Chloe came into the World in August 2017, it was the happiest day of our lives without a doubt. Her due date was September 10^th so she was two weeks early. I think I cried tears of happiness for two hours when she was born, genuinely. I couldn’t get over how lucky we were that she had made it safe and sound and that she was real! For the first couple of weeks, all she did was sleep and everyone commented on how chilled she was. I had prepped for colic well in advance of her birth by reading Dr. Harvey Kemp’s book Happiest Baby on the Block so I felt like I was ready for anything!

I was not ready for Silent Reflux – I had never heard of it and I did not recognize the symptoms and yet, it turns out, it’s extremely common and so many new parents really battle with it.

What happened our chilled little baby?

I think it was when Chloe was about 3 weeks old that she became very difficult – screaming crying for hours every day. Like so many, I thought it was colic. That’s what everyone said when they saw her, “oh, colic, that’s awful – they grow out of it”. I was an absolute pro at swaddling, I could do it with my eyes closed and it definitely did help to soothe Chloe for a short time, while I also rocked her and blasted white noise throughout the house – on my laptop, on my phone, all night long. No exaggeration. There are actual Youtube videos that play 10 hours of white noise, this was our go-to. God forbid you turned it off, she would wake instantly! All these anti-colic techniques are used to replicate the womb and they definitely help, but our problem was not colic, as I was to find out months later.

Chloe never napped throughout the day, it was a constant job of holding her upright, she hated to be cradled and would scream at the top of her lungs if anyone tried that. She always seemed uncomfortable and pushed you away. She liked being upright or held over your forearm and you had to be standing while holding her – no negotiations there. Try to sit and it would result in an immediate meltdown. It was literally like a crappy game of pass the parcel between myself, my husband, and my mother and my sisters when they were there. I recall every evening when the crying and screaming would be at it’s worst, where Brian and I would look at each other, and just think to ourselves, “What have we done.” It’s a horrible thought but it was absolutely horrific. And then we would remind ourselves that she does eventually stop, maybe at 9 or 10pm when she was absolutely burnt out. I found certain things helped like a bath before bed, that could calm her for a few minutes and maybe help get her down for the night, but not always. I was breastfeeding and she would literally feed every hour during the day, then about 30 minutes after a feed, the screaming would start again. The amazing thing was, she slept pretty well at night, maybe waking twice for a bottle but would go straight back to sleep most of the time, and then wake at about 6 or 7. The morning would be okay, but once about 11am hit we were straight back into the madness. Because it all happened at specific times, I again was sure it was colic.

Needless to say, we were absolutely house bound. She hated the buggy and the car seat, I’m not exaggerating when I say that the screaming was the most ear piercing scream you ever heard, which often led to coughing, spluttering, sort of a choking sound. A walk in the park? Forget it, we would leave the house and would barely make it two minutes before the madness began so it was just easiest, yet no way easy, to stay at home. Shattering my dreams of all the things I thought I would do with my baby as a new mom.

Rock Bottom!

One day I braved going into town. I made into Brown Thomas car park with a lot of screaming and pulling over along the way, but I had to get out of the house! Maybe it was a stupid idea but I just thought that maybe she needed to get used to the car seat, or used to the buggy. As I pushed her around Stephen’s Green shopping centre and the screaming started, I had to take her out to rock her. I stood there on my own for about 15 minutes, rocking this tiny baby in the middle of a busy shopping centre as others strolled passed me with their sleeping babies and I just couldn’t understand what I was doing wrong. I went to the feeding room, she was happy as long as she was being fed and there was another girl with a baby the same age (about 12 weeks), she fed her baby, put her back in the buggy and off she went. I was just amazed and also so jealous that it was so easy for her because I knew when it came to putting Chloe back in the buggy there would be uproar. And I was right.

