Congestion?

[jd11365]

Aftert DD feeds, she sounds "congested" though I don't see anything in her nose. She only sounds this way after a feed...Is this normal?

[Rachels]

How is she doing otherwise? Reflux can cause this, but in the ansence of other symptoms, I wouldn't worry.

-Rachel
Mom to Abigail Rose
5/18/02

[jd11365]

How do they check for Reflux? I was concerned because all of her spit ups and when I brought her to the ped...I saw the nurse and she just said no, she didn't have it. Is there a test? I'm starting to think she may have this because everytime I mention her symptoms on this board I see the word Reflux. Otherwise she is doing very well...It's tough, but I LOVE being a new mommy!

[nigele]

Well, since she spits up a lot AND sounds congested, you might want to ask your pediatrician (NOT the nurse) and be sure to mention the congestion. My DS has reflux and the only symptom he showed was congestion. He rarely spit up. Since your child is spitting up frequently, the ped may prescribe a medication for reflux without running tests.

We had two tests since I was convinved DS had reflux and my ped was not and she wouldn't try the meds without the tests. First, we had an Upper GI, which turned out negative, then we had a more accurate but invasive overnight hospital test which was positive. I won't go into details, but if you do want more information, just let me know!

Best of luck.

[etwahl]

Lisa, lauren is stuffed up all the time. she was on zantac, but he took her off it. they couldn't get me a gi appt until late july, at which point, we'll be leaving already.

but she sleeps fine on her back (12 hours a night). i thought that was a sign that she DIDN'T have reflux. Am I wrong? Should we try zantac again to see if the stuffy nose goes away? I always thought it was allergies, but i've removed all the stuff from my diet.

Tammy,
Mom to Lauren Genevieve
03/12/2003
www.evantammy.com

[ktdid74]

We're actually taking DD to a ENT doc in a few weeks to check out her congestion. Of course, we probably should have had it checked out sooner and now we had to wait a month to be seen. Mackenzie has had this congestion since she was 2 weeks old. It's definitely worse at night when she's laying flat. I worry most when she's breastfeeding and milk comes out her nose (usually when I nurse her laying down). I've never been able to suck anything out of her nose and she seems to choke and gargle saliva all the time now.
I recall seeing Tammy mention something about a wheat allergy but couldn't find any info. She's a happy baby and feeds well so I wasn't concerned about reflux- or should I be?

Katie
mom to Brendan 6/8/00
Mackenzie 3/26/03

[Rachels]

What all of you are describing raises the reflux flag for me. I didn't suspect that with Abigail because she wasn't very spitty, but it turned out to be what was causing her a lot of distress. Food allergies DEFINITELY exacerbated her reflux, too. Anyway, if your babies have symptoms, many peds will be willing to try zantac to see if it helps at all. The upper GI (which we did eventually) was stressful for me, but not invasive for Abigail.

Anyway, in dealing with her reflux, I learned a lot about symptoms. Here are some of them. If your baby has several, I agree, talk to your ped. A nurse CANNOT tell by looking whether a baby has reflux. How ridiculous.

Possible symptoms include:
Nasal congestion, especially during or after feeds
Arching backwards
Screaming shortly after latching on
Frequent, profuse spitting up
Frequent hiccups
Baby seems less comfortable lying flat than upright
Frequent waking while lying flat
Frequent, inconsolable crying
Baby acts hungry but seems distressed by eating
Baby nurses extremely frequently (reflux babies hurt if they get too hungry or too full-- Abigail nursed every hour for months)


There are more. I forget them all. But if any of this sounds familiar (and not all of it has to in order to be reflux), insist that your doctor help you evaluate it. I can't tell you the difference it made in our quality of life to have Abigail diagnosed and helped.


-Rachel
Mom to Abigail Rose
5/18/02

[nigele]

Tammy,

When a baby refluxes, it can come up and settle in a baby's nasal passages and really irritate them. This is what was happening with Tom (he rarely spit-up.) When Tom's reflux was at its worst, and before we had a diagnosis and Zantac, he would constantly and aggressively rub his nose. His night symptoms were downright scary - he would wake up and look like he was struggling to get a breathe. We found out during our overnight hospital test (PH probe) that he had sleep apnea related to the reflux. I can't give you any insight as to whether Lauren's great sleeping means she may not have reflux. Tom never was and still is not a great sleeper. It would be worth it to ask your ped or perhaps wait until you see a new one out here.

Good luck!

