Breastmilk and Spitting up Problems

Updated on July 31, 2008
K.L. asks from Essex, MD
5 answers

My son is 10 wks old and I have been nursing since day 1. He had issues with gaining weight because he was spitting up so much (sometimes it seemed like his entire meal came back out!) so he was put on Zantac for acid reflux. After the first week of it he gained 12 oz! (he had only gained 12 oz in the first 7 wks, then suddelny gained 12 oz in a week on zantac) I was also giving him two bottles a day that were mixed 2 oz breastmilk and 1 oz Enfamil AR.

At his 2 month appt the dr increased the dosage of zantac because the spitting up had gotten bad again (and during the previous 2 weeks he had only gained 8 oz). I also began offering him 4 oz instead of 3 oz. After about 4 days he started drinking all 4 oz but was still spitting up.

I noticed the spitting up was worse when I nursed him, so I pumped more often and offered bottles...didn't help. I then started mixing the bottle 2 oz breastmilk and 2 oz Enfamil AR...didn't help. Also, after a feeding he seems uncomfortable - his belly is swollen, he arches his back, he pulls his legs up into a ball. He also has problems pooping. Most of the time, after 3 or so days of not going, he gets uncomfortable and I have to mix 1 tsp of Karo syrup into his bottle to make him go.

Yesterday, after changing his outfit for the 5th time, his bib for the 8th time and my shirt for the 2nd time, I gave him a bottle that was 4 oz of Enfamil AR...he only spit up a tiny bit (the previous times it seemed like his entire bottle - or most anyway - was coming back out). He had a second all formula bottle last night (before bed) and spit up just about everything from it.

I don't know what to do! I am pumping and storing milk because I don't want to lose my supply or give it up unless I discover he definitely can't handle the breastmilk. I am frustrated though - isn't breastmilk supposed to be the perfect food?! Isn't it supposed to give the the least problems?! There was no issue for the first 5 weeks and I haven't changed anything in my diet. Is it possible that 4 oz is too much for him?

Has anyone else had any issues like this? Any suggestions? We have an appt with a new pediatrician on the 14th because we were extremely unhappy with the one we'd been seeing. Should I try to get him seen by the first pediatrician before the 14th? I just worry that maybe there is a bigger issue than reflux and its going untreated.

Thanks in advance for your advice!

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So What Happened?

Cody has a dr appt tomorrow afternoon. The dr wants to check for pyloric stenosis. I hope he doesn't have it because I hate the thought of my little guy having surgery, but I want him to get healthy!

Thank you all for your advice and support!

More Answers

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M.G.

answers from Washington DC on

www.kellymom.com is a fantastic resource for breastfeeding mamas.

Also, try contacting one of your local La Leche League chapter leaders. They can be very helpful and supportive. If you live in Towson, here is the link to your local leaders: http://www.lllofnc.org/OLD/towsonlutherville.shtml It looks like it's been a while since that page was updated, but I know that Carol and Esther are still quite involved.

If you'd like more links to helpful info, you are welcome to send me a PM and I can send them along to you.

Good luck to you!!

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C.B.

answers from Washington DC on

Perhaps it's something you are eating.

Right from the start whenever I ate anything with peanut butter my son was miserable - gas, spitting up and constipation. We were both still in the hospital while I recovered from a c-section and I had been eating peanut butter crackers to take away the tickle in my throat. On about the 3rd day there, one of the nurses said that he had had a terrible night (he was in infant ICU due to an infection) and she asked if I had eaten peanut butter. She said it is a common culprit for digestive distress in breastfed babies. Had that not had happened I might have chalked it down to colic or fussiness and never realized it was the peanut butter. I can't imagine the digestive problems it could have caused had I kept eating peanut butter.

You can bet I gave up peanut butter (and I LOVE peanut butter) to have a content, healthy baby.

I don't know personally if any other foods are known to cause distress - but it would not surprise me if there were.

I hope this helps.

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C.W.

answers from Washington DC on

Hi Kristin- I understand your frustration. With my daughter I felt that they were just throwing theories against a wall and seeing what stuck. I was happy to switch peds.
you should insist on getting an upper GI for your son to make sure that he really does have reflux. It is a painless test--your son drinks some contrast and you lay him down and you can watch the formula come back up. Second, one doc explained to me that zantac will not help with the spitting up, it will just heal the ulcers. all babies spit up, some more than others. my kids both drenched me every meal. try to vary the position that you feed them in and keep them upright after meals and no pressure on their bellies. Watch your diet and what you are eating. You may want to cut back on your dairy intake. Lastly, there are other drugs out there for reflux. My daughter was on prevacid for almost a year, and my son was briefly on Axid. Both were more helpful than Zantac.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

D.S.

answers from Washington DC on

Kristin,
I would love for you to try and get an appt earlier with another pediatrician! Keep breastfeeding! Even an ounce of formula can mess these little guys up. I can connect you with a lactation consult if you are interested. I don't know what area you live in. Our number is ###-###-####- Mothering Mommies, LLC
The other thing that came to mind is something called pyloric stenosis. This can be diagnosed by a pediatrician. Very easily fixed!
I hope it is just a feeding issue. Our LC has many tricks up her sleeve for you to try. I kmow you had tried some already.
As far as the pooping goes....over the counter infant glycerin suppositories will get him moving. Your Dr probably won't want you to use them all the time. Try and find out what the problem is!

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

M.W.

answers from Washington DC on

Hi Kristin,

I can totally relate to how frustrated you are. My daughter Lilly is now almost 6 months and we have gone through the same thing. Everyone always says the spit up looks like more than it really is but then when they actually saw my baby spit up, they are like " WOW". Sometimes it feels like they are a faucet right? I breastfead from day one as well and in the beginning, Lilly had weight gain that was on the low side of the normal range. The doc didnt recommend supplementing with formula so I just continued to breastfeed and do a lot of laundry. I hated that bibs covered up every cute outfit but more importantly, I was worried that something else was wrong. I used to be on the internet every night trying to find out some magic cure or info on some rare condition I was sure she had. Well, almost 6 months later, I never did find out the reason but I am happy to say the spit up has decreased dramatically since Lilly has recently started on solids. (Only the past few weeks)
Who is your pediatrician? Ours is Dr. Bouge at Pavillion Pediatrics. She never seemed concerned at all and didnt recommend Zantac or any other meds. But Lilly never had discomfort like you are describing.
I'm sure you are already doing this but try to keep the baby very still and in a semi-upright position for a half hour after each feeding. In a swing or car seat would be fine.
Also, have you considered a hind/fore milk imbalance? Give the lactation consultants at GBMC a call, they are extremely helpful. The number is: ###-###-####. Just leave a voicemail and someone will get back to you within a day.
I hope this helps, good luck and hang in there!

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