Living with Silent Reflux – ‘Resident Blogger’ Hannah

hannah reflux 1Resident Blogger and all round lovely lady Hannah is new mum to Toby, now three months old. Poor Hannah and little Toby have not had the easiest of times unfortunately, as Toby has been suffering from a condition called silent reflux, where a baby’s stomach contents come back up their oesophagus but they show no sign of vomiting. It can cause tremendous pain to the baby, and a lot of upset and anxiety for mum, as Hannah explains in her latest post here.

Hannah blogs at www.buddingsmiles.co.uk

Anyone who reads my blog and/or follows me on Twitter may well know about my son Toby’s diagnosis of silent reflux. He was diagnosed at 6 weeks old and now at 13 weeks, I feel it’s time to write about our experiences so far.

The first few weeks of Toby’s life whizzed by in a blur of sleep deprivation, figuring out breastfeeding, scheduling visitors and snuggling our new son. Looking back, he was never a truly settled baby and try as we might with the Moses basket, Toby would only sleep in mine or his Daddy’s arms. By about 5 weeks it was very clear that he was more unsettled than other babies; as we ventured out more and met up with our NCT friends and other new parents, Toby would cry constantly unless being fed or bounced whilst their babies cooed and slept. Still, neither the health visitor nor GP thought anything was wrong at the scheduled checks so we just carried on.

Things became really tough quite quickly and soon Toby was pulling away from my breast screaming, arching his back and going almost rigid. It was horrible to see and it felt like a personal rejection to me. I was told to work on my latch but I knew that the latch was fine. One day, I noticed Toby’s tummy gurgling during a feed, then he pulled away and sounded like he was going to be horrifically sick but nothing came out. When this had happened a few times, I called the health visitor and she immediately said it was silent reflux. It was that simple!

hannah reflux 2I had a phone consultation with a GP and Infant Gaviscon was prescribed, but after a few days of even more screaming – we’re talking 10 hours a day – alongside constipation, we stopped the Gaviscon as any possible benefits were totally outweighed by the terrible pain he was in from constipation. I called the GP back, ready for a fight, but he immediately got us an appointment and prescribed Omeprazole.

Seven weeks later, we’ve had good days and bad days; the Omeprazole does seem to have helped and since, Toby’s also been put on Dentinox for colic. On the bad days, Toby has cried and screamed for hours on end and I won’t sugar coat, I too have cried very many tears. I have told myself repeatedly that if silent reflux is as bad as it ever gets for Toby then Phil and I are very lucky, but when you watch your son screaming in pain and crunching his legs up, unable to open his bowels or have a full feed then it’s heartbreaking.

As the stress took its toll I accepted that I couldn’t keep exclusively breastfeeding because it meant that I couldn’t have a break, allow Phil or our families to help out on the bad days so that I could rest. Some people continue to feed no matter what and I commend them, but I felt incapable of being the best possible Mummy to Toby if I was an emotional wreck. We began combination feeding during our family holiday a couple of weeks ago and that was a huge turning point. With shared responsibility at night and on the weekends, I can have a bit of time to breathe, to reset my head and to go back in with more strength to help Toby through this.

Whether it’s the feeding, the elusive 3 month mark, the medicine or complete coincidence, Toby does seem a lot better. Toby now sleeps better, smiles more and is developing at an amazing rate. Sometimes he cries, he is a baby after all, but the frequency of the gurgling tummy has reduced and Toby seems so much happier. Phil and I obviously don’t want Toby on medication long-term, but for now things are working and I think we’ll wait until weaning commences (which I’m so excited about!) then speak to the GP and figure out a course of action.

hannah familyFor any parents reading who are experiencing the horror of reflux, please do accept help, fight if doctors won’t listen to you and take each day as it comes. I hated it when people told me it would get better, but it truly is doing and I feel like the Mummy I was born to be, with a perfect, beautiful, smiley son who I love to the ends of the earth.

I’m doing a reflux series of posts on my blog, the first of which was my very first vlog, so please have a read and do get in touch if you want to chat.

Follow Hannah on Twitter @BuddingSmiles

Find out more about reflux and silent reflux from the NCT website

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To buy or not to buy…? – ‘Resident Blogger’ Hannah

Wonderful Resident Blogger Hannah is back after her first month with beautiful new baby Toby! Here she tells us what she has found you realistically do and don’t need for life with a newborn. Lots of you will relate to this post, and if you’re currently making your new baby shopping list, you may just pick up some useful pointers.