[jd11365]

Went to the ped to have it checked...better safe than sorry...I saw the actual dr. not the nurse...

She said the baby didn't have reflux and was just exhibiting normal signs of a spitty baby that has difficulty burping. Since Kayla has gained a whopping 2 pounds in 1 month, she feels reflux is not the case. Yes, Kayla was 7lbs. 6oz at birth and now weighs 9lbs. 8 oz! She also said to start supplementing with a little water and a pacifier when Kayla just wants to "snack". She hates both, so I don't know how that's going to go... but I don't want her to earn the nickname "supersize"...

BTW, is it regular 'ol over-the-counter Zantac you are using?

[etwahl]

Wow, I've never heard of a pediatrician prescribing water for a month old baby. Has anyone else ever heard of this?

Tammy,
Mom to Lauren Genevieve
03/12/2003
www.evantammy.com

[stillplayswithbarbies]

No, especially not in a breastfed baby. I would not give water, and would find a new doctor.

If she just needs to suck and doesn't like a pacifier, try letting her suck on your little finger.

...Karen
Jacob Nathaniel 2/27/91
Logan Elizabeth 3/25/03

[jd11365]

Just curious...why no water?

[Rachels]

Giving water to a breastfed baby can be dangerous and is at the very least unnecessary. Among other things, it can interfere with your milk supply, increase bilirubin levels, disrupt the balance of sodium and electrolytes, etc. The idea that your baby has gained too much weight or needs to diet is absurd. I agree-- find a new ped! This is bad, possibly dangerous advice. But here are what some of the breastfeeding websites have to say about water for newborns:

Storknet.com's answer:
The fact is: Breastfed babies do not need any supplemental water, but formula fed babies often do. Formula fed babies may need water supplements due to the renal solute load of formula (the higher salt level is harder on their kidneys, and they may need extra water in order to excrete it). Formula fed babies also have less efficient metabolisms that breastfed babies, so they use up water faster. Breastmilk is composed of 90% water, and that provides all that your nursing baby needs, even in hot weather. Nursing babies that are thirsty will regulate their own intake by feeding more often and taking in enough of the watery foremilk to satisfy their thirst, but not enough of the creamier hindmilk to overfeed. They are able to regulate their own fluid intake, which is one more nice thing about breastfeeding.

Supplemental feedings fill up your baby with empty calories, making him less interested in nursing. Water supplements interfere with breastfeeding, and can actually contribute to weight loss and elevated bilirubin levels.

A newborn who is supplemented with water may actually develop higher bilirubin levels, and tends to lose more weight than a baby who is not supplemented with water. Water supplements in a newborn can also interfere with the establishment of a mother's milk supply.

Giving supplemental water to a newborn (under 5 weeks old) can actually be dangerous. Too much water can dilute the sodium in the baby's bloodstream to the point where "oral water intoxication" develops, and this can lead to symptoms like low body temp, bloating, and seizures.

Once again, Mother Nature knows best. You don't need to give your breastfed baby water.


Dr, Jay Gordon's answer:
First, no, water is definitely not needed for breastfeeding babies. There have been a few wonderful research papers published about this very topic. In very hot climates, a well-hydrated mother produces more than enough milk for her baby. I am talking about 105 degrees F or more! These studies have been done more than once. In other words, moms need extra water and babies don't.

In the newborn nursery, giving water to babies leads to more weight loss and increased jaundice. This makes sense when one realizes that colostrum and breastmilk are fuel and get digested for that purpose. Water tends to just "flow through" the baby and contains zero calories for metabolic energy, zero protein and so on. The weight loss and jaundice research was done many years ago and is ignored in the majority of hospitals throughout the country. The truly dangerous aspect of this antiquated practice is that bottles of water in the nursery can delay mom's milk coming in since it takes away from the time that baby is at the breast. She could then get home and find herself with less milk and no water and a very confusing situation.

When do I recommend water for babies? Starting after six or seven months of age it may be convenient to grab a small cup or bottle of H2O in a hurry, but there is still no "need" for water in a breastfeeding baby in the first year of life.

www.kellymom.com's answer:
For newborns (especially under 4-5 weeks), water supplements can be risky -

* Babies under two months should not be given supplemental water.
* Water supplements are associated with increased bilirubin levels in jaundiced newborns.
* Too much water can lead to a serious condition called oral water intoxication.
* Water supplements fill baby up without adding calories, so water supplements can result in weight loss (or insufficient weight gain) for the baby.
* Babies who get water supplements are less interested in nursing. If baby is not nursing as often as he should, it will take longer for mom's milk to come in and can delay or prevent mom from establishing an optimum milk supply.


