Infantreflux.org | Timing of PPI - WWYD?

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September 23, 2006 at 8:16 pm #14153

Anonymous
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My DS is back on a PPI. This time we’re trying Prevacid solutabs, which we dissolve in a syringe of water. I was really surprised that our new GI doc felt that timing of the meds around food wasn’t necessary. He said that keeping a constant level in the body is more important. Since I trust him on every other issue we’re dealing with (he specializes in kids on the autistic spectrum), I just decided to nod my head and time it around b’fast anyway.

So here’s the ‘problem’. DS wakes up pretty early (5:30-6a) and typically gets a bottle of almond milk (he has cow’s milk intolerance), and then b’fast isn’t until 7:15-7:30ish. So I’ve been giving him the Prevacid immediately upon waking, then waiting 30-40 minutes for the almond milk, then b’fast ends up being over an hour after the meds. I also hate having to rush in as soon as he wakes up (he’s often content to play in his crib for a bit), so that he doesn’t have to wait too long to get his bottle, KWIM?

Almond milk is significantly lower in fat and calories than regular whole milk. He drinks ~6oz, which is only 45 calories and <2g fat. So … does anyone know if I can give him the almond milk, THEN the Prevacid, THEN b’fast 30-60 minutes after the meds?

Hope this all makes sense. Feels like I typed an awful lot for a pretty simple question.

September 23, 2006 at 9:08 pm #14154

Anonymous
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Hmmmm….I see your dilemna.

Well, ideally you are supposed to give it on an empty stomach and follow it up with a full meal 30 minutes later. I read here that Joel said the closer to 30 minutes the better. Since the almond milk is so low in calories and fat maybe it would work to give him his bottle first, then the prevacid an hour later, (I’d wait at least an hour) then the full meal (breakfast) 30 minutes later. I really don’t know but I think it’s worth a try it as it may make your mornings a little easier.

Is he getting Prevacid only once per day?

Where do you get Almond Milk? I’ve been looking for some for Myles. Is it available online?

September 23, 2006 at 9:35 pm #14155

Anonymous
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We are in a similar situation with the prevacid.

The morning dose is ok, but then we added a second dose for the afternoon. The am dose is usually around 8:30 when he wakes up. The second dose doesn’t fall good timing for before lunch. If I give it at 12:30, he eats lunch at 1 which falls too close to his naptime.

In some situations, I think it’s just important to get it in them. It has to be doing something for them.

In my opinion, I’d go for the earlier dose for your DS. It’s still controling the acid for his meal later. Just my opinion of course.

September 23, 2006 at 9:53 pm #14156

Anonymous
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Is there anyway you could give him the almond milk with breakfast?? Then you could give him the prevacid 30 min. before he eats. Otherwise, I agree with Christine, in waiting at least an hour.

September 23, 2006 at 10:22 pm #14160

Anonymous
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The timing of the meals really doesn’t have anything to do with how much fat or calories in in the milk. If he has had the milk, the larger the volume of the milk, the more proton pumps will be activated. It doesn’t matter if this is low fat milk or whole milk, or any other kind. But that being said, I know how hard it can be to time the meds, so I’d say to just do your best, and see what happens. Good luck.

September 23, 2006 at 11:27 pm #14165

Anonymous
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have you considered zegerid?

September 24, 2006 at 7:08 am #14167

Anonymous
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Wow, thank you for all the great responses.

Christine – I get the almond milk at my local health food store, or at Whole Foods. Our supermarket carries it too (Giant and Clemens both), but it’s much more expensive there. I think Trade Joes also has it.

Heather – He will only drink milk from a bottle, and only water from a cup. He’s a stubborn one like that, but I’m not planning to worry about the bottle issues until he’s 2yrs. I’ve been offering him Vanilla Almond milk (much tastier) in a sippy after dinner, he will drink some since it’s so yummy, but not very much, maybe 2oz. He gets mad if I put anything other than water in his sippy during a meal. The other problem with giving milk w/ b’fast is that I don’t want to be making him b’fast at 6am … seems too early, plus he’s usually not inerested in food right when he wakes up anyway.

nataliachik7 – Last go around, we settled on Zegerid after Prevacid didn’t work for us … 1st the compound kept going ‘bad’ and then I couldn’t get the timing of the solutab right and it just seemed like Nate was miserable all the time. What I know now that I didn’t know then is that Nate has an autistic spectrum disorder (PDD-NOS) that was causing him to ‘zone-out’ all the time, not answer to his name, etc. Once I stopped vaccinating him, things slowly got better, but there have been so many variables affecting how he feels. He also has ulcerative colitis .. he has ulcers not only in his throat, but also the bottom of his stomach. His colon is inflamed too. My poor baby. Anyway, we did like the Zegerid, but it made him very constipated. But then again, back then everything made him constipated. Now that he’s off milk, it might be better … but our GI doc has a ton of experience with autistic children and what works specifically for them, so I figured I’d try the Prevacid first, and ‘fight’ with the doc later if need be. I also thought the Zegerid was a pain to mix up and ‘wanted’ the solutabs to work this time, KWIM?

