If you've got a baby with reflux or a fussy baby, you might particularly appreciate how peaceful Ben looks here. I shared the pic on my local moms Facebook group because I was so excited he was taking an actual nap. Not the kind in which he'd wake up crying after 20 minutes—the type he mostly has taken since he was born. Not the kind in which he'd immediately spit up after waking. The deep sleep, two-and-half-hour form of nap. It seemed miraculous. Then I'd worried that I'd jinxed myself by crowing about his nap, except he took an early evening nap, too, just like I'd read babies do.
Ben has been spitting up literally since the day he was born. I remember a nurse in the hospital pointing out that I needed to be careful that he didn't choke on it, and thinking Hmmm, I didn't have to deal with that with the other two kids. Little did I know what we were in for.
For months, Ben spit up profusely, earning his nickname Mr Spitup von Fussypants. He was fussy. And because of his gastric distress, he didn't nap well. Gaining weight wasn't an issue, but he really did spit up that much. People always tell you the spit-up is less than what it seems, but the stuff flowed out of him like lava—right after he ate, and then on and off again for the next few hours. At feeding time, I'd cover myself and our couch with towels and put on two bibs; mere burp cloths were no match for him. Sometimes, he projectile vomited.
Recently, though, Ben turned a corner. The spit-up is now negligible, the kind that dribbles out of babies instead of gushing. The napping, it's happening. Overnight sleeping is still crappy-ish, but as his daytime sleeping gets better I figure nighttime will as well.
Along the way, I've learned about gastric reflux and a couple other issues that also contributed to Ben's challenges. I'm sharing here in the hopes that if you've been trolling the web for answers, something here might help you.
First up: Gastric reflux is SO not "just a laundry problem"
I felt annoyed every single time I read or heard that. Having a baby who constantly and voluminously spits up isn't just a matter of more clothes to clean; it's exhausting, stressful and distressing. Who wants to see a baby puke up a lot of what he'd just nursed? I felt awful for Ben. He'd fall asleep, only to awaken a few minutes later screaming because he had to burp again.
Dealing with all of it—especially during those first few hormonal months after childbirth—put me on edge. I didn't feel like dressing Ben in cute baby outfits, since he'd inevitably spit up on them minutes later. As for cleaning, well, it wasn't just clothing. Ben would spit up on furniture, bedding and my own clothing too, yet more stuff to deal with when I was already on overload.
So if anyone tells you gastric reflux is just a laundry problem, hand him your baby so he can promptly puke on him.
Don't accept a diagnosis of gastric reflux
Our pediatrician eventually put Ben on Pepcid, to help relieve the distress (no medication can relieve the spit-up). When it didn't work, the doc said we'd all have to live with it and that Ben would eventually grow out of it. Meanwhile, I'd been reading up a lot on the issue, and crowdsourcing suggestions on my local Facebook moms group.
I did all the right things: I held Ben in an upright position while nursing, broke up feedings up so he didn't take too much in at once, burped him frequently, kept him upright for a while after feedings and had him sleep in an inclined position. I bought BioGaia ProtecTis probiotic drops to see if they would help with the stomach problems (they come with Vitamin D, so at least he could get his dose that way). I didn't see much difference. Remedies like gripe water were useless.
During a routine checkup, I mentioned to another pediatrician in the group that my other two babies had been chubby. "Is it he not chubby because of the reflux?" I asked. "Yes!" she said, entirely too cheerfully. "You're just not going to get the roly-poly baby this time!"
Something in me snapped when I heard that. I wanted a roly-poly baby. Ben is our last kid, and damned if he wasn't going to be chub-alicious.
Maybe it's an allergy
Several moms in my Facebook group noted that their babies' source of fussiness had been an allergy to their dairy intake. I was surprised the doctor hadn't mentioned that as a potential problem. Of my own accord, I took the baby to a gastroenterologist. Thanks to my Facebook crew, I knew to bring a poopie diaper she could test it for an allergy. Sure enough, Ben's diaper had a slight tinge of blood. It wasn't a major allergy, but it was there. She told me to cut out dairy.
NOT. THE. CHEESE.
But, yes, the cheese had to go. And regular milk (although I discovered that almond milk tastes even better in iced coffee, my fuel of choice). And butter.
After two weeks of giving up dairy, though, I still didn't see much change in Ben. AND I HAD TO GIVE UP CHEESE.
Could it be tongue tie? Nope—something even more unexpected.
I have a friend who became a lactation consultant; she came to our house, checked inside Ben's mouth and noted that he had tongue tie. That's when an unusually short or tight piece of tissue (aka the frenulum) tethers the bottom of of the tongue's tip to the floor of the mouth. Ben also had lip tie (when the upper lip is tethered to the upper gum).
Ben didn't have a weight issue, one symptom of tongue and lip tie. And I didn't have nipple pain, uneven breast drainage and low milk supply, other symptoms. Still, he most definitely had reflux and fussiness, and tongue and lip tie can prevent a baby from properly attaching to the breast and/or lead to a high intake of air—which can lead to lots of spit-up. (Here's an excellent guide to diagnosing tongue tie and lip tie.)
So off to the ENT we went. She was a cheerful, fast-talking doc who had come highly recommended and who cooed sweetly at Ben. She took a look inside his mouth and probed it with a finger. She watched me nurse him, for less than a minute. And just like that, she knew what was up: Ben had a high palate, which caused him to take in a whole lot of air when he nursed and wreaked havoc on his little stomach.
"So tongue tie isn't the issue?" I asked.
"He has it, but that's not the diagnosis," she explained. Although tongue tie can lead to speech issues, she didn't think that would be the case with Ben. Her recommendation: Quit nursing (except for "fun") and pump. Give the milk to the baby via The Medela Special Needs Feeder, a bottle with an elongated nipple and special valve that adjusts milk flow to suit a baby's sucking and helps reduce excess air intake.
I felt so relieved to have an answer...until we actually tried it.
Make sure a doctor gives you a full how-to
Normal Me knows to ask questions when doctors give advice. Sleep-Deprived Me did not think to do so. The doctor should, at the very least, have mentioned that transitioning a baby who has only been breastfed to a bottle could be challenging. But really, she should also have given some basic advice, as I discovered after we ordered the Medela bottle online, it came within two days and I tried it.
Ben wailed. He cried. He screech-cried. He would not take the bottle. After an hour, I gave up and breastfed. My nerves were frayed. Throughout the day, the pattern repeated. I Googled and discovered that it would have been best for someone who was not me to give the baby the bottle, as my scent was likely distracting and/or confusing him. Too bad, because Dave was away on business.
The next day day, I called the doctor's office. Which leads to my next bit of wisdom:
If you see a solo practitioner, be sure she has backup.
The staffer at the doctor's office who answered the phone told me she was away. I asked who was covering for her. Nobody was. I asked if she could send an email to the doctor. As we spoke, Ben was scream-crying.
"I can't focus!" the staffer wailed, making me wish Ben could puke on her over the phone. The doctor didn't call back. Luckily, Ben finally did take the bottle from me. And that's what did the trick. Within a couple of days, Ben's puking petered off.
If you see a practitioner in private practice, ask beforehand or at the first visit who is available should the doctor not be available. You could spare yourself a lot of grief. The doctor did answer my questions by email the following week, but Ben and I had to endure an ordeal that neither of us needed.
My mom's group celebrated the New Ben with me. As one mom said, "Yay for you! Fellow mom of a difficult, reflux-y, sleep-hating kid who's now 14 months old and takes two one-hour naps and sleeps through the night. It gets better!!!!
Oh yes, it does.