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I don`t know whether she has a silent reflux, lactose intolerant problem or it`s behavioural

Hi Glenda,
I have a 4 ½ month old daughter who is having difficulty Sleeping and feeding through the day. She has been formula fed since birth with no problems. I give her NAN 1 HA. The past 4 weeks she has changed her sleeping patterns and feeding patterns and since her 4 month needles she has gotten worse.

When she wakes of a morning she is happy but does not seem to be interested in feeding. I give her a bottle after 45min-1hr after she wakes for her first feed for the day, she starts to drink for about a minute and then she arches her back and pushes the bottle away. It takes me up to an hour to feed about 100ml and she wants to burp about 3-4 times. This happens to all her feeds until night.

She poo`s nearly every day but they are green and very loose. When she shows sleep signs throughout the day I put her to bed and she starts to cry. I hold and pat her to sleep for 20 mins for her only to sleep for another 10-20 minutes, this happens all day until around 7pm. She does sleep well throughout the night/morning, and when she wakes for a feed through this time she is happy to drink most of the bottle with no problems (no arching of back or rejecting the bottle).

I`m don`t know whether she has now a silent reflux/lactose intolerant problem or it`s behavioural. I`m unsure where to go from here. Please help.

Answer: Hi, Thanks for contacting our organisation. It certainly sounds as though your daughter is uncomfortable and I would recommend you talk to your doctor about your concerns. Your child health nurse may also be able to help. It may not necessarily be lactose intolerance – it may also be worth talking to your doctor/child health nurse about things like cow’s milk allergy or soy allergy/intolerance, or perhaps whether she could have an infection of some kind. I’m not sure that the problem is behavioural – with her poos being green and very loose – though anything is possible, of course. Have her poos always been like that, or is that something new? I understand the questions that are running around in your head. I can remember doing that too, and I think it’s common for parents, particularly as they are trying to work out what is going on. It helps us get the answers we need, so talk to the doctors about all those concerns and I hope it helps you work out what’s going on with your little girl. You may already know that some children with reflux do sleep well overnight, and some may also feed well then too, even if it is a battle during the day. It may help if you keep a written record of everything – keep details of all her feeds, sleeps, problems settling, early waking, when she back arches, pushes the bottle away, cries, vomits, poops etc. even write the details of the dirty nappies as they are all clues. Record anything that you think is relevant as it can all help put all the pieces of the puzzle together, and show your doctor. It can really help them to have everything written down. Alternatively, just write a list of all her signs and symptoms to show them. Also, it may help if you videotape one of her feeds, or arrange to feed in front of the doctor (though talking to them about what is going on may be enough). Consider taking a family member or friend with you, someone who can back up what you are saying, as that can carry weight with what you are trying to say. If your doctor does diagnose reflux, there are some great tips and ideas on our website, at www.reflux.org.au. We have a lot of families in our group whose children suffer from reflux as well as allergies/intolerances so please check out the site if it is diagnosed. Parents often report reflux flaring after things like vaccinations, teething, illness, so perhaps her recent needles are impacting on her as well. Also, it may help to know that lots of babies with reflux do sleep through the night – and sometimes they will feed well overnight even if their feeds/sleeps are bad during the day. I hope you get some answers so your baby can feel more comfortable soon – so please trust your instincts and keep talking to your doctors. Best regards, Glenda
Answered: 29 Jun 2009