It's perfectly normal for your baby to vomit after a feed. Don't worry - you're just too kan cheong or anxious.
That was what everyone told first-time mummy Geraldine Tan (not her real name) when her then two-month-old daughter kept vomiting everything she took in.
Born two months premature, little Kayla (not her real name) suffers from gastroesophageal reflux disease (Gerd), a condition more commonly associated with adults.
Like grown-ups, babies who suffer from Gerd feel pain and discomfort when food and gastric acid in the stomach backs up into the oesophagus.
"In the early days, everyone, including doctors, told me she was fine. They said I was overreacting because Kayla was my first child. But they didn't see what was happening at home," she recounts.
"It wasn't just normal spitting up. We're talking about projectile vomiting. On bad days, my baby would vomit up to 30 times a day, throwing up everything she took in - even water."
At first, Geraldine tried to cope with Kayla's constant spit-ups on her own. She kept several spare mattresses and bed sheets at home so she could easily swop one for another when Kayla vomited on them.
When they go out, they would have at least three sets of clothes for changing.
WORRIED THAT BABY WOULD CHOKE ON HER VOMIT
During that time, Geraldine hardly had a night of proper sleep. She was too worried that Kayla would choke on her own vomit.
Even with a domestic helper around, Geraldine almost worked herself to exhaustion caring for Kayla.
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She remembers how, despite giving her baby small, frequent feeds - think a teaspoonful of fluids every five minutes - Kayla continued vomiting, which left her so dehydrated that she had to be hospitalised when she was six months old.
Without family support and a severe lack of sleep, Geraldine began spiralling into depression. No one took her seriously when she told her family about her child's condition. "They told me to live with it," she says.
Even her husband felt she was too anxious. Whenever Geraldine took Kayla to the doctor's, he would get upset. He felt she was subjecting their daughter to too many unnecessary medical check-ups.
A MOTHER'S INSTINCT PROVEN RIGHT
"I was really lost and living in denial," shares Geraldine. "On one hand, I kept telling myself that Kayla would outgrow it. But my maternal instinct also told me it wasn't that simple."
She was right. When Kayla was 18 months old, a doctor referred her to a specialist at National University Hospital (NUH), who diagnosed her with Gerd.
By then, Geraldine estimates that she had taken Kayla to see more than five different doctors.
"I was so depressed until I met this doctor, who taught me how to better manage her condition. The doctor really saved my life, as well as Kayla's," says Geraldine.
She also found a local support group comprising parents with children who have the same condition.
Now three years old, Kayla is still feeling the nasty effects of Gerd. She's currently on daily medication that stops acids in her stomach from overproducing.
Unlike most toddlers who can happily munch on tasty, crunchy snacks, Kayla's regular diet consists of milk, porridge, soups and prescribed rehydration fluids.
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Having experienced Gerd most of her life, her stomach and taste buds have become very sensitive to textured food.
"She gags on anything that has texture or a stronger taste, so she can't handle school food. She's better now, though. Recently, she started to chew a little. We gave her some biscuits and french fries," says Geraldine.
Because of her special dietary requirements, Kayla can only attend half-day preschool.
At mealtimes, she has her own special lunchbox. Usually, it contains a soupy dish lovingly prepared by mummy and a packet of milk.
"I'd love for Kayla to attend the full-day programme at school, but I simply don't have the time to prepare enough meals to last her through the day," says the 36-year-old, who runs her own business.
Ensuring that Kayla doesn't become malnourished is a delicate balancing act. At her age, she's on the lower 20th percentile of the growth chart.
"In addition to feeling terrible when she's ill, she has to cope with vomiting, too," Geraldine laments. Recently, Kayla had a bad bout of stomach flu, with vomiting and massive diarrhoea.
"She lost a kilo very quickly. Bear in mind that helping her to gain back that kilo would take about a year!"
AT THE DOCTOR'S, AGAIN
Even so, Geraldine has come to terms with Kayla's condition.
"I still feel very depressed and down whenever I see her all skin and bones, especially after a bad bout of illness.
"But with each hospital visit, I've come not to resent Kayla's condition because there are so many children whose condition is worse than hers," she says.
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Although her doctor can't say if she'll eventually outgrow Gerd since every child's condition is different, Geraldine notices that her daughter's plight has improved.
"The low point is no longer that low. She seems to be getting better. Previously, she'd be vomiting every day. But, now, she can sometimes be vomit-free for two weeks," says Geraldine.
Her husband finally realised that she had grounds for "overreacting" and apologised. However, Geraldine says she no longer confides to anyone about her daughter's condition, unless another parent in a similar situation needs help.
"I don't want to be seen as too depressing. After all, I've lived with this for so long that I can now manage it on my own," she says wistfully.
For Geraldine, this experience has put her off any thoughts of having another kid.
Kayla, she adds, will be her "first and only" child. "One reason is I had some pregnancy complications. Plus Kayla's condition is tough enough for me to manage. I don't think I'd want to go through all that again."
This article was first published in Young Parents.