So I called it a day, went back to the car and attempted to drive home. I got as far as the Radisson Blu Royal Hotel, which is exactly a 9 minute drive from BT car park and I had to pull in. The screaming was out of control. I hopped in the back, took her out of the seat, checked her nappy, fed her, swaddled her, rocked her, but she wouldn’t stop crying and screaming. Then, like a baby myself, I started crying! I didn’t know what to do, I felt useless as a mother and clueless. I felt so stuck and lost and all I wanted was for Chloe to be happy but she was just so miserable. So I called my mom. She told me to get out of the car and walk around with her and she would come in to help me. I walked up and down the street with my tiny screaming baby, rocking and shushing her and I just had a realisation that this could not be right, that there was something very wrong here. My mom got a lift into town with my sister so that she could mind Chloe as I drove home. She told me she had been researching it and that she read that some babies are just high needs babies, and that they usually become great leaders in the future – hilarious! But I knew in my heart that it was something else. I called the doctor to make an appointment for first thing in the morning and spent the night raking through Google to try and find the answer. Typing in different things that she does that may be a symptom of something, which was hard to tell since Chloe is my first baby and I really didn’t know what is considered normal and what to look out for. She had been to all her public health nurse checks and doctors visits and they had said she was doing great, gaining weight and really healthy. I searched for hours and finally saw something that made me stop. It was an article about colic but then it mentioned something about how if a baby arches their back after feeding, this is a sign of reflux, but sometimes reflux is silent!

What is Silent Reflux and what are the symptoms?

What this means is, when a baby normally has reflux, they spit up. Chloe never spat up… ever. So I assumed she did not have any reflux. WRONG! What was happening Chloe was she had reflux, the acid would travel up her oesophagus and then she would swallow it again, meaning that it was burning her throat on the way up and then again on the way down. And the constant feeding? To sooth the burn but the catch 22 being that it was just a vicious circle as the feeding caused the acid. Can you imagine how painful that is for a little baby? There are a lot of other symptoms to look out for, a baby will not necessarily have all of the symptoms but may have only a few. These are the symptoms listed on Mummypages ;

• Baby crying excessively, and not just in the afternoon (as is with colic)

• Baby seems to want to feed ferociously, but never seems full (a baby may do this to ease the acid burn)

• Back arching when being held or seeming distressed when laid down on a flat surface

• Poor sleeping habits, during the day and night

• Baby hates the car seat (some babies dislike the hunched over position of the newborn seats)

• Baby seems to be constantly trying to get away from being held, will push and scrape at parents’ face or arms (more noticeable in older babies)

• Baby cries most of the day or whines and wants to be picked up, or will display attention-seeking behaviour (this is to distract themselves from the pain). You can’t spoil a small baby!

• Pulling or scratching at face or back of the neck

• Head banging or head extended right back when sleeping (this can be a sleeping technique that some babies adapt to stop the acid travelling up the oesophagus and into the throat)

• Sneezing, itching, rash or excessive runny explosive nappies (some signs of allergy/intolerance to cow’s milk protein or soy (CMSPI). It’s good to remember these factors can also be present in a baby who repeatedly vomits or spits up large volumes of feed. These signs and symptoms can be found in bottle-fed and breastfed babies!

Treating Silent Reflux

By the time I got to the doctor the next morning, I knew I had discovered the problem. He prescribed Zantac for Chloe and said that I should see some sort of relief almost straight away. I did not. I called a nurse that I knew that was working at the Coombe and she told me that Zantac was not widely perscribed anymore, and that Losec Mups was more effective so I asked my GP to switch the prescription. Losec Mups (Omeprazole) is a proton pump inhibitor as opposed to Zantac (Ranitidine) which is an acid blocker. A proton pump inhibitor basically reduces stomach acid production. After more constant research I found a Facebook page called Surviving Reflux Ireland and saw many parents raving on about a paediatrician in Sandymount called Dr. Emma Buckley at the Children’s Practice who specialises in reflux babies. We booked the earliest appointment that we could get. The appointment set us back about €180, which isn’t cheap but honestly, I would have paid everything we had to get to the bottom of the situation, it actually is extremely cheap when you weigh it against the importance of the problem.

Through my research, I also suspected Chloe may also have Cows Milk Allergy or lactose intolerance as this can also cause silent reflux and other symptoms such as perspiration, poor breathing, diarrhoea, flatulence, stomach discomfort, facial swelling etc. Here is a link to CowsMilkAllergy.ie that fully explains the difference and here is a little bit of information in case you’re interested in knowing more.

The main difference is that CMA is a food allergy, which means that the immune system overreacts to one or more proteins contained in cow’s milk. To avoid a food allergic reaction, it is important to avoid the intake of the protein.