 What are your tips for other expectant parents to buy for the nursery – and what should they leave in the shop, regardless of how cute it is? Share your dos and don’ts at @BlogsForBabies.
Hannah blogs at www.buddingsmiles.co.uk
As Toby prepares to turn a whole one month old (it’s gone so quickly!) I thought I’d write about the things that have proven invaluable in this first month, along with the things we probably could have lived without.

Essentials:

  • Bouncy chair… Toby really likes his bouncy chair and the movement has worked well at calming him from very early on. We went for the Fisher-Price Calming Vibrations chair in the Happy Forest theme because it looks really cosy where some look as if baby is perched on top of them and don’t look comfortable. Toby took a while to like the vibrations being on, but he does now and he’ll happily nap in his chair or just sit and look around.
  • Breast pads… I didn’t leak at all during pregnancy, but my goodness sometimes it’s like someone’s left a tap on! If I do Toby’s morning feed and forget to put a pad in, the side I’m not feeding from drowns us both! Even if you’re not breastfeeding, you’ll need these for a while because just the sound of your crying baby will likely set things off!
  • medela pumpBreast pump… I have just invested in a Medela Swing electric pump and it’s amazing. Prior to that I used a Tommee Tippee manual pump, which did the job but less efficiently and was less comfortable. I express 4oz a day for my husband to feed to Toby at 11pm so that I can have a break before the night shift commences. It’s also good to have some in reserve so that I can, on the odd occasion, be away from Toby for one feed. We’ve been doing this since Toby was 2 weeks old and it thankfully hasn’t caused any confusion with breastfeeding.
  • Slumber Bear… My friend’s baby slept through the night very early on (show off!) so she didn’t need Slumber Bear, who has various settings including white noise, womb noise and classical music. Toby drifts off at night to either the white noise or womb noise setting and seems to enjoy the classical music during quiet/nap times in the day.
  • Muslins, muslins, muslins… Quite simply, buy as many as you can fit in your drawer, changing bag and changing unit because you will need them. All of them. From milk dribble to sick, to that age old baby trick of weeing the moment you remove their nappy, you’ll go through more muslins each week than breast pads!
  • toby hannah slingSlings and carriers… These aren’t for everyone, but I adore my Calin Bleu woven gauze wrap and Toby settles instantly in it. He also likes walks out with Daddy in his Baby Bjorn Original carrier. They’re so convenient both around the house and for walks when taking the pram isn’t necessary. Toby also seems calmest when he close to us physically and our wrap and carrier mean we can give him that reassuring closeness and still have our hands free to get on with things.
*Warning, sickening gushy moment alert!!*
  • My husband… He has been absolutely wonderful and Toby and I are very blessed to have had Phil at home for the first four weeks. From family time to taking Toby so I can snooze, I’m so lucky to have such a great husband.
Now, those have been our essentials, but what could we have done without?
  • Moses basket… The purchase of a Moses basket was entirely my doing because I think they’re adorable with a cute newborn in them. However my son had other ideas and barely spent half an hour total in his before we put him in a glider crib instead.
  • toby carrycotCarrycot… Along the same lines as above, I wanted to take my gorgeous newborn out and about in a carrycot pram. We do use it, but a lot less often than the car seat and slings, so we could have coped without it in all honesty.
  • Teddy bears… I seriously do not want to sound ungrateful, but Toby has been bought so many teddies we don’t know what to do with them! I know as he gets a little older he’ll become attached to a few of them, but he doesn’t need dozens to choose from!
  • Disposable baby wipes… We started with cotton wool and water, then recently went on to reusable wipes which are a load more efficient at cleaning and don’t fill up the bin with smell! I haven’t added disposable nappies, however, because we’re still on a mix of disposable and cloth until Toby’s a little bigger.

There are, obviously, loads more things that can go on both lists, but ignoring the obvious ones, these are the main things that spring to mind.

I’d love to hear what your newborn essentials were, so get in touch!

Follow Hannah on Twitter @BuddingSmiles

Lessons for parenthood – Rob George

RB pic - RobIn his latest post, Rob has been along to an NCT antenatal class with his other half Pam to learn all about breastfeeding – and has a terrifying realisation about the limitations of nappies.

Rob blogs at www.daddysmurfdiary.blogspot.co.uk

BOOBS, nipples and poo filled my Saturday morning yet it’s still almost six weeks until J graces us with his presence.

