Prilosec Questions

[Anonymous]

First off I wanted to say thank you to everyone in this
forum. I have been browsing the forum
the past couple weeks and have received so much helpful information and
encouragement!

Our daughter is three weeks old today (11/21) and the
doctors (Pedatric Ear Nose and Throat, and Pediatrician) think she has GERDs/silent reflux.
My wife is breastfeeding and we have started her on the no dairy, soy,
or beef diet on 11/14. The pediatrician
suggested to skip Zantac and suggested to start her on Prilosec. We were prescribed and started giving her Prilosec
on 11/18. On 11/18 she weighed 7 lb 12
oz. Our pediatrician prescribed the
liquid Prilosec made by the pharmacy. The
prescription says Omeprazole-Sodium Bicarbonate 20-1680 MG Pack and is in a 2mg/ml
concentration. The dosage is 2 mls one
time a day, so she is receiving 4mg each day.
We are also giving the Prilosec 30 minutes prior to her feeding. After her first dosage from Friday night to
Saturday afternoon at 12:30PM, she had no reflux symptoms (no screaming in pain)
and we thought the acid production had been reduced. But that was the only time since Saturday
afternoon that we have seen improvement and the screaming after refluxing has
returned to what it was prior to taking the Prilosec. But we are giving it and the elimination diet
two weeks per the suggestions on this board.
With this said, I would love to receive your feedback/thoughts on any of
the above and a few questions I had.

I’m concerned about the dosage. It seems to be low based on the
concentrations suggested on this forum and I don’t want to spend two weeks on a
low dosage and then have the pediatrician say that the Prilosec didn’t work and
so we need to move on to a stronger medication, when it might have been that
the dosage was too low.

I’m also wondering about the frequency. Is it better to split this into multiple
administrations per day?

I read here that the tablets and solutabs require the 30
minutes rule, but does this also hold true to the liquid Prilosec?

Also, I read in one of the threads that liquid Prilosec is
not worth doing, but is there an alternative form to giving Prilosec to a three week old?

What is the best way to give her the liquid Prilosec?
She cries (probably due to the terrible
taste) and then we are challenged with preventing her from inhaling and choking
on the liquid. Right now we are giving
it to her at 4 drops at a time (so she doesn’t choke on it), hold her up to
allow her to swallow, and then give her four more drops. But since we have to give her 2 mls, it takes
about 10 minutes to give her the entire amount.

[hellbennt]

I’m answering from my phone, so I can’t be too detailed. Zegerid. Go to search & look up zegerid mixing instructions

Dose is way too low.

Read Prevacid 101.

Read ‘stickies’ in the Medicine Forum.

In the meantime, I’d give zantac, too, seperate it by 4hrs from the prilosec. Theres a link to zantac dosing in Prevacid 101.

[hellbennt]

I don’t know about the prilosec packets- this is the second time I’ve ever even heard of it & I’ve been on this board eight years…I’d research zegerid, because I personally (my son!) had great success w/ what is no longer available – a product called caracream-the same research team developed ZEGERID & then sold it off…long story short, I trust anything & everything that comes from the research at the University of Missouri (you may see it also referred to as marci-kids on this site)

Was your baby ever prescribed zantac? pepcid? when switching from a H2 blocker (Zantac, Axid, Pepcid, Tagament)

to a PPI it is important to KEEP GIVING THE H2 bolcker!!!! Because if you do not, it is as if your baby isn’t on ANY meds AT ALL. No one told me this and I learned the HARD WAY: my baby shrieked/howled for 24hrs straight and LOST HIS VOICE!!! It is SAFE to give both meds, just make sure to space them 4 hrs apart.

