Silent reflux – what helped us

Silent reflux is a bastard.  It’s tricky to diagnose and exhausting to manage. G Major had it, and I caught it, amazingly, in the first two weeks. But only because both my mother and I had had reflux, and I was on the lookout for issues, and because a friend’s baby had suffered with diagnosed silent reflux, and I was familiar with the signs.

Compared to ‘normal’ reflux, the lack of exorcist puking makes silent reflux difficult to diagnose. Symptoms of silent reflux typically include: crying after feeding; arching their back; persistent hiccuping and coughing; extended suckling and excessive feeding to sooth the burning. You may also see milk being regurgitated into the mouth.

Because your baby keeps feeds down, as opposed to projectile vomiting them across the room, it’s likely the’re gaining weight well. You don’t have that permanent sour milk vom smell attached to you and it’s safe to venture out of the house without a whole separate bag of muslins. So people, and your GP, might be unsympathetic. They won’t understand that you and your partner literally, genuinely, hold your baby 24/7.

I actually cried when G Minor fell asleep flat in her basket seconds after taking a massive feed. I had no idea it could work like that.

The good news is, silent reflux doesn’t last forever. In the meantime, here’s some advice from the front lines.

Here’s what might help:

  • See your GP as soon as you can. And keep going back. Not all GPs are familiar with reflux, and certainly not silent reflux. It will be harder to get a diagnosis when they’re not a puker. Persist until you get help. Then keep going back to get your meds adjusted as baby grows.
  • Keep a diary. Then you can show the doctor how often you’re feeding, how much (if you’re bottle feeding) and how long they hollered for after a feed.
  • Film your baby. I took videos of G Major’s bawling mouth and you can actually see the milk rise to the back of her throat and then drain away again. I showed this to the GP when they were umming and aahing about what it was.
  • Drugs! You’ll probably initially be prescribed Gaviscon, which neutralises the stomach acid and forms a little blanket on to of the feed to help keep it down. You may then move on to ranitidine, which reduces the amount of stomach acid being produced. Beyond this, your GP can prescribe something like omeprazole, a proton pump inhibitor, which again inhibits the production of stomach acid. Make sure you give meds regularly – don’t just stop when you start to see an improvement.
  • Propping baby up to sleep. You can put books under one end of the cot or a wedge pillow under the mattress to elevate baby’s head. At one point G Minor was sleeping almost upright – we made a nest in the moses basket out of a wedge cushion and a V cushion and dropped her down the hole.

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    G Major sleeping at 90 degrees
  • Get a sling. You will die without one. Baby is upright but can sleep on your chest. Parents have their hands free to do stuff. Plus, lovely snuggly baby time and they’re not screaming. Seriously, get a sling
  • A dummy. This will create extra saliva to help sooth any burning in their throat
  • Sleep in shifts. I used to go to bed at 7.30pm, just after supper. Big G would hold G Major and watch Breaking Bad, give a bottle of expressed milk at the late feed then go to bed at midnight. Then I’d be on duty for the rest of the night. That way I’d get at least five hours unbroken sleep, and Big G would get six or seven (depending how late he slept). We barely saw each other in the week for a few months but I kept my sanity.
  • Ignore routines. If your baby has silent reflux, there’s no “putting them down sleepy after a feed” – they’ll scream the place down. Accept that you’ll be holding them in the dark for hours, charge up your kindle and phone, and settle in. You can still keep a bedtime routine of bath, feed, lullaby etc – G Major actually went to bed brilliantly after she grew out of the reflux.
  • Get the hell out of the house.  Baby will still cry after a feed but at least there are other people about. It’s miserable on your own. We went to at least one activity or group, sometimes two, every weekday.

Here’s what won’t:

  • Co-sleeping, in and of itself. Baby will still be lying flat. If you want to co-sleep, all power to you, but just bringing baby into bed with you will not make it any better for you or them.
  • Colief or Infacol. This isn’t gas. Or still-not-actually-defined colic. You need something to thicken the stomach contents and something to reduce the acid levels.
  • Switching to formula. Again, go for it if it works better for you. It will be easier to share the load with your partner. And formula is slightly thicker than breast milk. But it’s still going to come back up. Keep breastfeeding if you want to – it’s not your milk, it’s their digestive tract.
  • Eliminating dairy. Reflux is not CMPI; there is no evidence to suggest they’re linked. Baby will have issues with feeds whether or not you’re drinking soy or almond milk, and you’ll be sad because cheese. (Babies with CMPI might well be pukers, but it won’t be silent reflux.)
  • Cranial osteopathy. Reflux occurs because the muscular valve at the end of baby’s esophagus, which acts to keep food in the stomach, hasn’t developed properly yet. No amount of pissing about with their skull will make that develop faster. That’s like suggesting cracking your knuckles will fix your pelvic floor.

Remember, hang in there. For most babies, silent reflux disappears between 12 and 16 weeks, and keeps improving as they sit up and wean. And the one advantage of silent reflux over normal reflux is that you’ve not had to deal with months of puking, keeping your clothes and soft furnishings intact.

Have you had a baby with silent reflux? What did you find helped?

Practical tips for partners to help with breastfeeding

Jamie Oliver last week announced that his next campaign is to get more mothers breastfeeding. There have been plenty of people who have already addressed his mansplaining, who have questioned whether people actually aren’t sufficiently informed or who have spoken out in support of the idea.