Yes, it was time for the breastfeeding session of the NCT antenatal classes and yet again what an eye opener for this rather dense dad-to-be. I started the sessions thinking I knew a fair bit, well OK, just enough education to perform my duties, but turns out I am a complete newbie.

Again the teacher was lovely – breastfeeding consultant Alison Needham was a delight; very passionate about her subject but not one-eyed enough to suggest the mums-to-be would be murdering their child slowly if they didn’t breastfeed! She breastfed her three sons and is very knowledgeable about the subject but has a great way in walking mums-to-be through the process, breaking down what clearly is an emotional rollercoaster for mums desperate to breastfeed and also desperate not to ‘fail’.

We learned a lot about the stages of breast milk from the colostrum to the proper milk and she walked us through a typical day, using cue cards at relevant times. One of the cards mentioned unexpected visitors who want to be waited on hand and foot – let me tell you now any visitor in the first month who expects that will be pointed to the kitchen themselves!

Now, I am going to get dirty…not in the way you are all thinking, you mucky pups!

See, one of the cards also said ‘Matthew’ (the imaginary baby used in this day) had done a poo and it had gone ‘all up his back’. This was quite a shock; I know the brown stuff is going to be catastrophically smelly but did think from the adverts for nappies any explosion would be contained – clearly not! I clearly need more preparation in that area!

After a short break, us dads got together to discuss certain situations which all just need a little common sense approach but it’s good to hear we are all pretty much in the same boat.

We were then treated to a video about breastfeeding; again I never quite knew how a baby actually did it but I do now! I would say it was far more useful for Pam than for me but certainly opened my eyes and that is never a bad thing. Thanks to Alison for her time and expertise.

One more session to go then apparently we will be ‘ready’ for parenthood – eeek!

Follow Rob on Twitter @DaddySmurfDiary

Combining breast & bottle-feeding with twins – Isabelle Lee

isabelle lee 2I’m really pleased to share this informative post with you by mum of now six-year-old twins, Isabelle. She recounts her struggle to get into a good feeding routine with her twins, a boy and a girl, and how she eventually made combination feeding work for her and her babies. I think this article will be of real use to any mum considering combination feeding, whether with twins or otherwise.

Isabelle currently lives in California with her husband and six-year-old children, having moved from Kent nearly two years ago. In her previous life she was a teacher, but now is a full-time mum.

Isabelle blogs at www.perplexedparent.com

Isabelle says: “This is a piece I wrote a few years ago when my twins were three. I thought it might be useful for anyone who is about to, or has just had twins and is contemplating the difficult issue of breast- or bottle-feeding. It doesn’t have to be either/or, and after a lot of muddling through, I managed to combine the two with my twins for seven months. It is quite a long piece, but I feel it covers a lot of issues you don’t find in twins books. A shortened form of it appeared in the Tamba magazine in 2011.”

My twins are now three years old – life is so much easier now than it was a year ago! The first few months after their birth were the hardest of my life, despite being over the moon to have my “instant family”. Part of what made the time immediately after the birth so difficult (apart from the sleep deprivation and getting over a twin delivery!) was the anxiety and guilt over the decision not to exclusively breast feed my babies. I can look back now and feel happy that I managed to mix breast and bottle-feeding for seven months, but it wasn’t plain sailing partly due the fact that there is almost no information on how to successfully combine breast- and bottle-feeding twins. I muddled through and found a way that worked for me and my babies, but I felt that I wanted to share my experience with twins-mums-to-be in case it can be of any help.

Great expectations

I was always certain that I would exclusively breastfeed any baby I had, and when I discovered I was expecting twins, it never occurred to me that I would treat them any differently than if I had had them as singletons. After reading a couple of books about twins, plus the tiny sections on twins in other baby books, I felt confident that that was not only possible, but straightforward. I’ve since realised it was just the first of many situations where I had to let go of the idea that I could approach raising twins in the same way as raising a singleton.

There is a lot of information available on the benefits of breastfeeding, but next to nothing about bottle-feeding. This is to encourage mothers to breastfeed, and rightly so, however what happens if you find you are unable to? Where is the information on how to choose formula, how to ensure you don’t over-feed your baby, what to look for in a baby bottle? And what about if you don’t want it to be either/or – where is the information on combining the two? This is particularly important when it comes to twins.