Here is where to check the highest dose by weight:

Zantac dosing– my/other’s question (has axid & pepcid doses, too):

https://www.infantreflux.org/forum/forum_posts.asp?TID=8288&PN=1

I would continue w/ the zantac/rantidine- just make sure you give highest dose for weight and give 4hrs from the PPI

as for the compound- theoretically it can be given at any time, not timed around meals.

check the PPI dose here:

https://www.infantreflux.org/forum/forum_posts.asp?TID=2668

and, if you must go the compound route, read here & TELL THE PHARMACIST how to do it:

***How to ASK for PPIs to be Compounded (condensed version):

https://www.infantreflux.org/forum/forum_posts.asp?TID=4505

and another ‘condensed’ version:
https://www.infantreflux.org/forum/forum_posts.asp?TID=7855&TPN=1

And the ‘long version’ (Scroll down to purple posts): https://www.infantreflux.org/forum/forum_posts.asp?TID=3104&a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;a mp;TPN=1

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

also: why are you suspecting your wife’s diet? It may or may not be something in her diet. ME, yes, I did do the TED (Dr. Sears Total Elimination Diet) because I was DESPERATE. This way (TED), you eliminate all at once and not one thing here, one thing there. If your wife is eliminating dairy & soy, be sure to look at HIDDEN ingredients!

Milk protein and soy protein can hide

Reasons a breastfeeding mother MIGHT think her baby is reacting to something in her milk:

*poop that is not ‘normal’ mustardy yellow, seedy breastfed baby poop

*mucous in poop; mucous can look like: snot, jelly, cottage cheese, stringy like the inside of a banana

*foul-smelling poop

*stinky, foul-smelling painful gas

*straining and grunting to poop and, when baby finally does poop, it’s soft

here’s some more light reading for you :

MSPI ‘Main’ page:

https://www.infantreflux.org/forum/forum_posts.asp?TID=2697

best EXPLANATION OF FOOD ALLERGIES/INTOERANCES and their RELATION TO REFLUX that I have found, to date: 2nd post: https://www.infantreflux.org/forum/forum_posts.asp?TID=2697&PN=2

Misconceptions about how Neocate & Elecare work: https://www.infantreflux.org/forum/forum_posts.asp?TID=6013

THIS IS REALLY IMPORTANT:

Erin‘s sticky: https://www.infantreflux.org/forum/forum_posts.asp?TID=12948&PID=105126#105126

More Erin: https://www.infantreflux.org/forum/forum_posts.asp?TID=13175&PID=106395#106395

Erin post: https://www.infantreflux.org/forum/forum_posts.asp?TID=13576

Great anne post: https://www.infantreflux.org/forum/forum_posts.asp?TID=9242

Exposure to foods & blood testing: https://www.infantreflux.org/forum/forum_posts.asp?TID=12993

Sheri’s allergy/intolerance explanation: https://www.infantreflux.org/forum/forum_posts.asp?TID=10223&PID=87638#87638

Another Sheri explanation- intolerance/allergy post:

https://www.infantreflux.org/forum/forum_posts.asp?TID=11579&PID=97442#97442

Accuracy of allergy testing & great post by sherri explaining IgE and IgG (intolerance/allergies) https://www.infantreflux.org/forum/forum_posts.asp?TID=10815

(sue again, replying to gina- breastfeeding info to (TED)https://www.infantreflux.org/forum/forum_posts.asp?TID=11324&PN=1

probiotics, brands used:

https://www.infantreflux.org/forum/forum_posts.asp?TID=8970&PN=1

erin posts that mentions enzymes:
https://www.infantreflux.org/forum/forum_posts.asp?TID=12781&KW=enzyme

https://www.infantreflux.org/forum/forum_posts.asp?TID=12610&KW=enzyme

https://www.infantreflux.org/forum/forum_posts.asp?TID=12227&KW=enzyme

Post from me:
https://www.infantreflux.org/forum/forum_posts.asp?TID=12200&KW=enzyme

hellbennt2011-11-21 14:05:07

[Anonymous]

Thanks for the quick responses! I hadn’t read all the medicine stickies and they were very helpful.

