Twins with Reflux, how it all started….
When our twin girls were born at 32 weeks and whisked to intensive care the only thing on my mind was ‘please let them be ok’. They did have some breathing and feeding issues but finally came home after 5 weeks in intensive care. Those 5 weeks were amongst the longest in my life! Very little had prepared me for what was to come after that. They were my first babies and I was pretty clueless. My first nappy change had happened in intensive care and I felt very clumsy and scared to handle those tiny and delicate little humans.
When the incessant screaming started for hours on end and long into the night, every day and every night neither my husband nor I thought we would survive this. We were past 40 after all and already quite old for sleepless nights! I spent their sleeping hours googling frantically about screaming babies and came to the conclusion that they had colic. Every feed was a disaster. They screamed, they arched, they contorted themselves in every possible way. I spent 45 minutes burping each baby after every feed, alternating between the two. By the time I had finished feeding, changing and burping each baby I had a 30 minute break before starting again. It was quite horrific. I assumed that was just what happened with twins and used gripe water and colief to relieve the symptoms. It worked to some extent.
The twins with reflux diagnosis
Then came the night when it all began in earnest. I still remember that night quite vividly. They were already around 10 weeks old (2 weeks adjusted age). It was a Saturday night and my husband and I had just finished feeding the girls (on the weekends it was a joint effort!). Both of them were screaming their lungs out. My husband was pacing up and down the room with one of the girls burping her on his shoulder when suddenly her entire feed projected out of her mouth across the room. We looked at each other in horror. What on earth had just happened? Was she sick? We called the doctor on the night line, she advised us to come in the next day if it persisted or go to A&E if she carried on vomiting. They both screamed for 5 hours straight. My husband then went away on a business trip for several days and called me to say that he was scared of returning. I could not even blame him for saying that, the whole thing was just beyond description.
It happened again the next day, after every 2nd feed, sometimes more. My other twin girl then started doing the same thing, albeit less violently and less frequently. Every piece of clothing, the bouncers, the carpet and the sofa was covered in some kind of vomit. I turned into a robot, just trying to plough through it all and not go insane. I had no idea how to even make it to the doctor but eventually did. The GP diagnosed severe reflux and prescribed Zantac for both of them. The Zantac did not stop the vomiting, it just dealt with the pain and discomfort. It was so bad that my smaller twin even had an ultrasound to check if she had intussusception (blocked intestine). She thankfully didn’t. I was advised to feed them small quantities, more often and to feed again if they vomited the whole feed since one of them was not gaining enough weight. I had to double my breast pumping volume to keep up. I spent every spare minute that I was not feeding or pumping doing laundry or cleaning carpets. Until they were 6 months old, this was what happened every day. It was unbelievably hard but we got through it. Our routine became: feed, burp, change, clean up vomit, feed again, wash everything. Start again. Vomit just had to be incorporated into the routine and we got used to it.
When did it stop?
My paediatrician advised me to start solids early at 4.5 months to make sure that the food would stay ‘down’ better. It did. As soon as we started adding cereal into the equation, the vomiting frequency decreased and it got better still when we introduced proper solids at 6 months. My bigger twin stopped the Zantac at 4.5 months and was no longer vomiting, my smaller twin carried on the medication until 9 months old. Her projectile vomiting pretty much ceased at 5 months but the reflux symptoms did not actually disappear until later. She was still experiencing visible pain and arching until 7-8 months.
How do you know if you have twins with reflux?
Twins are much more prone to reflux then singleton babies because they tend to be born early. This means their digestive system is often still underdeveloped. Premature twins (prematurity being twins born before 35 weeks) have a very high risk of reflux. Not all forms of reflux result in vomiting or spitting. Some babies just experience ‘silent reflux’ but are still in pain. The signs to look out for are:
- Heavy discomfort during and after feeding (relentless crying, screaming, restless)
- Back arching or contorting of the body
- Heavy spitting and/or vomiting
- Refusing to eat, not gaining weight
What helps with twins with reflux?
If you are experiencing any of the above signs with your twins, make sure they get checked by a paediatrician. The biggest help for the pain reflux causes is medication (you may need to try out a few before finding one that works). Other than medication I have found the following things helpful:
- A little Woodwards Gripe Water 150ml” target=”_blank” rel=”noopener” data-wplink-url-error=”true”>Gripe water before and after feeding
- Breastmilk is apparently better digested than formula so stick with that if you are able
- Sleeping upright (or definitely not flat)
- Small feeds, lots of burping during and after feed
- I found that the vibration of the Fisher price bouncer helped them with the digestion (better than burping even)
To get your twins to sleep upright you can buy a baby wedge for the cotbed such as the The Wedgehog® Baby Wedge for Reflux and Congestion (Cot Bed – 70cm Reflux Pillow) – includes Reflux Support Membership . These do work to some extent, however our twins kept sliding down to the bottom of the cotbed so you need a way to harness them so that they don’t slide. A good product that seems to now exist is a wedge with a 3 point harness. Whilst I have not tried it out as it did not exist, it has very good reviews. You can buy the Clevamama ClevaWedge with 3 Point Harness here.
A reflux baby will often wake up at night from because the lying position is the worst for reflux. The acidity of the reflux will hurt your babies’ oesophagus and throat and that’s very uncomfortable. Consequently, don’t expect your reflux baby or babies to sleep through the night without waking up and avoid large feeds before sleeping. A reflux baby will just have to continue with smaller feeds for longer.
I know this post may sound scary and horrifying. Having Twins with reflux was not easy but I got through it. Most cases are not as severe as the one we experienced. Motherhood is always a challenge and some experiences are more challenging than others. In the end, when you look back it doesn’t seem half as bad as it was and we now laugh about our famous ‘vomit rug’ (we purchased a mustard coloured rug to hide the stains). The essential thing to remember in those situations is that reflux, even if physically challenging for the parents, is not all that dangerous unless it causes serious complications. And if you really are struggling, make sure you get some help!