For babies past the newborn stage:

* Too much water can interfere with breastfeeding because it fills baby up so that he nurses less. Babies need the nutrition and calories in breastmilk to grow - water has none of these.
* Breastmilk has all the water your baby needs, even in very hot weather.
* When your 4-6 month old baby is learning to use a cup, giving him a few sips of water a couple of times a day (no more than 2 ounces per 24 hours) is fine and fun.
* Once baby starts solids, you might want to give him a few sips of water with his solids - some babies need this to prevent constipation.




-Rachel
Mom to Abigail Rose
5/18/02

[jd11365]

Wow...thanks so much for the advice! This is all so new to me. I am concerned about her weight...my husband has a streak of obesity in his family, and I would hate to do something to the baby that would intentionally make her large...like overfeeding her. Perhaps I should just start with giving her the pacifier if she wants to feed less than 2 hours inbetween? I know everything I read says to breastfeed on demand, but doesn't the gain of 2 lbs. 2 oz. seem a bit much for a 4-5 week old baby? She also gained 3 inches...went from 20 to 23 inches...

[danielleh]

Hi,

I wanted to share my DS's weight history with you; it may put your mind at ease. He was BF until 7 months, starting solids at 4 months (but he never ate much of it until recently).

Birth: 8lb 8oz
1 month: 10lb 5 oz
2 months: 12lb 8oz
3 months: 13lb 5oz
4 months: 13lb 13oz
5 months: 15lb 2oz
6 months: 16lb 2oz
9 months: 17lb 8oz

As you can see, he also started out gaining about 2lbs a month and I was worried that I would have a really huge baby. Imagine my surprise at his three month appointment when he gained less than a pound! Of course, then I started worrying about him not gaining enough weight. This whole time he was fed on demand, never going more than about 2 hours during the day and 5 hours at night (at best). Anyway, he is very healthy and active and has been consistently in the 90th percentile for height, so I am trying to just feed him when he is hungry and not worry about the weight. My ped said that BF babies tend to gain faster in the beginning and then slow down; I don't know if this is just something he said to make me feel better, but maybe someone else has heard this too. Sorry this is so long, but I thought it would help to see that weight gain can change a lot even staying with on demand BF.

HTH,
Danielle
mom to Jimmy born 8/29/02

[egoldber]

If you are worried about obesity (and it runs in my family too) there are two great books by Ellyn Satter. One is called "Child of Mine: Feeding with Love and Good Sense" and the other is called "How to Get Your Child to Eat...But not too Much". Satter is a pediatric deititian who has done extensive research and therapy with children for all types of eating disorders.

The first book is about feeding your baby from the VERY early days (lots of terrific info about breast and bottle feeding) through the preschool days. It made the transition to solids so much easier for me. And the second book is more about the philosophy of eating rather than a how to of feeding your child.

Study after study shows you cannot overfeed a baby. (But it helps to distinguish hunger cues from sleepy or need to suck cues.) If they are hungry, you should let them eat. And studies also show that children and babies who are allowed to control how much they eat, grow into adults who are also able to regulate the amount of food they eat. And weight in a baby has very little correlation with adult propensity for obesity.

HTH,

[daisymommy]

Many uninformed doctors believe that as long as a baby is gaining weight, they don't have reflux. All that means is they don't have it severely. Many reflux babies nurse/eat more frequently because the milk coats and soothes their sore esophagus and throat. Sometimes reflux babies are pretty chuncky as a result (like my DS Josh was). Also, not all reflux babies pit up alot. Some have what's know as "silent reflux", where the milk only comes up part way, not all the way out of their mouth, and then goes back down to their stomach. They are still getting the majority of what they ate (and therefor gain weight), but are still in alot pain. Josh is just now back on the charts for his weight, but he had reflux pretty bad and often sounded like he was gargling or even drounding after feeding (way worse when laid down). I would highly recommend seeing a different Ped. who will listen more closely to your concerns, and maybe is more experienced with babies who have reflux and allergies (which as Rachel said, does makes reflux even worse). Good Luck!

[jd11365]

Update...

Took your advice and saw another ped today. He is also a dr. of internal med so I thought it was a good blend and he comes highly recommended....

