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When I feed him his bed time feed he always throws it up and screams in pain for hours

Hi Glenda,
My 13 month old little guy suffers badly from reflux. Because of this he has severe feeding refusal and has been tube fed since he was 3 months old.

Although he refluxes on and off night and day, he mostly manages to keep his daytime feeds down. When i feed him his bed time feed he always throws it up and screams in pain for hours. I have tried giving him half a feed and letting him sleep before finishing his feed, but we get the same result, only twice!

Im just wondering if you had any suggestions? I feed him in an upright position
Thanks, Lauren

Glend...
Answer: Hi Lauren, It sounds like you are having a really tough time; poor little man sounds like he is very uncomfortable still. You don’t mention what medications your son is on, if any, or whether you see a feeding team to help with his feeding refusal, but both of these came to mind when I read your question. I presume you are under the care of a paediatrician or paediatric gastroenterologist – but are they aware of the problems you still have? If not, then please talk to them about what is happening. Perhaps you could keep a written record of everything that goes on – include details of any solids, feeds, sleeps, dirty nappies, vomiting, screaming – and any other point you consider to be relevant. This can help your doctors understand what is going on, and can often help point to any patterns that may not be otherwise noticeable. If he is on medication, then this may need to be reviewed – often there can be a lot of trial and error involved to find the right medication – dose and combination, particularly as they grow. Sometimes too, medications like Zantac need to be increased as bub puts on weight. Some babies/children on tube feeds seem to need to have their feeds slowed down so they can tolerate them. If you are seeing a feeding team, then perhaps the dietitian could help with ensuring he gets the right amount of calories, but in the smallest amount of liquid. Or maybe they would consider using a pump so feeds can be given at a slower rate over a length of time, rather than giving him bolus feeds; this may stop him from vomiting or at least reduce it. You don’t mention what formula he is being given, but it is very common for refluxers to have food sensitivities. If he isn’t on an elemental formula e.g. Neocate, EleCare, then that may be something else worth talking to your doctor about. I have known some babies who refuse feeds until they are put onto one of these formulas (they are available on prescription), and this they drink fine. (they are bitter though, and some babies refuse to drink them. Since your bub is tube fed, then this is an advantage – no refusing!) While you are not at all obliged to join our organisation, we do have a parent group where families discuss tube feeding issues, and they may also be able to offer you some ideas as well. You can find more information on our website, at www.reflux.org.au. In the meantime, I would recommend you keep talking to your child’s doctors and keep looking for answers for your little guy. I hope he feels better soon. Best regards, Glenda
Answered: 29 Apr 2009