Milk oh milk....

I always thought that babies would drink one type of milk...either mother's milk or one formula milk type for the rest of their infant or toddler days...boy, was I wrong..this is happening to my baby at the moment...when Ridhwan was in the ICU they started giving him Enfalac A+ (they just couldn't wait for mine...cet...oh well, my didn't come out much later pun, sob..sob..) ...so he was first introduced to the milk called cow's milk...huwaaaa...my baby's first milk was a cow's milk....well, one can never know the future kan, you plan like mad, buy a milk pump and all but it's all Allah's work...as they say 'kita hanya merancang, Allah yang menentukan jua..' ....so Ridhwan ended up drinking formula milk called Enfalac A+...but i must say, as much as I felt really guilty not being able to give Ridhwan delicious mummy's milk, I believe he will be okay as my brother's twins grew up totally on Enfalac A+, and boy are they smart and active...so I guess it proves to show its not just about the milk, its also about the love, the nurturing, the attention, the teaching and also the genes....if your mama is smart, the children would be too...that's what I heard from someone lah....it seems that if you want a smart child, marry a smart girl...hehee, but I know men sometimes are quite 'tercabar' with smart girls..yea ke? Back to milk....Ridhwan is drinking fine with the Enfalac A+, until recently he just couldn't take it anymore...i think...he was first with Enfalac A+, then his reflux got quite bad and he started throwing up so many times after feeding that we got pretty scared and worried, so we when to see our local paed, Dr. Amdan...he's the best! hehee, I like this paed dr. because he takes the time to explain what is reflux/regurgitation all about and he just know lah what Ridhwan was going through...and as a first time mummy, we do need info and people like these to guide us and show us what to do...so now it's Enfalac A+ and Enfalac AR ...great another type of milk...

What is Reflux?
My baby spits up all the time. . . My child won't gain weight. . . I have an unhappy toddler. . . My child has a chronic cough . . . wheezing . . . recurrent pneumonia . . . My infant cries and cries . . . any one of these symptoms alone may indicate a common condition called Gastroesophageal Reflux Disease (GERD).

Most babies "spit up" after they eat, but some babies spit up so much so frequently that they are diagnosed with Gastroesophageal Reflux (GERD). The definition of reflux is splashing or pushing of stomach contents backwards up into the esophagus, and sometimes, out the mouth or nose. All of us have some reflux every day. Most of us aren't aware of it when it happens. One important thing to remember, over 90% of Children who have reflux will outgrow it.

How Do I Know if My Child Has Reflux?

• Baby has poor weight gain
• Baby vomits frequently (more than once or twice daily)
• Baby has recurrent pheumonias
• Baby shows discomfort eating (i.e. refusal to eat, stiffens up, arches back (opisthotonus), tries to push away from the bottle)
• Persistant Hiccups
• Persistant Cough
• Chronic nasal and/or sinus congestion (from aspiration)
• Frequent Choking episodes
• Along with other symptoms: one hour, or more of crying a day
• "Sour" breath
• Child complains of burning pain in the chest area
• Complains that eating hurts Chronic reflux can result in Esophagitis. This is caused by erosion to the esophagus from the acid in the vomit. Signs can range from pain during feedings (a baby may seem eager for a bottle, but after a sip suddenly refuse to take any more) to blood in the vomit. If this continutes for a long period of time it can cause scarring on the esophagus and rarely, it can lead to Barretts Esophagus or even Cancer. It is important to diagnose reflux early and when necessary treat it medicinally. Reflux may be diagnosed based on the description of the Child's behavior. Often the doctor will order tests to confirm the diagnosis.

Tests for determing Reflux
There are tests your doctor can order to accurately diagnose reflux. The most common is an upper GI series (this will check for structural abnormalities, while important, it is not uncommon for reflux to not be seen on this test), a milk scan which is similar to a UGI, however it lasts longer and often shows reflux more clearly, another more sensitive is a pH probe (this test detects normal and abnormal reflux). There are more tests (listed in the testing section) for determing the severity of the damage done from reflux as well as whether there are other systems affected by reflux such as the respirat ory system.

What is the Cause of Reflux?
Reflux is usually considered to be incoordination of the upper digestive system. Often resulting from an underdeveloped digestive tract. Which means the good news is that most babies are expected to outgrow reflux. Recently studies have shown for many families reflux is genetic. (see reflux.org ). Most babies do have some degree of reflux, and just because there is one child in a family with moderate to severe reflux does not guarantee that there will be another.

What is the Treatment for Reflux?
Treatment of Reflux depends on it's severity. In mild cases thickening of the formula and keeping the child upright is enough (usually when thickening the milk rice cereal is tried first, but more often than not it is too difficult for the child to digest, oatmeal cereal seems to be tolerated much better). Ideally, children are kept upright while sleeping as well Through elevation of the head of the crib, either by physically adjusting the crib or by purchasing a "wedge" (ask your doctor for further information on this). Also, your child can sleep in an infant seat or a 'bouncy chair'.

If this is not enough then medications are commonly prescribed (see medication section). One type of medication is used to reduce the acid the stomach produces (i.e. Zantac, Tagament, Prilosec, Prevasid). Another type of medication used improves the function (or motility) of the stomache and digestive system by helping it to empty better and reflux less (i.e. Reglan). Other medications used are Maalox, Mylanta (or similar O.T.C. ) which coates and temporarily relieves the discomfort of reflux, and Carafate which coates and allows the healing of the stomach and esophagus while preventing further damage. Most often Gastroenterologists reccomend that Adult Strenght Mylanta/Maalox be given rather than Children's Mylanta which has been shown to aggrivate reflux, ask your GI for more information. If, after careful consideration, the medication fails then surgical treatment may be indicated.

Adapted from http://riic.org/ Well, now that the reflux is settled..he suddenly refused enfalac anymore and started making this wanting to throw up sound...baby, kenapa ni?!! ...and so we decided to change his milk to S26 gold...hmm...imagine that yea.....it never occured to me that I would have to change milks for Ridhwan to ensure no more spitting up and of course that there will be a time he would refuse certain types of milk...but luckily my midwife Ai Ling said that this condition is quite normal and she had met babies with worse condition with refusing milk altogether even before they are ready for solids...well, Ridhwan is soon to be 5 months and then 6...so Insya-Allah when that time comes Ridhwan will still enjoy his milk and of course his solids even more...but for now as long as he still drinks milk even when I am 'bergeluting' with him at times....that's all that matters cause in the end seeing my baby happy is what makes my day....

Ayah suapkan susu..nyum..nyum...