The doc said she does have a mild form of reflux but would prefer not to give her Zantac or other meds quite yet because it is not severe and said it will get better with time. He spent a good 30 minutes with us, and answered a lot of my questions...

1. He agrees that BF babies don't get fat. Also he showed me that Kayla is still at the 50th percentile for weight and not to worry.

2. He did say a pacifier was fine for when she just wants to suck because frequent "snacking" hinders her from getting necessary hind milk that requires a long hungry feed.

3. I told him about the other ped suggesting water...He said water was not really necessary as BM is mostly water, but a little bit, once in a while, in the middle of the day wouldn't kill her, especially being in such a hot climate. He wouldn't have suggested it or brought it up had I not asked about it. (I am going to avoid this though as it's not necessary and Rachel's post was pretty clear on this.)

4. He said to sit her upright for several minutes after a feed before trying to burp. Since she is hard to burp, it avoids excess motion from the thumping. He also said the Mylicon was fine to give after each feed since it is not absorbed.

I feel better that I had a second opinion and appreciate your leading me to more clarity! I am also ordering the books that Beth suggested since I am concerned about her weight and want to do what I can to avoid a 90 lb. kindergartener in the future. It was good to see Danielle's weight history of her DS. I guess I'm not the only one with a baby gaining 2 lbs. in a month. It was also comforting for me to see Kayla was still at the 50th percentile even though she had gained the weight quickly. I am so happy to have the support of this board!

Thanks!

[etwahl]

Jamie, I am wondering how he knew she had a slight case of reflux without having any tests done? I am trying to figure out if Lauren has reflux. We tried her on zantac, but it didn't seem to do much, although she is still very congested. However, I can't get a GI appt until near end of July, at which point we are moving. So I'm trying to decide if we should just get back on zantac and see if it clears up the congestion.

I ask you about this, because my doctor said there's no way to tell if she has reflux without having tests done.

Tammy,
Mom to Lauren Genevieve
03/12/2003
www.evantammy.com

[jd11365]

Tammy,
I think it's based on his judgement/experience as a ped. by her symptoms and his examination. He said that she would be writhing in pain all the time and very fussy if it were severe. He also said it is extremely common and basically the only ways to solve it are medications and/or change in mother's diet if necessary. He would like to try avoiding meds for such a young baby for now as he feels this is very mild and should improve. ( I kinda like that he is not so fast to medicate.) So it seemed as though for Kayla, the need for any more testing/determinations was somewhat unnecessary at this time, though available if necessary. Though she can be fussy, it is not as much as a child with more severe reflux and she is gaining weight...clearly lots of it! He listented to her carefully and said the congested sound was normal as well. For right now, I think I am ok with the assessment and would prefer not to do anything more invasive like a GI unless her symptoms worsen. I am goint to continue to BF on demand, though try to avoid feeding/snacking less than every 2 hours with help of a pacifier or pinky. I think whatever you choose to do based on information + a little mother's instinct will be what's best for Lauren. So far that's what I'm doing...as a first time mom for only 5 weeks, it's all I have! :-)

[jd11365]

Ladies,
Thanks so much for your help with this! It has been a stressful couple of days...all the crying/spitting/2 visits to 2 different peds/all the unsure feelings. I still don't know if what I'm doing is right...though I never do and probably never will, but your support with this is incredible...I really can't thank you enough!

[daisymommy]

GER stands for Gastroesophageal Relux

GER in infants
http://www.people.virginia.edu/~smb4v/tutorials/reflux/ger.htm

Pediatric GER
http://www.geocities.com/HotSprings/Villa/2193/educate.htm

Dr. Sears: coping with GER
http://www.askdrsears.com/html/10/t106004.asp

Reflux support board
http://pages.ivillage.com/momlwt73/PSFP.htm

[Rachels]

Abigail's reflux was diagnosed before we did all the tests, just based on her symptoms.

-Rachel
Mom to Abigail Rose
5/18/02

[Rachels]

Hang in there, sweetie! I know it's hard. Your second doctor sounds supportive, which is so important. You can ask for a referral to a GI specialist if you continue to have a tough time. That was helpful for us. Among other things, our GI specialist from Children's Hospital in Boston had us give Abby a little bit of Maalox or Mylanta. It coated her esophagus and belly and helped us get over the hump of the really tough time until her irritated esophagus healed. Our ped (whom we love) didn't know about that option, so it was worth the expert opinion.

-Rachel
Mom to Abigail Rose
5/18/02