It’s great Jamie has seen breastfeeding happen successfully for his family. To be honest, I suspect Jools has found breastfeeding easy, or Jamie wouldn’t be so casual about it. She may have boobs that just do it easily, and babies who take to it enthusiastically. They have the luxury of time and money and can buy in support, whether that’s childcare for the other kids or breastfeeding support. So Jamie may well have his rose-tinted specs on.

But I don’t think it’s a bad thing that there is a man talking about breastfeeding.There is a lot that the non-breastfeeding partner can do to support a breastfeeding mother. Even with all the information and support in the world, it can be hard to get started.

So here are some ways you can help your partner in the early days of breastfeeding.

Do your research
When mum is crying and fighting a squawking baby, she may not remember everything she read. You are more likely to. Go online; read a book. Go to the antenatal breastfeeding sessions and pay attention. Before the birth, make sure you understand how milk is produced and what happens to boobs and milk production in the first few days. Learn a few different breastfeeding positions.

Know where to get support
Find out where your local breastfeeding café is and have a few pound coins ready for parking. Make a note of your NCT breastfeeding counsellor’s number and the La Leche League helpline. Bookmark some websites.

Know where to get supplies
Find the nearest 24 hour supermarket and pharmacy that opens late. You might need to get breast pads or breast shields. Probably Lanisoh. Maybe a dummy if you have a very sucky baby. If you decide to switch to or top up with formula , you’ll need to buy that, and bottles. Be ready to get in the car and go, with a minimum of fuss.

Ask what she wants to do
If mum is struggling, it’s likely that she will just wail at you, “I don’t knoooooooooow” but you still have to phrase this as her choice. Ask how you could help her to position baby, ask where she would be most comfortable feeding, tell her you are ready to hold baby for a while as soon as she is ready.

Act as gatekeeper
You may need to keep visitors away while feeding is being established. It often involves full boob exposure, pillows, sodden breast pads, squirting nipples. Not something I wanted to share with my father in law. And there is nothing quite as miserable as sitting in a bedroom, struggling to feed, while visitors sit on your sofa eating all your cake and impatiently waiting for a cuddle with the baby.

Help her feel less like a skanky milch cow
Breastfeeding can initially be messy and sweaty. Put clean sheets on the bed. Wash her jammies and her feeding bras and tops. Give her loads of time to shower and make her body feel her own again, to dry her hair properly, to put some makeup on if she wants to.

Nourish her
Make tasty, wholesome food that can be eaten one-handed if necessary and stands up to being reheated. Bring her snacks. Keep her water bottle filled up and within reach. Have a look online for foods that can help with milk production. Remind her to take her vitamins.

Wake up in the night with her
You don’t need to sit bolt upright to prove you’re in it together. But an acknowledgement that baby is still slurping away at 3am, an offer to get food or water, or rocking baby while mum has a quick wee will reduce her murderous, middle-of-the-night thoughts.

Pull your weight around the house
You’re all modern men and I’m sure you do this anyway. But no one wants to be pinned to the sofa with a baby looking at your dirty socks and the Xbox controller while there is washing to be done and kitchen surfaces to be wiped. It’s much nicer to deal with leaky boobs and cracked nipples in a clean, calm environment.

Keep your hands to yourself
If baby is feeding for 20 hours a day, it’s likely that mum will be touched out. Some women want a cuddle, massage can help with milk production and if that’s what she’d like, that’s lovely. I personally wanted to lie spread-eagled on a cool tile floor and have no one come near me for 20 minutes. You should facilitate that.

Don’t comment on the breast pump
No matter how noisy it is, how funny it looks with both sides going at once, how far her nipples are stretching into the cup. Absolutely no good can come of you saying anything about the pump.

Don’t worry, it does get better. Or else you switch to a bottle. Either way, baby is fed. Most of the above applies to both breast and bottle feeding, actually. Pull your weight, be kind to mum, nurture your new little family.

Was your partner a godsend in the early days? How did they help with breastfeeding? What advice would you give to new parents?

Superfun breastfeeding action

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Ah, breastfeeding. So lovely. Much bonding. Etcetera.

G Minor is currently 8 months old and has invented some new breastfeeding moves. Super fun for when we’re out and about, or when we had guests over Christmas and New Year. Here’s how your babies can do the same.

The Hook
Take a small, incredibly strong finger and insert it into mummy’s nose. Haul downwards with all your strength. Try and break the septum.

Variation: Apply pincer grip to your mother’s bottom lip. Haul as before.

The Romantic Dinner
Who doesn’t love a bit of eye contact while they eat? Direct, intimate eye contact, achieved by pulling mummy’s face down at incredibly awkward angle so you can stare directly into her eyes. In quite a menacing way.

This move is excellent as it means mummy can’t look at her phone or kindle, just examine your eyebrows up close while her neck seizes up.

The Hungry Hungry Hippo
On. Off. On. Off. On. Off. On. Off.

Take the entire feed in single sips, like it’s a fine whiskey. Don’t allow any pauses long enough for your mother to get up and fetch a whiskey.

The Door Bell
This is less a feed than a detailed examination of a nipple with the occasional face plant into the breast. Be sure to poke it good and hard. Take a very occasional drink so that the feeding session doesn’t end prematurely.

This one is great as it involves sitting bolt upright straddling one of mummy’s legs, meaning her boob is out for the world, and specifically your grandfather, to see.

Her teeth are coming in now. Ace.