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Unable to breastfeed baby, given Lactogen. Baby spitting, crying, vomiting. Is this a reflux problem?

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Pediatrician, Infectious Diseases
Practicing since : 2005
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Hi I had a baby boy on April 25th 2012 , It was c-section on 39thweek - baby weight -3.5 and later got reduced to 3 and now on XXXXXXX 7th 2012 its 4 , now its been more than a month, intially i had a problem in breast feeding my baby as there was no milkpresent, so i was unable to see at my baby cry went with lactogen through which baby used to take the content and sleep, there is no problem in urine and potty which is happening at intervals, offlate i have decided in between whenever i get milk i am feeding him and sometimes at night i am feeding lactogen through bottlefed --- Now my cause of concern - For the past one week my baby spits up a lot , he still cries a lot ( after that stopped lactogen) now only my milk but still vomits :-( , sometimes i used to apply colicaid ( sugg by doc) consulted a doctor here he says all normal to stop vomitting he suggested ondel drops sometime spitups gets reduced but yesterday after having my milk he again vomitted sometimes i see him feeling very very uneasy, i have stopped giving lactogen but his crying and uneasiness has not reduced i am going crazy here to understand whats happening inside in his stomach i also must say here there is NO PROBLEM IN MAKING HIM BURP after two or three burps he still spits up , Doc help me is it a reflux problem ? , how do i know hw much quantity my baby needs for his stomach, how can i know he is satisfied , he keeps belching sometimes i live in AP ( India) and i keep him in air conditioned as climate is too hot(46) and thats resulting in slight cough and cold i am totally down , what should i do does my baby has ideally weight as he is at 4 kg in ( 43 days ) , second he spits up what ever he takes inside? ( not all the times though) he keeps crying and shows uneasiness sometimes :-( is it advisable to go for scan and if yes which one second is it harmful to the baby, third my husband lives in Bangalore can i travel to bangalore as there are good docs there with my baby in car( its 10 hrs journey) ? Please appreciate if you can answer to all my queries by an expert Help me out DOC....Pls
Posted Fri, 29 Jun 2012 in Child Health
Answered by Dr. Hema Yadav 6 hours later
Thanks for posting your query.
Answer 1. Your baby seems to be developing normally however the persistent vomiting could be either due to infection, throat irritation or gastrointestinal reflux.For the exact diagnosis a thorough evaluation, and investigation like X-ray, complete blood counts , CRP( c reactive protein) , etc can be useful. Once infection or respiratory congestion are ruled out only then you may need to get a barium milk scan done for reflux.For this you can consult with his pediatrician and discuss before going ahead with any tests. Sometimes the doctor might want to give a course of antibiotics like cefixime or amoxicillin (if needed ) to watch for improvement, before proceeding with tests .
Breastfeeding babies decide how much milk is needed by them and hence you need not worry about overfeeding. The commonest mistake parents do is to start formula bottlefeeds thinking that mothers lactation is inadequate. There are many ways to improve mothers lactation by taking Ayurvedic supplements or metoclopromide tablets etc. The more the baby needs the more he will suckle and more milk will be produced. To assist you in feeding problems you can consult a lactation consultant or your pediatrician . Also there is no need to give baby so many drops before knowing the exact cause of his problem as these are just temporary measures and not curative.
Yes you can continue anti-colic and digestive drops if baby is too gassy but remember its a normal phase of development and once the baby's gut is more mature these colics will resolve on its own.
Answer3. The definitive test for reflux is barium milk scan in which a contrast ( barium) is given to baby and serial scans are taken to see for stomach filling and reflux if any. It is usually a safe procedure except if baby has any family history of allergy ( contrast allergy can occur).
Answer 4 . Though there is no need to travel just for consultation or scanning which will be more or less similar in any city , you can take a personal decision to travel . Breastfed babies can travel if mother ensures adequate feeding and hygiene ( including good diet and hydration of mother.) But if baby has vomiting issues it's more stressful and best avoided.
I would advise you to first of all avoid any stress to yourself as maternal stress can affect baby's feeding and cause many problems.
Next make sure to drink plenty of water and get adeqyate sleep and a balanced diet .
Feed your baby on demand and make sure you empty one breast before offering the other side , this will increase lactation , improve babys weight and give more satisfaction to baby .You can burp even between feeding to prevent spit ups.
Make sure your pediatrician rules out cough or congestion which can cause frequent vomiting .
If child does get diagnosed as reflux , do not worry as in most cases it resolves on its own gradually as the baby grows .
Please do not worry , it's just a phase and most probably your baby is developing normally.
Hope I have answered your queries.