I talked with the pharmacy and they verified that the prilosec compoud solution they made us had 8.4% sodium-bicarbonate and not the 16.8% recommended by U of Missouri. So it seems that the omeprazole was being degraded by the stomach acid.

So rather than trying to get qa pharmacy to make a Prilosec coumpound solution with 16.8% sodium bicarbonate, we’re going to start using Zegerid. So I’ve put a call into our pediatrician for approval of the Zegerid Powder for Oral Suspension.

I’ll keep you posted with how things go.

[hellbennt]

you NEED the 40mg packets!!! Even if you tell your dr you’re going to throw it out (you won’t!!!) tell her/him to please humour you & RX the 40 mg packets! good luck!

[Anonymous]

The pediatrician got back to us didn’t know anything about Zegerid and wouldn’t prescribe it. She did say we could start increasing the dosage of the Prilosec compound. So yesterday we increased the dosage from 2mg twice a day (4mg total) to 4mg twice a day (8mg total). It seems that the pain due to the refluxing in decreasing, but I have noticed she is experiencing increase due to gas build up. She’s crying different than when she refluxes and her farting has substantially increased.

Pediatrician also set up an appointment with the Ped GI specialist for Monday the 28th! This is good news as the Pediatrician was reluctant to send us to a Ped GI specialist at first. Last night I created an 8 page explanation of Zegerid from all the posts of this forum that I’m going to present to the Ped GI on Monday. So thankful for all those who spent time providing information on this forum. I’ll let you know what the specialist says.

[hellbennt]

yay! our ped GI got on board! this was 8 yrs ago! good luck!

(ps it’s not like you’re asking for anything outlandish! just another form of the same drug, prilosec…) AND: Dr Philips will even speak w/ your ped GI if need be…

[Anonymous]

Had appointment with Ped GI today. Our LO happened to poop while the Dr. was in the room while we were changing our LO’s diaper and she said the poop looked too runny and is suspecting a MSPI allergy. This makes sense as I have a significant number of food allergies and was allergic to cow’s milk growing up. We thought we were on the Total Elimination Diet for the past two weeks but didn’t realize all the things to look out for, including, casein, tuna, margarine. We now have an exhaustive list of milk and soy products not to eat and will start another two weeks of this diet today.

Dr. said we should continue with the PPI and was familiar with Zegerid, but did not feel comfortable prescribing it for an infant. We told her our LO can’t stand the taste of the omeprozole compound and she suggested we start the Prevacid solutabs. After the appointment, I went home and researched Prevacid solutabs only to find that the solutabs have lactose in them which something my wife can’t ingest since she is on the Milk Free Diet!

So I have sent the doctor this info and my write up on Zegerid and we wait to see what she says.

By the way, the omeprazole compound is currently at 10mg/day and seems to be helping her reflux. We just need to find a way to administer the omeprazole in an easier manner.

On the gas front, I noticed that the simethicone drops say “Natural Flavorings” which are also on the list of items that my wife can’t ingest since she is on the Milk Free Diet. So we need to find a simethicone, or gas relieving medication that does not have natural flavorings. CVS brand, Mylicon, Little Tummies, and Pedia Care all have natural flavorings.

Does anyone know of a simethicone that doesn’t have natural flavorings? Does anyone know of anything else besides simethicone we could use for gas relief?

[hellbennt]

well…some mspi babies do fine w/ solutabs because they have lactose which is milk sugar, not milk protein. also it may be fine to have some natural flavorings, too, for the same reasons. I really encourage you to read through the links (above) for information (probably information overload! ) & some ideas- your wife isn’t the first to go through this and there have been others who have documented their journeys here- there’s even a TED forum

sounds like you’re on a good path!

you could even have dr p contact your doctor…

email dr philips Dr. Philips: [email protected]

and/or call the office: (573) 884-0672

[Anonymous]

We decided not to take the chance on the Prevacid Solutabs in light of her potential MSPI and kept her on the prilesec compound. My wife found a new way to administer it to her and the prilesec has solved the reflux. She will still fuss and cry some with this new method, but it’s not the same screaming and choking scenario that she did before. The key was NOT to hold her head still while we give her the meds. Apperantly she was screaming because we were holding her head still rather than the bad taste of the meds. We also add the simethicone (Little Tummys) in with the prilesec which masks some of the bitterness.

