Acid Reflux diagnosis at 6 weeks
I've mentioned in several previous posts that Nathan had acid reflux. I figure this issue deserved its own post, so here it is.
When Nathan was born, he was a relatively good nurser from the getgo. My main concern was whether I was producing enough and whether he was actually drinking enough. I pumped quite often which showed that I definitely had the flow, and he had a lot of wet and soiled diapers so he was definitely drinking.
Before leaving the hospital we were very well versed on how his diaper output was to change throughout the course of the week (i.e. black meconium, to green poop, to yellow mustardy poop). During his first week, we watched his poop go through each metamorphosis until it reached the ultimate yellow mustardy consistency. However, within a few days later, I felt that his poop seemed a bit watery and that he was pooping very frequently. I informed his doctor that I suspected that he had diarrhea but the doctor assured me that breastfed babies' poop are typically runny. So I dismissed my suspicion of diarrhea and just accepted that babies poop after every single feeding and that it is expected to have a diarrhea-like consistency.
Nathan was primarily nursed but we gave him the occasional bottle of expressed breast milk. This allowed me to have some longer stretches of sleep at night when Andrew would feed him, or would simply be more convenient if we were not at home.
When Nathan was six weeks old, he started rejecting some of the nursing sessions. I would bring him to the breast and he would latch and start sucking, but once the letdown started, he would pull off and start crying. This was very frustrating for me because my flow was pretty high and it would just begin spraying everywhere while I tried to grab a breast pad or washcloth to catch the spray. In retrospect, it was likely that I also had overactive letdown which probably contributed to him fussing at the breast. Nonetheless, Nathan would reject nursing about 50% of the time the first day this happened. I was obviously concerned but continued to offer him the breast every couple of hours. The next day, however, Nathan rejected all of the nursing sessions in the same manner. I didn't know what was wrong. I then tried warming a bottle of milk to see if he'd prefer the bottle but he still rejected it. I attempted this several times in the day and would get frustrated with his refusal since I had to toss the breast milk after 30 minutes of warming. I booked a doctor's appointment the following morning.
The doctor suspected it was acid reflux and prescribed Zantac. I gave him his doses but he still continued to reject his feeds for the next 48 hours. During this time, I force-fed him a couple of bottles because I knew he was hungry and was concerned that he would become dehydrated. I basically pinned him down and put a bottle in his mouth to make him suck even though he kept fussing and trying to turn his head. I managed to get an ounce or two in him if I was lucky. I felt awful doing this but I didn't know what else to do. This was really rough for me. My husband was out of town and I sunk into slight depression. I was alone, and excited to be a mommy, but had a baby that wasn't eating. This was very stressful.
To my relief, the day after, he started nursing again. He would drink both by bottle or by breast. I was relieved that the Zantac was working. I was a bit bummed that I would have to continue giving my 6 week old medicine, but was just relieved that the kid was eating.
Unfortunately, this did not last long. A week later, the same thing started again. He would refuse to nurse even though he was still getting his doses of Zantac. I went to see the doctor again and the doctor decided to up his dose since he was still gaining weight and could benefit from a greater dose. I started him on the higher dose and within a few days, he would nurse again.
Again, this did not last long. It seemed that every few days he would enter a cycle of poor nursing sessions. He only seemed to nurse when he would wake in the middle of the night crying, but not while he was wide awake during the day. I decided that when it was time to nurse I would try to get him sleepy and then offer him the breast. This seemed to work. Which meant that each time I nursed, I would rock him back and forth until he was falling asleep, and then put him on the breast. Not ideal, but a mom's got to do what a mom's got to do.
At his next doctor's appointment, the doctor suggested that I try to cut dairy out of my diet since some babies have cow's milk allergy and that would cause reflux. I started this and continued a dairy free diet for 2 weeks. The first week, it seemed like dairy was definitely the culprit since Nathan was nursing like a healthy baby should, but then something happened the second week that made him fuss like he does in his typical poor-nursing cycles. By this point, I was already used to rocking him to sleep each time I nursed so it didn't matter anymore why he wasn't nursing.
I continued doing this for several months until I read somewhere that babies who have a cow's milk allergy also have a 50% chance that they have a soy allergy. My husband and I are both of Asian-descent so a lot of the food we eat contain soy. When I eliminated soy from my diet, I saw a drastic improvement on how Nathan would nurse. This must have explained all the poor-nursing cycles we have seen. Although eliminating milk in my diet worked, the days when I would consume soy would bring Nathan back to his fussy feeding habits. When I eliminated soy and milk from my diet, his poops were not as frequent and were definitely not as runny.
Although the cow's milk allergy could cause reflux, soy allergy would cause stomach cramps and this was likely why the Zantac wasn't helping. It was just a shame that it took this long to figure it out!