Above answer was peer-reviewed by
Follow-up: Unable to breastfeed baby, given Lactogen. Baby spitting, crying, vomiting. Is this a reflux problem? 45 hours later
Hi Doc
Thanks for the reply , but i have still some more queries and also few updates to give it you

First - regarding the baby weight he was born on Apr-25-2012 with 3.5 and later lost to 3 Kg today now at his 44th day he is now around 4 kgs met my PED at my placed he was like saying that my baby has not gained ideal weight and he is under weight acc to him he should have been around 5 kg by this time if he is properly breast fed and hence advised me to go with similac along with the breast fed, My first question how do i know the ideal weight of the baby acc to age if you have any chart please send it to me, second what are the techniques to increase baby weight ?

Second - Right from the day of birth, there are some red rashes on my baby's eyelids and on his forehead. When we consulted the PED here, they said its normal, and ud reduce gradually if he is breastfed properly. my question is how long will it take for it to reduce and since i do not get sufficient milk to feed him and he is on mixed feed,how long will it take to reduce? Also you mentioned some ayurvedic supplements to increase lactation, can u plz suggest me some so that i can purchase it and start feeding him only on my milk. also for your information, I have tried some home remedies to increase my milk, like Methi seeds boiled in water and took the water mixed with milk (twice a day), but dint work out at all. I am worried that i am not able to feed my baby to his full... please help me out. Also i tried extracting my milk using breast pump, i only get 25ml milk(from both breasts), but my baby's intake is 60ml, on every feed. He wakes up every hour for milk, but i am not able to feed him to his full. Also plz tell me as to how do i know that my baby's somach is full when he is breastfed? I was adviced by the PED here, to feed him atleast for 15mins.Sometimes, i feed him for more than half an hour(at both breasts put together), but still he keeps crying, and when i chk pressing my breast, the flow wud be very minimal(almost NIL).

Third - From the last 15days, my baby is experiencing stomachache(I presume it to be) everyday, coz when he cries he doesnt accept to drink my milk, keeps crying by having my nipple in his mouth. Presuming that he has stomachache, when i give him COLICAID Drops OR COLINOL Drops(Both suggested by PED), he sleeps immediately with great relief. Why does he get stomachache and for how many days shud i keep using these drops to make him relived from the pain? And why does he get it everyday? Does my eating habits affect him in this manner? If yes, what are the foods that i need to avoid? And what shud be my diet to increase lactation?

Fourth - Since i metioned that i only get 25ml of milk from both the breasts, I wud like to know, does the size of the breast affect the quantity of milk supply? My breast size is very small, and hence i doubt if this wud affect my milk supply.

It wud be very kind enough if you could answer all my queries. I really appreciate your help on this.
Answered by Dr. Hema Yadav 6 hours later
Thanks for the follow up.
Answer 1. If the baby had lost weight due to diarrhoea or any other illness and then gained weight then he is gaining appropriately .He should have gained around 800- 1000 gms by 6 weeks so that would be around 4.5 kg ideally but 4 if he had already lost weight.The WHO growth charts for boys are freely available on the Internet and you can even get it printed. They should be ideally provided by your pediatrician and the child's growth pattern should be monitored monthly on the same .There are no specific techniques to increase baby weight but exclusive breastfeeding is the best way to do so.
Answer2. Red marks on newborn skin if has been examined by the pediatrician to be normal then they should resolve on their own by 3-4 months but breastfeeding or formula has no affect on the rate of resolution. It's just a normal variation of the delicate skin and is not a matter of concern unless it's worsening.
Expressing breastmilk may reveal less than actual amount of breastmilk since baby's suckling is the main stimulus for its ejection and continuous production . Also a worried , stressed out mother may have temporary decrease in lactation but it can be reassured by eating a balanced diet of XXXXXXX leafy vegetables , cereals and pulses fruits , etc You may try the Satvarex powder which is a Ayurvedic preparation to be taken with milk twice daily.
15- 20 min of feeding is adequate for baby and if baby still cries you should get him evaluated for colic issues.Its normal to have less flow after 30 min of continuous feeding.
Answer 3. Your baby could be suffering from abdominal colic which is common during first three months of life and usually relieved by adequate burping and anticolic drops . These drops can be given as and when required. Your diet does not affect it much still there are some cases where there is a family history of food allergy in which case you should consult an allergist to rule out the same . However I don't think that to be the cause in your case , and most probably it's just a usual case of colic due to sensitive gut which will resolve as it matures in few months .
If the baby has any associated diarrhoea then get a stool routine& culture test to rule out infection as the cause of colic( stomach ache).
You can try digestive drops like neopeptine as per your doctors prescription which. An be given daily to babies with colic. The best thing you can do for a confirmed diagnosis is to consult a lactation consultant who may find any improper feeding techniques as the root cause of all problems and start appropriate management .
Answer4. No the amount of milk never depends of size of breast but it is affected by sleep, diet and mood of mother and proper position and suckling of baby.

Hope I have answered your query.
Kindly accept my answer if you have no further queries

Above answer was peer-reviewed by
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