Normal. I did have pregnancy asthma which cleared up when I gave birth.
Jonah was born on his due date. It was a pretty quick (and painful!) birth via kiwi at UCH. No subsequent complications or health problems.
I exclusively breastfed until day 4 and then combination fed for 6 weeks. Breastfeeding was very painful and it seemed like he wasn’t taking enough (I could be breast feeding him for 1-2 hours and he’d still be hungry for a formula top up). By 6 weeks I had moved to solely formula.
Due to reflux (see below) we started with regular Aptimel, then tried other types of formula (Comfort, Anti-Reflux and Pepti) to try to help the reflux with no improvement, then we moved to Alfamino as it was suggested he could have CMPA causing the reflux. He has been on Alfamino since 8 weeks old with no obvious improvement in the reflux, but we haven’t re-challenged with milk as his symptoms haven’t been stable enough for it yet.
We thicken the Alfamino – we tried Carobel but it gave him an eczema rash on his face so we now use a small amount of Thick & Easy – 1 scoop per 180ml.
We were also concentrating the Alfamino (by 20% with an extra scoop) largely because of the unsafe swallow / bottle aversion (see below) but stopped doing this about a month ago.
Jonah has suffered with reflux (both silent reflux and actual milk coming up) since he was about 2 weeks old. We have seen multiple paediatricians and paediatric gastroenterologists (Dr Lee Noimark, Prof Neil Shah, now under the care of Prof Mike Thomson) and tried multiple medications, none of which seem to have made much difference: Gaviscon, Nexium, Ketotifen, Azithromycin, Lansoprazole, Famotidine, and now Omeprazole. He had a barium meal swallow test last month which was normal; Prof Thomson has said the next step would be an endoscopy. I am anxious about proceeding with this but equally we have tried all of the medications and nothing has helped, and he is still suffering with the reflux now at over 6 months old.
The reflux has made him quite bottle averse – at one stage it was taking over an hour for him to accept the bottle even when very hungry. His aversion is no longer quite as bad, but we frequently have to give him the dummy first or give a bit of milk via a spoon bottle before he will drink the rest from the bottle.
We were also advised to try early weaning, which we did around 4 months. After a few weeks, Prof Thomson advised we stop while he was still so unstable and then we resumed again a few weeks later. The issue is that he often refuses solids (especially when uncomfortable with reflux) and I am very wary of transferring his bottle aversion into a food aversion. He does like to feed himself via the Clevamama feeder or finger food but obviously this is more for the experience rather than much food going in this way. We have been advised to do dairy-free weaning for the moment.
In November, Jonah also had a videofluroscopy which showed an unsafe delayed swallow but a subsequent MLB procedure showed normal anatomy and we think he has probably grown out of the delayed swallow now.
We have also been seeing a paediatric speech & language therapist and dietician (initially private, now moving over to NHS).
All times approximate:
6am-7am: wake
7.15am: 180ml bottle
8.15am: breakfast – porridge + some soft fruit finger food or via Clevamama feeder
8.30am (if 6-6.30am wake up) or 9.15 (if wake up closer to 7am) – 10am: morning nap in cot.
10.45/11am: 180 ml bottle
11.30am: lunch – offer puree / vegetable sticks – he is often uncomfortable and refuses spoon-fed puree. I have tried switching this around and offering solids before milk but he is then too hungry for the milk and won’t try the solids.
12/12.30pm (depending on morning wake up time): lunchtime nap in cot. Generally 1.5-2 hours.
2.45/3pm: 180ml bottle
4.30 – 5pm: afternoon nap in pram of 10-30 mins.
5.15/5.30pm: dinner – as with lunch, if he’s uncomfortable he will refuse spoon-fed puree.
6pm: bath
6.20pm: 210ml bottle
6.45/7pm: story, song, bed
Overnight – he wakes multiple times. Sometimes we replace the dummy and he goes back to sleep, sometimes he needs a burp and if we’ve tried both of those then I offer 120ml bottle once only between 1-4am. Some nights we do end up giving this and some nights not.
We use a dummy to get him to sleep for naps and at night. It seems to help with keeping the reflux down and soothing him when he is uncomfortable. This may be contributing to his night waking but I tried to remove the dummy one night and go in every few minutes and do the pick up / put down instead to soothe him but it didn’t work – he just cried and got more and more hysterical and overtired, even when being held, that after 45min I gave in and gave him the dummy. It seems like his night wakings may sometimes be caused by the dummy coming out but other times can be reflux/discomfort and other times possibly hunger.
He sleeps in a cot in his own room. He is in a sleeping bag, with a tightly tucked light cellular blanket, dummy and comforter. He can settle himself to sleep by himself but often there is reflux/wind that keeps him awake and he needs to be burped again (which can bring up reflux) and then I might need to calm him by sitting with him on the rocking chair before I put him back in cot, still awake. This means a put-down for a nap or at night might take 10-20 min.
No night lights, music, white noise. We have an Ollie the owl which we used a bit early on but haven’t for months now. I also bought a Marpac Hush white noise machine but haven’t tried using it yet – wary of adding another sleep association!
I have hayfever, eczema and had pregnancy asthma, which supports the CMPA diagnosis, though as mentioned the Alfamino hasn’t helped with this. Members of my husband’s family have IBS.
Any other advice on managing the reflux to make him more comfortable
How to proceed with weaning when he’s refusing solids
Helping him to sleep better at night – not waking up as frequently/for long periods
