We first learned our girls suffer from gastroesophageal reflux (acid reflux) in December. Over a week or two, Catie became more selective about latching to nurse. After an initial spell, she would wiggle and dismount. Then she would open her mouth eagerly like she was hungry for more, but repeatedly let my nipple graze through her open mouth without latching. At the time, I couldn’t figure out why. Sometimes, she would nurse but not take her bottle.
Then by the end of December, Catie began resisting bottles altogether. After nursing, she would make hungry-looking fish mouths with protruding tongue, but when we presented a bottle, she would resist latching on to the nipple. We brainstormed possible causes and remedies: Does that nipple smell like dishwashing detergent? Do we have a bad batch of formula? Has she decided that she prefers breast milk?
Burping her and swapping out nipples only occasionally led to her taking the bottle. Catie’s total consumption decreased dramatically, and as a result, her rate of weight gain fell further behind her sister. As the problem worsened, we became increasingly concerned. Slowly, Sam developed some of the same issues, though to a lesser extent.
Finally, after a weekend in which Catie hardly ate, we called the pediatrician’s office. When we described the scenarios and issues, they concluded that our babies had gastroesophageal reflux, meaning milk/formula doesn’t stay down in their stomachs where it belongs. When milk and stomach acid return to their throats, it hurts, and they refuse to continue eating. Reflux is common among babies generally, and especially prevalent among preemies, though I’m not sure why.
Armed with a diagnosis, we started both girls on Prevacid twice a day and implemented procedural and mechanical improvements:
- do Tummy Time and other lying-down activities before they eat,
- change to a more-inclined tandem nursing position,
- feed them smaller amounts at a time and burp them more often
- keep them upright after eating and keep working on burping, and
- offer them liquid antacid when they sound refluxy.
All of this makes feeding them even slower and more cumbersome. It often takes more than an hour of their limited awake time to finish. But they resumed eating and that’s important.
Now over the last two weeks, things are getting worse again. They had been eating almost 5 ounces of milk and/or formula 5 times a day, or about 25 ounces a day. But both girls have begun resisting/refusing their bottles again and we can’t figure out why. For example, Catie only took 19 ounces yesterday, and that’s typical this week. In fact, she’s taking so little formula that her bowel function resembles that of a breast-fed-only newborn for the first time in her life.
While Catie is clearly suffering more, Sam is suffering, too. Bill and I are struggling to figure out what, if anything, has changed in the last two weeks, and more importantly, what to do to solve the problem and keep them eating and sleeping. Hearing our babies whimper and cry and being unable to comfort them adequately is miserable.