So between the manual gas release, see this thread https://www.infantreflux.org/forum/forum_posts.asp?TID=14653&PN=1, and the prilesec, she’s doing very well. Thankfully!

We still have a few more days left on the 2 week TED to determine if it’s an MSPI that is causing the reflux.

Eric2011-12-08 11:02:27

[hellbennt]

when your wife is ready to stop the TED, I recommend adding foods back in slowly. Me, I didn’t have all the information that’s available now, so silly me, I went full force & drank a glass of milk. THANKFULLY my baby wasn’t mspi! BUT, if he was, it would have taken another full 2 weeks to get that glass of milk out of my system. The way to do it is to eat dairy as a hidden ingredient, like milk as an ingredient IN things…adding foods back in must be done slowly, so you know what’s affecting the baby. I would add something new in the morning – it takes about 3 to 4 hrs for the proteins to get to the milk. example: 10:00 a.m. wife eats eggplant then baby eats at 1:00pm or so. It’s not until after THAT feed that you’d notice behavior and poops…I only mention eggplant because my lo couldn’t tolerate it- also couldn’t tolerate tomato products- but I had to figure it out one by one…eggplant is an odd one, though…I’d start w/ wheat maybe or corn? like cornflakes?

you know if the TED is working if poops are normal seedy/mustard breastfed baby poops…

[Anonymous]

Hi–

I wonder if you could talk more about your new method of giving the Prilosec solution? Was it just not holding LO’s head or did you manage to get your Prilosec mixed differently?

[Anonymous]

Also–

Is anyone still in contact w/Dr. Phillips now that reflux solutions is gone?

AND is it possible that the 8.4% bicarb solution will work as long as you don’t count on a long shelf life??

[Anonymous]

jbird wrote: Hi–

I wonder if you could talk more about your new method of giving the Prilosec solution? Was it just not holding LO’s head or did you manage to get your Prilosec mixed differently?

When we stopped holding her head in one place and her her hands down she went from screaming with multiple chocking per dose to crying with an occasional chocking. We didn’t end up mixing the prilosec differently. We still give her the compound at a 2mg/ml omeprazole concentration in 8.4% sodium bicarb

Our biggest challenge was to learn how much we could give her without her chocking on it. We started giving her 0.3mls at a time and as time has gone on she has learned to take more, so now we give her 0.5mls at a time.

We found that if we give it to her under her tongue, she more quickly swallows it.

We basically give her 0.5 mls under her tongue, talk to her and console her until she settles down and swallows, and then give her 0.5mls more…..until it’s gone.

We have also found that it is difficult to give her the medication when she is sleepy because she doesn’t swallow it and lets it sit in her mouth.

I know how difficult and taxing it is. I hope you find out a system that works for you and your LO.

[Anonymous]

Thank you so much–

We’ve been doing okay with giving our LO her meds, but as of yesterday she has a new trick (no crying, just holding in her mouth then spitting out!) so we’ll definitely try the under the tongue method!

I’m encouraged that you’ve seen positive results while staying with the 8.4% bicarbonate solution. Our pharmacy can’t make a 16.8% formula, so we’re a little stuck. Ped upped her dose (from 2.25mL 1x day to 2mL 2x day–10mg/5mL mixture) and said to give it a little more time before considering a meds switch. We are continuing Zantac 2x day in the interim, but I really don’t want to be forcing her to take meds so often–ugh.

Can’t wait to have just one medicine that does the trick!!

Anyone have advice on how to ease off the Zantac and when?

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