Lactose intolerance is the inability to digest milk sugar which is called lactose. It is a food intolerance which means that the body cannot deal with this nutrient. The immune system is not involved so that no allergic reaction takes place. Symptoms such as bloating, abdominal pain, flatulence, or diarrhoea can be signs for lactose intolerance.  The skin or the respiratory tract are not usually affected. Again, the symptoms of lactose intolerance can only be managed by avoiding all foods containing lactose, e.g. all sorts of milk and dairy products. Fortunately, lactose-free milk and dairy products are available in most shops and can be a good alternative.

In order to see if this was affecting Chloe, I cut out all dairy from my diet to see if it would help at all, which it did seem to somewhat.

Dr. Emma Buckley was absolutely amazing, she just knew her stuff in a way a GP couldn’t as this was what she saw on a daily basis. She increased Chloe’s dose of Losec Mups to a full tablet every day – half in the morning and half in the evening. Chloe was 15 weeks old at this point. I told her we were also using Gaviscon infant sachets, however she recommended that we just use these 1-2 times per day if required as they cause constipation. When I told her that Chloe’s nappies were often ‘explosive’, the type that require a bath and an outfit change, she told me that nappies like that often mean that there is something upsetting the stomach from the milk. I explained that there had been a slight improvement since cutting out the dairy, Dr. Buckley said to continue to cut it out but that there is also lactose in breastmilk so this can still contribute to the problem, she gave us some options of formulas to try if we decided to switch. I tried to continue breastfeeding for another month, but we really didn’t see a drastic improvement until I switched her onto SMA Lactose Free formula as well as giving her Losec. I know there are many breastfeeding advocates reading this and shaking their heads but I honestly gave it everything I had and honestly, it was just making matters worse. After about three days of being on the lactose free formula, combined with Losec, we turned a corner and Chloe began to smile, the screaming eased off significantly and she finally began to nap during the day! We finally began to enjoy being parents and see our little girl happy. It did not fix everything 100%, there was still tough days but nothing was as bad as those initial few months of hell.

Aside from medication, here are some other techniques that help manage silent reflux;

• Giving your baby smaller, more-frequent feedings.
• Elevating sleeping position – books under one side of the cot so that the baby isn’t lying absolutely flat.
• Interrupting feedings to burp your baby.
• Holding your baby upright for 20 to 30 minutes after feedings.
• Eliminating dairy products, beef or eggs from your diet if you’re breast-feeding, to test if your baby has an allergy.
• Switching the type of formula you feed your baby.
• Using a different size of nipple on baby bottles. A nipple that is too large or too small can cause your baby to swallow air.

Personally, another thing that really helped Chloe was switching to Dr. Brown’s bottles as they expel the air from the bottle, so it really helps with wind.

Chloe is now 14 months, we were able to successfully wean her off Losec at 10 months but that wasn’t before a number of failed attempts that brought us right back to that initial hell and it would take up to two weeks to regulate her back on the Losec again. We have slowly been able to introduce lactose too, starting with small amounts of butter on toast, goats milk yoghurts, whole goats milk once she reached 12 months and now she is on regular cows milk with no issues.

Those initial few months truly made us appreciate the smiling little girl we know today. I do not understand why hospitals do not give out leaflets on Silent Reflux because I know a number of friends that have faced the same saga with their babies but never heard of it either. I put a post on Instagram briefly discussing it once we had figured it out and I had at least three friends contact me about it because they realised that their baby was suffering from it too. That’s why I am writing this blog post, to share Chloe’s story so that it might help a few others who might be going through a similar struggle. I just wish I had known sooner and that I had the information so Chloe could have avoided months of pain and discomfort.

I am not a doctor, and I’m not in any way medically trained. I’m just a mom sharing my own experience. All babies are different but if some of this sounds relatable to you and your baby, just get them checked out and don’t just accept that it’s colic like everyone keeps telling you. The Surviving Reflux Ireland Facebook page was a fantastic support for me, just knowing that I wasn’t alone and to read the experiences of others, so a special thanks to the founders and administrators for managing such an amazing page. Hopefully someone will find this information useful and it will help them on their way to finding the solution to their problem.