Reflux is difficult no matter how you look at it. This month, as we look at special circumstances and how to make Babywise work with them, I knew reflux would need to be included. I have written several posts on Reflux. I decided to ask Rhianna for her tips on making Babywise work with reflux. She has definitely gone through a more intense reflux experience than I ever did. Here are her tips. Thanks Rhianna for a great post!
When I was asked to do a guest blog post about reflux, it took me down this horribly hard memory lane as I thought through everything that I’ve been through with my youngest daughter, Aubrey, who is now 12 months old. The reflux journey is hard. I won’t lie. It’s a long hard road and we are barely coming out of it, as we still are doing feeding therapy. I will say though, that things do get better with time AND you learn lots of tricks to survive and work through it.
My daughter Aubrey started out great in the hospital. She was born at 39w2d and was healthy and round (8lbs8oz). She had no issues at all. She latched well when she was only 30 minutes old and I thought that she would be a breeze. As this was my 3rd baby, I knew how to breastfeed and I knew that if it started out this easy, all would be wonderful! The night we took her home, she seemed pretty laid back and was still nursing well. That first night home, I found out I was very wrong. My milk came in and immediately things went downhill. I tend to have a very overactive letdown and a huge supply for the first 4+months. Apparently, this created some extra issues for Miss Aubrey. I quickly discovered that she could only nurse side-lying because that kept the flow a little more under control, but then at that, only in the middle of the night was it ever completely controlled. All other feedings had to be pumped and bottle fed and even still it wasn’t done without constant screaming through the whole feed. Eventually, I had to switch to formula due to having surgery and discovering by accident that formula went down smoother for her. I so wanted to keep breastfeeding (which is a whole other post) but it was so hard on my older two kids that I spent so much time pumping and feeding this screaming baby. I just had to make the call to help her improve and save the sanity of my whole family, BUT it didn’t make Aubrey normal by any means. Every feeding was still hard, but the little improvement I saw was worth it. Her reflux, when flaring, caused her to choose to not eat, rather than eat and feel the pain of reflux. Many babies still eat with reflux, but then spit it up and want to eat for comfort. Both extremes are just specific to how that baby is happening to exhibit reflux. Eating was a huge issue for her since she refused when in pain. She has since been on about 4 formulas and is now on thickened feeds with a higher calorie mix and finally at 10.5 months was able to take solid foods. She is in feeding therapy and has had multiple swallow studies, an Upper GI/Esophagram, and an Endoscopy with biopsy and blood work as well as multiple other small tests. We’ve experienced a lot in her short life and I hope to use what I’ve learned with her reflux as well as my son's reflux to help others. My son's journey with reflux started after 6 months, so I didn't use too much of his story to write this post.
So, with that said, here are some helps that got me through the newborn stage with a Babywise baby.
~ Follow the Sleep Hierarchy.
One huge help to me was the My Sleep Hierarchy for Newborns post and then also the Sleep Hierarchy: 3-6 Months. As a Babywise mom, I really had a hard time with the fact that I never felt I could get full feedings in and when I did, they all came up in projectile vomiting and then I had no idea where to go from there. It helped me tremendously to think in form of a routine (not minutes/hours scheduling, but a routine: Eat, Wake, Sleep). With Miss Aubrey, I focused on getting some sort of feeding (her issue was not necessarily keeping the feeding down, but rather getting it down, since she found safety in not eating in order to protect herself from the pain of reflux). Then I would focus on an appropriate happy waketime (which was rare, but I tried), then I would work on the sleep routine. If a feeding took her full waketime, I’d try to have some quiet time with her that was positive after the feeding and before I put her down. But I really focused on one step at a time through the sleep hierarchy on this blog.
~ Get a consistent bedtime routine.
I focused on doing the Baby Whisperer’s 4 S’s as noted in this post: http://www.babywisemom.com/2009/04/sleep-training-four-
~ Take it one step at a time.
I was dreaming of a great eater that sleeps through the night on cue and took perfect naps. Reflux doesn’t allow everything to happen at once (many times). With Aubrey, when eating was under control, she was a great sleeper. Her eating wasn’t under control if her reflux wasn’t, so it is all connected. She did sleep through the night early on, but then we hit a huge flare at 4 months and she didn’t sleep through the night without needing a feeding for about two months as we figured out what was going on. When we switched to a new formula, she slept through the night that very night because it was higher calorie AND went down much smoother for her! She had the skills to sleep because we had been consistent in the routine, but when she was needing the extra calories during that flare, I had to follow that cue and feed her. When the problems were worked out, she slept great again. I’m so glad that I stayed consistent in the areas that I needed to be consistent in. I didn’t let reflux be an excuse for bad habits. There are some things I could control and some I couldn’t. I worked on promoting good habits wherever I could, one step at a time.
~ Make a schedule based on your baby’s specific needs.
It is important to read your baby’s needs carefully. Overfeeding a reflux baby can aggravate it more and underfeeding is also something you want to avoid (for obvious reasons!). This is why I feel that a schedule is definitely helpful for a reflux baby. In the early days, focus on the routine of feeding. As the baby gets older, begin shooting for a consistent 2.5-3.5 hour routine. With Aubrey, she could easily have gone 4-5 hours without eating and then just take a few drinks and not eat again for a few hours. Had I not been proactive to note when was appropriate to get a feeding in AND get a full feeding, she would have eaten even less than she did. I used an app (and website) (http://www.babybix.com/) to track feedings and amounts so that I knew for sure how much she was taking in and when (if breastfeeding, track feeding time on each side). I also set times in my head as to when I would need to start the next feeding (since she was not going to tell me when). I created a flexible schedule based on what was appropriate for her current age and what her specific needs were. She wasn’t (and still isn’t) a normal baby, so I couldn’t necessarily compare her to every other child her age, but I could keep in mind what is normal for her age and then make a plan based on her specific needs. Reading your baby’s cues is a big positive note of Babywise and it is so useful with a Reflux baby. Don’t be discouraged if you still have trouble reading cues, there is a lot of extra crying with reflux which makes it hard to discern things, but take notes, track things, and you’ll start getting to know your baby’s patterns and needs.
~ Don’t be afraid to seek out help.
A very important point, that isn’t specifically Babywise but is good to mention, is don’t be afraid to look for more help on the reflux side. Find someone who has experienced it and ask them questions, bounce ideas off of them about meds and medical testing and support. A great resource is the Babycenter group: Surviving Reflux. These ladies know a ton and if you don’t know where to go with reflux questions, it’s a great place to start. If you suspect something is not right, start looking for some support. Many pediatricians don’t know a lot about reflux, so it’s important to learn all you can so you can be proactive for what is best for your baby. Feel free to contact me if you ever need to vent or let off steam or ask questions about reflux.
There is another post on this blog that I want to note that has tips that I felt unnecessary to completely repeat. Each of the tips listed are a great start in dealing with the basics of reflux. http://www.babywisemom.com/2007/11/bw-and-reflux.html