Ask Beth: dealing with reflux and no sleep
Q: It was great to see EB offer your support via email. It is currently 3am and just a typical night for us.....feed, cry, more cry until she falls asleep. My 13 week old daughter, Penny, was born at 36w3d. She was a healthy, but very jaundice baby. She didn't have phototherapy but we relied on a strict feeding routine, skin to skin, and exposure to small amounts of sunlight. We have been suffering from reflux from about 4 weeks, which I know is all too common in little ones. At night she becomes more unsettled after a feed and I can't seem to get her down for sometimes up to 2hrs later, by which time her next feed is only moments away. I demand feed at night, and at 13 weeks I was hoping we could drop a feed as I am still getting up twice a night. Is there any way we can try to extend her feeds overnight, and how do I best deal with her reflux at night so I can get some sleep too?
A. I do feel for you Meredith and sitting up with unhappy babies in the middle of the night always seems much worse than during the daylight hours!
I am assuming from your question that you are breastfeeding….I only ask this as I will address your milk supply a bit later and if you are bottle feeding then it will be a moot point! Firstly I would ask you if the reflux problem has been diagnosed by your doctor and is Penny on any medication for this. If she has been prescribed medication for her reflux then this should be helping with her feeding and settling? Maybe this needs to be reassessed? And there are other little techniques that will help reflux babies such as sitting up in a baby chair for about 20 minutes after a feed and raising one end of the cot with a book stuck under each leg to raise baby’s head and shoulders a little so she is not lying flat, this helps with comfort in the tummy! I know sitting up in a chair in the middle of the night is not ideal! But the raised cot should help and also feeding her in a more upright position rather than laying down across your body. Does she burp well or is she on medication for this in conjunction with the reflux?
Secondly with such long and sometimes stressful days with Penny, I am wondering how your milk supply is holding up? Do you think she is getting enough at a feed particularly towards the end of the day? I know how hard it is for new mums when you feel like you have tried everything and you start second guessing yourself……but I am asking these questions on the basis that I am not physically assessing you and Penny. Do you think if you gave her an extra feed during the day say every 3.5 hours, that she may need less at night and settle, or would this exacerbate the reflux problem? Do you wake her if needs be and give her the last feed for the day or dream feed (I use the term loosely in this situation!) at say 10 or 11pm in the hope that this may tide her over for a longer period til the next feed?
I guess the other thing I would assess is her nappies…if her bowel movements are very loose, explosive, or green coloured and she struggles to settle with lots of flatulence and an unsettled digestive system, then I would head straight back to your GP and get her checked out for lactose intolerance as a precaution.
I think I have covered the possible issues for Penny, you may have already considered these things and without physically assessing her with you it makes it a little harder. If you feel that you need further assistance and depending where you live, then I would suggest that you contact your nearest Tresillian or Karitane Family Health Centre (or equivalent) and book you and Penny in for a residential stay. If you have private health care then you will receive some rebate. If you would prefer an in home solution then I am sure you could source a mothercraft nurse to provide some support and solutions. And there is your Early Childhood Clinic nurse and of course your GP.
Meredith good luck to you and Penny, I wish you both well.
Beth Barclay is director of Mothercraft for Babies and has 15 years experience working with mothers and babies.
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