No matter how many books you read or advice you listen to, nothing prepares you for the reality of caring for and feeding two newborns. My daughter fed within a few hours of delivery, but my son wasn’t interested. I felt so exhausted from the birth that I probably didn’t persist with feeding them as frequently as I should have within the first 24 hours of birth. This may be a contributing factor to the fact that I simply did not have enough milk to feed my two exclusively, and I never experienced the milk let-down. They lost a lot of weight in their first week, which is common, however they lost up to the maximum that is considered “normal” and were dehydrated.

I tried pretty much everything to build up my milk supply – I ate and drank as much as I could (my hips regretted it later!) I fed the babies frequently – sometimes every hour or hour and a half – which meant I sometimes had no gaps between feeds, because as soon as I finished feeding one baby, the first one was hungry again. I felt that my breasts never had the time to “reload. I then started to feed them simultaneously to save time, but I found breastfeeding very painful at the beginning, partially due to both twins being tongue-tied. Having pain in both breasts at the same time was hard to bear. Also, as a novice at breastfeeding, it was hard to latch one on and then latch on the other – the first one always seemed to slip off, which increased the pain.

Bottle guilt

After a week of this, and my babies still being dehydrated, unhappy and losing weight, the community midwife told me to top them up with a bottle. I was initially reluctant, but I really had no choice as they were not thriving, and they were not receiving enough nourishment from breast milk alone. In a way, it was a relief that I no longer had a choice, but I felt like I had failed at my first task as a mother. I felt guilty that I dreaded each breastfeed because of the pain, and that maybe this had contributed to their failure to get enough nourishment; I felt guilty with every top-up bottle I gave because I felt they weren’t receiving all the benefits of breast milk; I felt like a failure as a mother and as a woman because I alone couldn’t provide the most basic of needs to my newborns. I thought to myself “How would I have cared for them in the wild?” All I can say is sleep deprivation, first-time-mother panic and the guilt of not keeping to the letter of what is recommended is a potent combination for feeling depressed and anxious.

I certainly don’t mean this as doom and gloom, and “look how hard I had it” – all parents of multiples have it hard to start with, and I was very lucky in other ways – mine weren’t premature and I had a lot of support from my husband and my family. I did manage to muddle through and continued to combine breast and bottle until mine were seven months old. Here’s what ended up working for me:

Practical guide to combination feeding

I started out breastfeeding each baby in turn, then passing each to my husband to top them up with a bottle. This didn’t work for me. The whole process used to take about two hours from start to finish, even with two people. I also never knew how much to top up with, and in fact we ended up overfeeding the twins (yes, it is possible with bottles) and they vomited frequently, had bad wind and tummy aches, which didn’t help the colic. I realised at the end of my husband’s four-week paternity leave that this wasn’t sustainable, even with support. I woke up one morning (or night – it’s hard to tell in the early stages!) and realised I had to change the routine if I was going to be able to continue to breastfeed at all.

I decided literally to half breastfeed, half bottle-feed. I would breastfeed one baby and bottle-feed the other for one feed, and then swap over at the next feed. Alternating feeds worked really well for me. It meant if I was on my own, the process of feeding two babies didn’t take so long because bottles went down a lot faster than a breastfeed. I could monitor, at least half of the time, exactly how much the babies were taking, and I knew I would have enough breast milk for a feed now that I wasn’t trying to split each feed between two babies. Also, it meant that if I did have someone else around, they could give the bottle at the same time as I breastfed, which saved a lot of time, especially if we were out and about (the few times we were at the beginning!) It also meant that over-feeding was not such an issue, since I could more or less follow the guidance on the formula packet, without trying to guess how much breast milk they had taken.

I always used to start the feeding cycle with the bottle feed for a few reasons: Firstly, because formula takes longer to digest than breast milk. By starting with a bottle, it meant that it was always the baby who had last had breast milk who would go first, and the one who had taken a bottle would have a longer gap before their feed. That way, I tried to reduce the number of times I had to sit through one baby crying with hunger while I was feeding the other. It’s not fool-proof! It also meant that the baby that was going second didn’t have to sit through a whole breast-feed (which takes a long time at the beginning) until they got fed. Bouncy chairs were a God-send at that time, and can pacify a peckish baby until his/her sibling has finished (also not fool-proof!)

If either looked like they needed a top-up between feeds, I used to offer the breast, so that I kept my milk supply up and they didn’t start getting more bottle than breast, and then start to reject the breast. It also meant that they weren’t too over-full for the next feed and get out of step with their sibling. My milk supply easily coped with what was the equivalent of feeding one baby. In fact, once my two started to go a little longer between feeds at night, I started to have enough milk in the mornings to breastfeed both (one after the other. I confess I never mastered the art of breastfeeding in tandem). Then at the 11pm (ish) feed, my husband gave two bottles so that I could have some extra sleep.

