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Twins with Infant reflux
Needing support for twins with reflux? Then you have come to the right place! Infant reflux (also known as pediatric (paediatric) reflux or GERD) is common in sets of twins simply because many twins are born prematurely or have low birth weights.
There are lots of Moms out there looking for support in coping with twins who have reflux because as we all know, looking after an infant with special needs is very hard work, let alone two infants who need the attention. WE UNDERSTAND!
TwinMum (an established member on this site) has shared her experience of having twins with reflux here. She is active on our message boards and is happy to help with any questions a twin mommy may have about coping with twins with infant reflux!
Her article also includes reflux sites she has found useful, along with twin sites that have valuable information and resources available. This article certainly reflects the many highs and lows that you can expect from having twins with reflux!
PLEASE READ ON!
Twins with Reflux & Our Experience
Our journey into parenthood and the reflux journey all began on New Year's Eve, 2004, when our twin sons, Matthew and Stephen, were delivered via c-section at 34 weeks gestation. Stephen arrived first and weighed in at 4 lbs. 6oz. Matthew followed closely behind and weighed 4 lbs. 9 oz. They went straight to the Neonatal Unit and remained there for almost 3 weeks.
The reason for being in the Neonatal Unit was purely for them to learn how to feed and to grow. We were fortunate that they had no significant medical issues. Stephen had a high blood cell count and a problem with his liver. He was also diagnosed with a heart murmur. These were, however, all things that in time will resolve themselves. The reflux was not diagnosed until they were at home, at the age of about six weeks.
It took us a while to figure out what was going on&. In the hospital they took forever to feed (they were on expressed breastmilk and formula via bottles), but of course this was related to their prematurity. At home we had the same difficulty of very long feed times, but it was now accompanied by screaming following the feeding. The boys were always difficult to burp, Matthew in particular, and so we always put it down to colic and gas. Of course, our outreach nurse enlightened us to the term reflux and gave us some Infant Gaviscon to try.
The issue was on-going and Stephen wasnt really gaining weight very well so our family doctor put them both on Gaviscon. I like to be holistic and to try natural things too, so I started using the tried and true gripe water. I used this for nine months and found it to be a wonderful product!
Having two newborn babies with reflux was very difficult, and thats putting it mildly. In those early days, they were feeding every three hours but taking two hours to feed. (Thats feeding one boy after the other). I was trying really hard to give them time to bring up their wind so they would be more comfortable and settle better. Of course, this meant significant sleep deprivation. Forty-five minutes sleep in between feeds is not very much, especially when youre doing it week after week.
The stress this deprivation caused in our home was hard. It was difficult not to snap at my husband and vice versa. I had several meltdowns in the microwave and even had one little explosion, all from not paying attention and being too bleary-eyed to see the digital display. Not adding water to the bottle sterliser also did significant damage. Luckily, no one was hurt and we did have a good laugh after the fact.
Other parents of twins thought we were crazy feeding one boy after the other and said to feed both at once. "Put them in their carseats and give them the bottle at the same time. Its much quicker! they all said. I tried that and what a stressful and time-consuming event that was. Matthew started out great, but straight away Stephen started gagging and the milk was going everywhere. In order to sort him out, I had to stop feeding Matthew. He didnt like that, started screaming, and then when I reintroduced him to the bottle, he didnt want it. SIGH. So, it was back to feeding one after the other for us.
My husband always said I had these hair-brained schemes with the boys feeding. But I was really willing to try anything to help my sons feed better and lets face it; by this time I was exhausted and desperate! We tried numerous brands of bottles and several types of teats. I even bought ones from overseas via the internet. Did I say I was desperate? It cost us a small fortune and I ended up with a cupboard full of unused bottles! The boys were on different formulas too, as neither of them tolerated the same one. The trial and error phase , as I call it, was very frustrating and we couldnt change too many things at once, otherwise we wouldnt have known what was actually making the difference.
I think the hardest thing about having twins with reflux is the crying, or should I say the ear-piercing screaming! It seemed to never end. You would get one of them sorted and settled and the other one would start, so there was hardly any quiet time in our home. They often screamed together and that was even worse, as it was so difficult to comfort them both at the same time. I am a stay-at-home-mom, and my husband returned to work almost straight away after the boys were born. Thus, I bore the brunt of the continuous crying. It really gets on your nerves& feed and cry, feed and cry& all day long. And all night too.
