Baby reflux: a case study

On a home visit, I encountered an extremely distressing situation. I was asked to visit this delightful 5-month-old who was literally screaming the place down at bedtime, not sleeping day or night, not taking his breastmilk feeds properly and the whole household was at breaking point.

They also have a two-year-old who had many issues that had just been dismissed as ‘normal’. By sharing this case study, I am aiming to provide hope to parents who are struggling with similar issues and the importance of seeking further help if the problem is not resolving.

Reflux symptoms you shouldn’t ignore

Here is a list of ‘odd behaviours’ and physical symptoms that the parents have constantly questioned. These had frequently been dismissed as ‘normal’ by health professionals they had asked.

The 2-year-old:

• Head banging for ages in his cot every nap & bedtime and taking hours to go to sleep.
• Truly awful, mushy, runny, explosive stools.
• Constantly craving food and enough is never enough.
• Dribbling loads.
• Build-up of mucous throughout the night and his cot is soaked in the morning from mucousy saliva.
• Permanent cough & cold.
• Waxy ears.
• Not wanting his hands to get dirty.
• Never wanting shoes on.
• High pain threshold. Very emotionally sensitive.
• Struggled with bedtime and night-time sleep.
• Constantly tired.

The 5-month-old:

• Short, frequent breastfeeds round the clock.
• Crying at feeds.
• Screaming (and I mean REAL, heartbreaking, gut-churning screams) when put down for a nap or night time.
• Frequent explosive liquid poos.
• Constant, painful and really smelly bottom wind.
• Skin on his face going bright red every feed time.
• Hiccups.
• Incessant and relentless whinging, crying, moaning ALL day.
• Staying awake for hours on end at night.
• Almost aggressive in his movements: grabbing, pinching, biting (even though he has no teeth), clawing, scratching and pulling at anyone that holds him.
• Never giggled in 5 months.

The treatment for reflux

They had already seen a paediatric gastroenterologist who had diagnosed reflux for their 5-month-old, along with full CMPA. He was prescribed medicine and Neocate LCP formula. Trouble was, the baby simply wouldn’t take the medicine — he just spat it out. He certainly wouldn’t take a bottle but just smacked on the breast round the clock.

So now, how could things possibly be changed? It seemed like the biggest mountain to climb and when they asked for my help, I knew it was going to be a tough journey! But with calm perseverance and a lot of patience, I was able to eventually get the little chap to take a bottle of the Neocate thickened with Instant Carobel.

It wasn’t even the taste that bothered him, but so much more his complete oral phobia of anything going near his mouth. He had simply learned that what goes down hurts — a lot — so he didn’t want to do it.

Treatment progression

Once he started taking his bottles with me, he then had to learn how to take them from Mum, then Dad. It’s been a tough journey with many highs and lows. However, a month on and the parents both say it’s been life-changing.

Their little baby can now go to bed without screaming, drink his milk without pain and panic, and is also happily eating solids. He sleeps, for the most part — through the night though often wakes around 5:30/6 still. But from where they were it’s a hugely positive change and feel they can accept the slightly early start to the day for now, though it’s still work in progress.

Their two-year-old, however, has more complex associations and behaviours to address that have developed from when he was a baby and had similar issues as his younger sibling.

Sadly, as is common, all his symptoms and behaviours were just dismissed by most as ‘just normal baby behaviour’!

We are now addressing the evident reflux and digestive issues he still struggles with. Hopefully soon he will feel more comfortable too and sleep will be fully restored to the whole house. Although mum and dad will probably need some help to get their sleep back on track!

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