Is this worth phoning NHS 24 for?

[stargirl1701]

DD (21 weeks) has silent reflux. It's gotten a lot worse this week. Saw GP on Wed and he upped the dose of Ranitidine. Phoned surgery on Fri in tears and GP suggested SMA Staydown formula.

She took 4oz at 8pm and 6oz at 11pm last night. At 3am, 7am and 11am she has refused to take more than 1oz - 3oz total in 12 hours. Her last nappy was dry. Her Fontanelle is sunken.

What do we do?

[AnyFucker]

Make the call.

[Charmingbaker]

Phone them if you are worried.

[aimingtobeaperfectionist]

Definately worth phoning. How is she in herself? Is she still alert? To be honest, if there was any change in her (floppy, unreactive, hard to wake) I'd be taking her to a&e

[ilovepowerhoop]

Maybe the thickener is making her feel fuller. Did she wake for the 3am feed? I wouldn't be that worried yet as she had taken 10oz between 8pm and 11pm last night. Is she acting hungry? Some babies sleep 12 hours between feeds at this age (mine didn't! )

[AnyFucker]

have you tried her with water in the meantime, OP ?

[Sirzy]

I would take her to A and E where they can monitor her fluid intake/output

Hope she is better soon

[stargirl1701]

I phoned. We have an appt at 2.30pm with OOH. I just managed to get 3oz into her as she fell asleep. She always eats more if asleep.

[stargirl1701]

Doc has given us syringes and we've to syringe her feeds in when she refuses the bottles.

Apparently, it's just a stage.

[AnyFucker]

Oh.

Not too sure about "a stage" but anyway. Keep your eye on baby, and don't hesitate to go back to the doc if you are worried.

[fledtoscotland]

Hope you have phoned. Otherwise I would take her to yorkhill or sick kids (depending on where you are)

[ilovepowerhoop]

You could also try using a beaker for the milk rather than a bottle - either with the lid on or off.

[stargirl1701]

We're not happy. We plan to return to GP on Mon and push for a referral to a consultant paediatric gastroenterologist.

The OOH doc said if she smiles at stages during the day then she's fine - she's not in pain. The 6 hours of screaming clearly just for fun then

[ilovepowerhoop]

have you tried with the old milk again as it could be a taste/texture issue with the new milk

[fledtoscotland]

If you aren't happy take her to yorkhill

[stargirl1701]

The problem with the old milk was the vomit - 25-30 times in 24 hours.

Is Yorkhill in Glasgow? Ninewells would be closer.

[fledtoscotland]

Where are you?

[ilovepowerhoop]

have you tried cup feeding?

[stargirl1701]

We're near Perth. Not tried cup feeding since the days of bf. We have managed to get her to take 3oz 3 times - at 1pm, 3pm and 5pm. She will eat when asleep so using the car to put her to sleep then dream feeding. She also took 3oz at OOH when I walked up & down the corridor and fed her at the same time.

[dorapeppageorgenoddy]

Could be cows milk allergy/intolerance as strong links to reflux - will try and find a link -

But worth taking in if having less than half of normal intake - GPs who say how smiling means fine are crazy - paediatrician don't list smiling as a criteria for ill health -

Hope you are ok -

[dorapeppageorgenoddy]

Just for you to have a look at re symptoms; www.cowsmilkallergy.co.uk/

Lots on google re; links -

My oldest had silent reflux and all the meds but slowly looked more like cows milk intolerance/allergy and once on nutrimegen was so much better -

Number 2 - very sicky after stopping BF got worse and worse over a week and at a and e they put him on Nutrimegen still was poorly so next day put him on neocate and fine since -

[fledtoscotland]

I would take her to A&E at PRI initially and they can assess her /transfer her to Ninewells if needed x

[redwellybluewelly]

Another with a dc with silent reflux and CMPI, also no soya.

Id start jumping up and down for urgent referral. A friend whose dd had severe relfux found weaning solved issues however I do know that goes against current guidelines. Can take 10-14days to see improvements if you do start hypoallergenic formula.

Balls of steel are whats required here

[stargirl1701]

Hi everyone. Thank you for your messages. A family friend, who's a paediatric nurse, came round. She doesn't feel the situation is urgent at the moment but that we have to really push for an urgent referral come Monday. She didn't think A&E would do anything we're not doing.

Is it a separate referral for intolerance than reflux or would a gastroenterologist look at both? We have videoed a feed to show the GP on Monday so she can see how distressed DD is.

DH and I are coping - just! We got in a take away because we couldn't face cooking dinner. We'll take the night in shifts in case she's up all night again.

Many thanks for all your ideas and support. It has really helped.

[AnyFucker]

you sound like great parents

I hope you get it sorted, soon

[trixymalixy]

My DS is allergic to CMP. He had all sorts of reflux meds before being properly diagnosed as my GP was convinced it was reflux and was not interested in trying anything else.