If it happened that I was giving an odd number of feeds in a day, for example seven, I would alternate daily which baby got four breast feeds in a day so that I didn’t end up with one having more breast than the other. After a while, I actually did end up giving more bottles to my son than to my daughter because he was the hungrier baby, and she was a very windy baby and was more comfortable after a breast feed.

Nights didn’t follow too much of a pattern. I just tried anything to get them to sleep – sometimes just offering the breast so there wasn’t the hassle of preparing bottles, sometimes just giving bottles in the hope that formula would keep them fuller for longer.

Finding a routine

I did have to stick to a feeding routine in order for this to work. I only started doing that when they were a few weeks old – I don’t think newborns are really capable of any routine to start with, and I think muddling through as best you can is probably the only way, until you find something that suits you and your babies. I eventually worked out (with the help of my health visitor) how many feeds the babies needed in a 24-hour period, and tried sticking to a 3- to 4-hourly cycle once they were a few weeks old. Again, this was an adjustment as I never thought I would impose a rigid routine to newborns, however I needed to get the twins in synch somehow, otherwise I really would have lost my mind! I was as flexible as I could be, and did offer top-ups of breast-milk if they were hungry.

It was always a bit of a juggle when the babies grew out of one routine and needed a new one, for example, when they were ready to drop a feed. It’s difficult to tell if they are ready to drop a feed if you have them in a routine and not feeding on demand. You end up being afraid of changing the routine in case it messes everything up and your babies end up cranky, and you more tired. Again, I had a good health visitor who helped me with that.

Concerns over nipple rejection

I am very lucky that my babies took so easily to combining breast and bottle, because I know that some won’t take to bottles at all, and some won’t go back to the breast once they have had the quick and easy flow of a bottle teat. I don’t know if I had particularly easy babies in that respect, or if I by chance introduced the bottle at the right time for them to accept both. I can only tell you what worked for my babies.

I introduced the bottle after they had been exclusively breastfed for one week. I thought that would be too soon, but it worked fine. If you introduce the bottle very late (say, a month or two down the line) they apparently may not take to it at all, however I obviously personally don’t have any experience to say that authoritatively. The type of bottle I used may be significant – there are a few on the market that say they are suitable for combination feeding. I personally used the Tommee Tippee “Closer to Nature” bottles, which to me looked the most like a breast(!) These served me very well.

I also tried to replicate the latching-on to a breast when I bottle-fed. I would rub the teat by their lips, and wait for the babies to open their mouths for the bottle, rather than shoving it in so that they didn’t get out of the habit of opening their mouths to latch on to the breast. I didn’t do that all the time, because sometimes you just want to take advantage of the faster bottle and get it done quickly. This is probably the only problem I did have with combination feeding – my babies sometimes didn’t try to latch on properly to the breast. This problem did resolve itself, and eventually they did swap between the two as if it were second nature to them.

Happily ever after

isabelle lee 1I managed to keep going like this for six months, and then I gradually weaned them off the breast when I felt ready, and when I felt my babies were ready. After a while, I looked forward to breastfeeding my babies, because it no longer became a source of guilt, stress or pain. It did become a lovely feeling of closeness between the babies and me that no one else can feel.

I hope that this opens up a third option to twin-mums that isn’t discussed in many books. I’m sure there are a lot of different ways of combining breast and bottle, and if that is what you want to do you will find your own way that works. I only wanted to show that it doesn’t have to be an either/or situation, and share the practicalities of how I went about it. I also hope to prevent other twins-mums who may not be able to breastfeed exclusively, from feeling the guilt that I went through. If your babies have received any breast milk at all, you are doing really well, because it is far from simple with more than one baby, and, I believe, practically impossible if you are not receiving support from others. In any event, your babies are not going to remember whether you breast-fed or bottle-fed them, but whether you provide comfort and love. There is so much more to being a mother. I hope my experiences are helpful to you, but do whatever is right for you and your babies.

In a nutshell

  • Breastfeed one baby and bottle feed the other at each feed.
  • Alternate which baby gets the bottle or breast at each feed.
  • Start with the bottle feed since formula takes longer to digest than breast milk.
  • Try to get your baby to latch on to the bottle as if it were a breast.
  • Don’t feel guilty about not following the guidelines to the letter.

Follow Isabelle on Twitter @PerplexedParent