enfamil AR. It has the rice starch added to the formula so there is no need to mix it with cereal. I used this with my 2 yo and it worked great along with Zantac. I actually stopped giving him the meds around 4 months.
7. Zantac doesn't help with PREVENTING the spit up, it helps with reducing the acid so it doesn't burn. This will only help with the symptoms your baby experiences DUE to the reflux..like the burning. It will NOT improve the spit up itself.
Being as reflux is typically due to an immature digestive system...adding the cereal can actually make matters worse by introducing something that the digestive system isn't equipped to handle just yet.
I'm not totally against the cereal, as I said, I did it with FOUR of my kids...but I learned from that, that it isn't necessarily the best thing and can actually cause more harm than good. Something else to think about is that your baby may have a sensitivity to milk based formula. Have you tried switching to a soy based to see if it improves?
Typically 2-4 ounces is find for a baby of a month old. But keep in mind the cereal is going to make her fuller so she will take less formula. This actually isn't a good thing becuase she needs more formula for the nutritonal value. The cereal doesn't have that. I have had 4 kids who were ALL on reflux meds..but having learned something from them I was able to keep my last baby off meds and cereal. These are just some things that I"ve learned and maybe they will help you:
1. Many parents have the tendancy to want to make the baby finish a bottle. DON'T. When your baby starts giving cues that s/he is full...STOP. Overfeeding is a big reason for reflux issues.
2. Keep your baby at an approx. 45 degree angle during feeding but ensure that her abdomen isn't bent too much causing pressure on her stomach. Also ensure that her diaper and clothes aren't too tight around her waste causing pressure.
3. Burp her after every ounce. Too much air built up can cause the food to reflux as the air tries to make it's way out. Frequent burping can help to prevent this.
4. Once she is done eating, pick her up to burp her one last time then put her in a bouncey/swing or something else that is inclined. Don't lay her flat. Try to keep her inclined for atleast a half an hour after each feeding. Also, don't move her around too much.
5. Keep in mind that spit up is NORMAL. All babies are going to spit up some. Up to a few table spoons. HOwever if she is spitting back her entire bottle and/or it's projectile spit up. You may want to speak with her pediatrician about having an upper GI done. My oldest had one due to severe reflux. We found out that the flap that closes off the esophogus wasn't fully developed yet, in addition the muscle going from the stomach to the intestines was spasming. These two combined were causing severe episodes of projectile spit up. She was put on a med to calm the spasms. This was a pretty extreme case of reflux though.
6. Honestly I think 1 tsp of cereal per ounce is a bit much. Honestly I would talk with your ped about switching her to a formula like Enfamil AR. It has the rice starch added to the formula so there is no need to mix it with cereal. I used this with my 2 yo and it worked great along with Zantac. I actually stopped giving him the meds around 4 months.
7. Zantac doesn't help with PREVENTING the spit up, it helps with reducing the acid so it doesn't burn. This will only help with the symptoms your baby experiences DUE to the reflux..like the burning. It will NOT improve the spit up itself.
Being as reflux is typically due to an immature digestive system...adding the cereal can actually make matters worse by introducing something that the digestive system isn't equipped to handle just yet.
I'm not totally against the cereal, as I said, I did it with FOUR of my kids...but I learned from that, that it isn't necessarily the best thing and can actually cause more harm than good. Something else to think about is that your baby may have a sensitivity to milk based formula. Have you tried switching to a soy based to see if it improves?
If she has reflux, you should be doing small, frequent feeds and not big ones. The more you put in her tummy at once, the more likely it is it will come back up. Her tummy is still tiny.
I also feel rice cereal may not be good for such a little one, and I think you are seeing the effects already. She is not taking many bottles because the rice, which has no nutritional value, is filling her up. It's empty calories, and right now her body and brain really need the nutrients found in formula. But do not force bottles on her, as it will aggravate the reflux. Once I did the math- following the directions for adding cereal to a bottle, the average person is giving a tiny baby a full adult sized portion of rice each day! When you think of how tiny the baby is, and what her needs are, that is a LOT. I understand you have a dilemma, because you want your little one to keep her feeds down. Before adding rice, was she gaining properly? Some babies spit up a lot, but it looks like more than it really is. I know it sounds silly, but with my first I was so concerned about how much she was getting, I used a sensitive food scale to measure the weight of a burp cloth before and after my little one saturated it. It gave me an idea of how much was coming up. This number would be off if the formula has cereal in it though. Are you doing all the other interventions like holding her upright during feeds, burping frequently, keeping her upright at least 20 minutes after a feed, sleeping her in an incline, etc...?
Did you notice any improvements with the zantac? Before the zantac did she have signs of *acid* reflux (screaming when burping, arching back in pain, etc....?) I ask because some doctors do prescribe zantac when there aren't signs of a problem with acid, only spitting up.
Normally, you wouldn't have to wake the baby to eat. However, if she truly has reflux, she may be refusing to eat because of that. Or, like I said, it could be because of the rice. Allowing her tummy to get too empty may aggravate the reflux too. Honestly, it may boil down to trial and error- finding what works best for her. And if you see no improvement, definitely consult the ped, and possibly request a referral to a gastro.
I also feel rice cereal may not be good for such a little one, and I think you are seeing the effects already. She is not taking many bottles because the rice, which has no nutritional value, is filling her up. It's empty calories, and right now her body and brain really need the nutrients found in formula. But do not force bottles on her, as it will aggravate the reflux. Once I did the math- following the directions for adding cereal to a bottle, the average person is giving a tiny baby a full adult sized portion of rice each day! When you think of how tiny the baby is, and what her needs are, that is a LOT. I understand you have a dilemma, because you want your little one to keep her feeds down. Before adding rice, was she gaining properly? Some babies spit up a lot, but it looks like more than it really is. I know it sounds silly, but with my first I was so concerned about how much she was getting, I used a sensitive food scale to measure the weight of a burp cloth before and after my little one saturated it. It gave me an idea of how much was coming up. This number would be off if the formula has cereal in it though. Are you doing all the other interventions like holding her upright during feeds, burping frequently, keeping her upright at least 20 minutes after a feed, sleeping her in an incline, etc...?
Did you notice any improvements with the zantac? Before the zantac did she have signs of *acid* reflux (screaming when burping, arching back in pain, etc....?) I ask because some doctors do prescribe zantac when there aren't signs of a problem with acid, only spitting up.
Normally, you wouldn't have to wake the baby to eat. However, if she truly has reflux, she may be refusing to eat because of that. Or, like I said, it could be because of the rice. Allowing her tummy to get too empty may aggravate the reflux too. Honestly, it may boil down to trial and error- finding what works best for her. And if you see no improvement, definitely consult the ped, and possibly request a referral to a gastro.
First thing sounds like it could be constipation or or irritability. Remember it takes about 6 weeks to recover and begin to feel normal again so even a little constipation could cause those pains again.
I'm a firm believer that babies shouldn't receive cereal until the recommended 4-6 months so I cannot answer the second question. There are a lot of other mothers here who've had babies with reflux who will be better able to answer that.
Finally the only time you need to wake baby to eat is during the day. If she will sleep let her sleep!
I'm a firm believer that babies shouldn't receive cereal until the recommended 4-6 months so I cannot answer the second question. There are a lot of other mothers here who've had babies with reflux who will be better able to answer that.
Finally the only time you need to wake baby to eat is during the day. If she will sleep let her sleep!
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