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Help with my son... He has silent reflux!

by Andrea Mocca
(Maryland/Washington D.C. Metro area)

At 3 weeks and 2 days my son began an eating frenzy, I figured he's going through a growth spurt. 2 days later, he begins fussing while he eats and burps. It has now been 9 days and he has all the symptoms of silent reflux. He gets a mix of pumped breast milk and formula.


We have military health and go to the Naval Hospital in Bethesda, MD. It is also a teaching hospital. I went in not knowing anything about silent reflux. I explained the pain he was having. The pediatrician I saw brushed it off as colic and sent me home.

Over the next 4 hours it got worse where he couldn't take 2 sips without pain on his face and start screaming. I called back the peds office and they never returned my call (this was early Friday afternoon). So Saturday morning I ended up at an urgent care. Saw the ped there and she asked me all of these reflux questions. He had all the signs of silent reflux. She gave me a script for Zantac 1ml 15mg per...every 12 hours. And we of course are doing bed elevation, smaller feeding, lots of burping, and Enfamil A.R.

It is helping but it seems the Zantac stops working after 10 hours instead of 12. And he is still having painful burps all day long, it is usually only one big burp after 1oz. He eats about 2-3oz every 2-3 hours.

I followed up with the military ped and again got a young one that said to me... "well there's really not much more we can do, hopefully it is a phase an it will pass". They didn't offer me a different does or different meds or any tests or a referral to a specialist. He said "if he is not having projectile spit ups then he might not have reflux."

1. Can your give the infant Zantac 3x a day instead of only 2? Or is there a different med that could last longer?

2. Do you have any professional journals or website links about silent reflux? I want to show the military pediatrician.

3. Is there any other advice?

P.S. We've tried several different bottles to reduce any air he is sucking. MAM, Milkbank by dexbaby, Breastflow. Avent seems to work the best so far!

Comments for Help with my son... He has silent reflux!

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Quick Response
by: Heather ;-)

Andrea,

It's about 2:50 Central time here...the Earthquake hit you a few hours ago. I'd be totally freaking out - what a weird sensation that must have been! Glad it was minor!

To your question. First off, on number one I can't help you. I have medical background to give that kind of specific advice. Wish I could, but I can't.

As for the others, the are going to take a little time for me to do some digging. Up until now, I've never heard of silent reflux, but that's not surprising...there are a lot of things out there I've never heard about. lol

Bella's nap is officially over, so I can't give your question the attention it deserves right now. However, I WILL be able to hunker down to research tomorrow. So expect another, more in-depth reply tomorrow, okay?

It's always hard to see your little one suffering. You are earning your "mom" badge with flying colors. Keep being his #1 advocate and the answers will come. You're doing great Mom!

until tomorrow,
Heather ;-)

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Thanks
by: Andrea

Thank you for the support! Oh yeah did we feel the earthquake! Hopefully never again.

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Research Results, Part I
by: Heather ;-)

Andrea,

First, let me address the issue of "silent reflux". You probably already know this, but humor me for the sake of other readers. ;-)

Silent reflux is different than GERD in that there is normally no spitting up. This makes it harder to diagnose. Instead, the baby swallows the bile, which is actually worse because it hurts on the way UP and then again on the way DOWN. ;-(

A few of the possible symptoms are:

  • Hoarseness

  • "Barking" or chronic cough

  • Asthama

  • Noisy breathing or pauses in breathing (apnea)

  • Trouble feeding, spitting up, or inhaling food

  • Trouble Gaining weight


Possible Treatments

If you're breastfeeding, try using the laid-back breastfeeding position, which keeps your baby laying upright while feeding.

Try to feed more often, in smaller amounts and keep your baby in a vertical position for at least 30 minutes after each feeding, rather than laying him down right away. At night, put him on your shoulder and rock for 30 minutes. It's a loss of sleep, but necessary.

If you don't feel Zantac is working, talk to the doctor about trying something else. Axid, Pepcid, Tagamet, Prilosec, Prevacid, Aciphex, Protonix, Zegerid, Kapidex, or Nexium have all shown to be affective with this form of reflux.

Whatever you do, keep pursuing solutions until you find something that seems to be working. This form of reflux can be harmful if left untreated. It can create ulcers, increase ear infections, and affect the vocal chords.

(See next comment for Part II)

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Research Results, Part II
by: Heather ;-)

(As always, I've chatted too much and had to break my comments into two section to get them posted!)

As for professional journals, I've found a few I can share. You can print the abstract and share those, since the actual report requires a membership to access. I would assume your pediatrician will have access to the full study.

(FYI - Silent reflux is known in the medical community as Laryngopharyngeal Reflux or LPR.)


  • This study discusses diagnosing LPR and how it differs from GERD.


  • This article from The Journal of Pediatric Gastroenterology & Nutrition talks about the possible link between LPR and apnea in infants.


  • This last article discusses how surgery helped infants struggling with GERD. Even though it's not LPR, the treatment would be almost identical, so I thought this may also be helpful.


I hope this information can be helpful to you Andrea! I actually learned a lot while researching this, and will be turning it into a new article on a new website/blog I'm developing called Incredible Infant. Thanks for bringing this up!

Heather

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Thank you very much!
by: Andrea

I really apreiate it! Today I finally am trying the 5th different bottle. Dr brown. One feeding down and am already amazed.

The ped said he can have the Zantac to 3 timesrather than two only. I'm just cutting down on the dose.

The article abstracts are perfect. I really appreciate it.

Again thank you!

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Good luck!
by: Heather ;-)

No problem! I'm glad to hear Dr. Browns is helping and that you got the Zantac question answered.

He's a blessed boy to have such an attentive and caring mama!

much care,
Heather

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