The boys did get into a better phase when we began 4 hourly feeding and it really made such a difference to us and our sanity. Matthew started proper medication at six weeks. Unfortunately, the trial of Zantac did not help, so we were introduced to Prilosec (Losec) or Omeprazole (which helps to reduce the production of stomach acid) and Gaviscon (which helps to coat the stomach and to keep the formula down). This combination worked very well for us.
At six months, the boys started sleeping through the night properly, and by nine months they were doing well with solids, which meant the medication was much easier to give. Previously, the Prilosec had been given as a compounded medication, so it was a liquid suspension that wasnt overly-stable, and had to be made up every two weeks. The taste was foul and it was hard to get into him. Once Matthew was on solids properly, we were able to give it via his food. We used to break the capsules and put the beads in his food.
At twelve months we had a bit of a set-back and the medication dosage wasnt enough for Matthew anymore. The dose was doubled and the reflux symptoms disappeared again.
Since then, we have had several trials of reducing the medication, each time being unsuccessful until about three weeks ago. At twenty months old, we have managed to half his medication, and we certainly have significant hope that this experience and journey of reflux may soon be behind us. Of course, I always get my hopes up, only for them to be dashed. So, were taking it one day at a time.
Stephen had minimal periods of reflux and he was luckier, because it did not bother him once he started solids, and apart from the odd period of gagging on thin liquids and vomiting here and there, he has been mediation free since six months.
When your children are sick or have special needs, I think it is natural to look for answers as to why us? . I felt guilty that there was something that I did or did not do when I was pregnant. Hence, I got on the internet and searched for clues as to why they would have reflux. There were several possibilities. They were twins, they were conceived via IVF, they were premature, and they only had breast milk for 3 weeks. Did this make any difference?
TWINS:
There is no research to prove that being a twin (or any multiple in fact) would contribute to having reflux. Having twins, though, increases the chance of your baby having reflux, as reflux occurs in approximately 50% of infants. Thus, by having 2 babies at once, you are increasing the odds of one or the other having reflux. The other complications that can occur with twins, such as low birth weights and prematurity could also be factors.
PREMATURITY:
Up to 85% of premature infants have an increased risk of developing symptoms of GER. In pre-term infants, the most common causes for this are immature muscles and abnormal breathing from chronic lung disease. If the lower esophageal sphincter is weak or underdeveloped, it can remain open when it should be closed, letting the stomach contents flow back up the esophagus. When an infant or child breathes abnormally because of chronic lung disease, the muscles used for breathing work harder. As these muscles work hard to breathe, they can pull on the muscles near the top of the stomach, stretching the sphincter and causing it to remain open.
IVF/FERTILITY TREATMENT:
I have not been able to find any research or data that shows that the drugs used in IVF treatment can cause reflux. The embryo and fetus develops normally, as any other naturally conceived embryo/fetus. The rate of congenital and other disabilities and disorders is the same in IVF conceived children, as it is in the normal population (that is, naturally conceived children).
A 2004 systematic review sponsored by the American Academy of Pediatrics, the American Society for Reproductive Medicine, and the Genetics and Public Policy Center at Johns Hopkins University concluded that children born from IVF were at no higher risk of developing cancer, disabilities, or mental disorders than their naturally conceived counterparts.
BREASTFEEDING:
Again, I have not been able to find any data that suggests by not breastfeeding the boys, I have caused their reflux. It is obvious that any infant has a tolerance for some formulas and not for others. Just like some things a mother eats affect the breastmilk and some babies have allergies to what is being passed on through this milk.
I guess by doing all of this research, it has helped me to alleviate some of the guilt that I felt when I thought that I had in some inadvertent way caused all of this.
The joy of having twins is immense, but the reflux journey certainly adds a different dimension to the parenting experience!
In my searching, I found some very helpful websites. I have listed them below.
Twins related websites:
(includes twins with reflux stories/questions)
http://forums.twinstore.com/eve
http://www.twinsmagazine.com/
http://multiples.about.com/
http://www.twinshelpstore.com/
(Check out the resources section.)
http://www.kapimanamultiples.org.nz/profiles.html
Written by: TwinMum, Sarah
Read more about Reflux Information:
Colic or Infant Reflux?,
Asthma and Infant Reflux / GERD - A Definite Connection,
Conditions that Mimic Infant Reflux,
Reflux and Dental Problems,
Reflux and Speech,
Can Infections be Caused by Reflux?
»View all articles«
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