Nate’s also on an anti-inflammatory for his bowel disease, and I actually think that’s doing more for his comfort than the PPI. The reflux is actually a side effect of his lower GI issues, so if the inflammation goes down, it makes sense that the reflux will subside.

This morning was let him have his milk 1st, then the PPI, now we’re waiting for b’fast. Did the same thing yesterday … we’ll see how it goes. Maybe I will try b’fast earlier and save the milk for later in the day … used to be he never wanted to eat anything early in the morning, maybe that’s changed by now.

Seems like I’m always trying to decipher some predicament with my little one.

September 24, 2006 at 7:33 pm #14186

Anonymous
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We are doing prilosec and zantac. I think I have it timed perfect now since she is doing much better. I give her the prilosec first thing, then her bottle. We give the zantac 4 hours later, then before bed. She had been spitting up 20 plus times a day, now its maybe 8

September 24, 2006 at 7:42 pm #14187

Anonymous
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ok, I have never timedd Aidan’s prevacid around anything, he gets it before he eats breakfast, sometimes it’s 30 mins before, sometiems right before, and then again before dinner…..a while back I did try the (pain in the butt) wait til they have an empty tummy then give it, wait 30 mins then have them eat thing, and there was no difference in his reflux. It worked for him either way. And actually the timing thing was horrible and made him angry because he had to wait to eat…not saying it would work for all babies, but his dr, and gi, and my best friend who is an rn said there’s no difference as long as they take it before they eat, doesn’t matter if it’s 30 or 10 mins before, as long as the medicine gets into their tummy before the food does.

September 24, 2006 at 8:07 pm #14189

Anonymous
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aidans mom, im glad that it worked for your baby. however i just want to point out that for many babies it does matter about the 30 min, so your doctors were incorrect, and here is why:
https://www.infantreflux.org/forum/forum_posts.asp?TID=3228&a mp;a mp;a
mp;KW=rule

and

https://www.infantreflux.org/forum/forum_posts.asp?TID=6026&a mp;a mp;PN=1

nataliachick72006-9-24 20:18:48

September 24, 2006 at 9:17 pm #14193

Anonymous
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That’s all really interesting information, and I have read it before. But she asked what we would do and I was just sharing what worked best for us. They weren’t wrong. The med works no matter what. It just works at it’s optimum level if you time it. Like I said, I tried it and didn’t see any difference in Aidan. Every child is different. My ped is familiar with MARCI kids and was before I came in with Aidan, she knows all the information, and has said to play around with it as not all kids need that much time, some need more, some, less.Some need it closer to before bed, some need it in the afternoon and the morning. The MARCI kids info is helpful but in my opinion you ultimatley have to play around with the timing and splitting to find out what works best for your baby.

September 24, 2006 at 10:31 pm #14196

Anonymous
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i disagree, the med doesnt work no matter what.a friend of mine was told she didnt have to time, and she didnt know why the prevacid wasnt working. once she found out she was supposed to time it, the meds worked very well.
in your prevoius post, you stated that the docs said the timing doesnt matter, and that in fact is incorrect. it does matter, however there are some babies that respond to the med even if that rule is broken.
*i am not trying to start an argument here* i just dont agree.

September 25, 2006 at 12:28 pm #14220

Anonymous
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sorry, I tend to believe what a doctor says. Especially ours since she is very up to date with all the things regarding PPI’s and infants, Aidan was put on 30 mgs of prevacid (up from the 15 he had been on since around 3 weeks) at 3 months without me having to say a word. Back then I did try to time it a little, 15 mins or so before he ate. The timing never mattered because his motility was so slow that his tummy was never empty, but I KNOW the med DID, (and still does) work no matter what because he got better and better after the increase to 30 mgs. When I found out about all this timing stuff I called the manufacturer who told me that yes, it does work BETTER if given on an empty stomach, but that it still works regardless. After all, why would they give PPI’s to children with DGE if they didn’t work unless the stomach was empty?

September 25, 2006 at 1:52 pm #14225

Anonymous
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Myles had dge and I doubt his stomach was always empty when he got his Prevacid, but I did try to time it properly. I’m sure the medication works to some degree even if the stomach isn’t emtpy, but the emptier the better. Myles and Aidan were able to absorb enough of the medication to alleviate their symptoms without a fully empty stomach. Moms like us should be thankful for that.

Ideally, the medication should be given on an empty stomach so more of it is absorbed and the fullest effect is achieved.

September 25, 2006 at 4:23 pm #14239

Anonymous
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Our GI told us the timing did not matter either but the prescription always has a sticker to take before meals. So, I do try to give on an empty stomach and wait the 30 minutes if I can. I figured it can’t hurt. I know Joel posted on here one time that it only takes 4 oz. of food (for an infant) to activate the med. and that it is better to wait longer to eat than the 30 minutes if you had to vs. getting the medicine on a full stomach.
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