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April 22, 2007 at 10:01 am #31163
Anonymous
InactiveHi. It has been a long time since I’ve posted here about Andrew’s reflux. The Zegerid has somewhat gotten it under control so that he has occassionally slept through the night (1 night here, 2 nights there). Ironically, he slept 4 nights in a row like an angel starting with the 1st night of my in-laws visit. We’d been telling them how hard it had been with him waking 5-7 times a night…and he sleeps straight through! Go figure! But, even before they left, he was back to his old schedule again.
I know teething makes his reflux worse and so he’s been in bad shape with that since he has cut three teeth in the last couple of months. And then there was also last week’s stomach virus (not rotovirus, but along the same lines).
So, now he is back to “normal” and back to waking 2-3 times a night with reflux pain. I can simply pick him up, walk right into the bathroom, give him about 1-2 ml of Mylanta (2 -3 droppers using an old infant Tylenol dropper), and he falls back to sleep immediately (even before I put him back in the crib). It is a 1-2 minute process start to finish. If I don’t give him the Mylanta, he starts howling immediately when back in the crib. If I only give him one dropper… again, howling. So, I’m pretty sure that it is a reflux-induced waking, not just a sleep training issue. Plus, he can sleep through the night – he just doesn’t do it frequently.
I have upped his Zegerid for his weight gain. He’s at the top of the dosage parameters. He normally wakes first about 4 hours after getting his medicine and going to bed. Then it is about every 2-1/2 hours after that.
Any one else have a pattern like this? Any suggestions?
Inclining his bed isn’t an option anymore – he ends up upside down at the bottom.
Thanks for your input!
April 22, 2007 at 10:12 am #31165Inactivewe were also on the zegerid 40 mg packets. at about 7 months old Trace started to require 60 mg of zegerid a day. there is another baby on the board that was also on 60 mg a day (after dr phillips suggested it) i am wondereing what you consider the “top of the dosage parameters?”
anyway, we have now switched to prevacid and he only requires 30 mg a day of that. i feel more comfortable with that also.
we were also having bad nights, until Dr Phillips suggested over the counter pepcid complete at night time. it has been amazing. its like i have a totally different child. he went from waking 4-5 times a night to sleeping through the night or waking once.
maybe look into the pepcid complete?
nataliachick72007-4-22 10:13:8
April 22, 2007 at 10:13 am #31166Inactiveoh yeah, another thing that helped us, i started suspecting a wheat/gluten intolerance. i cut that out and it has helped tremendously. just a thought!
April 22, 2007 at 10:29 am #31173InactiveWe know that he has intolerances to gluten, milk, and soy. (We did the EnteroLab stool test and gene test and learned those results and that the gluten intolerance is genetic.) He’s been free from those three – plus other intolerances – for months now.
I used the Marci-kids calculator and it shows: “Your child, who is 13 months old and weighs 10.4 kg, should receive a dose of 8 to 12 mg of Zegerid delivered 3 times per day for a total of 24 to 36 mg per day.” I plugged in 24 lbs (I think he’s 23 lbs but its hard to tell on my bathroom scale) and it says “a total of 27 to 39 mg per day”.
Right now, we’re giving him 16 mg in the AM and 20-22 mg at night (depending on if my dh or myself draws up the med). So, he’s getting 36-38 mg/day.
My ped has been really great about accepting the Marci-kids dosages from the calculator and the mg/kg calculations. I think he would be shocked though, to have me want to almost double Andrew’s meds. When you started giving Trace such a high dose of Zegerid, did it work? Were there side effects to so much med?
I do like the idea of trying Pepcid Complete. I wonder if I should use that as the Zegerid buffer instead of the Mylanta. (I give him equal volume of Zegerid and Mylanta.) And I assume, since you’re using it successfully with Trace, that Pepcid Complete is milk/soy/ and gluten free?? How much Pepcid Complete are you giving him?
Thanks!
April 22, 2007 at 10:35 am #31174InactiveSounds like his Zegerid dose is not high enough. And he’s only getting two doses a day. Dr. Phillips reccommends three doses.
Also, there can be breakthrough acid at night even when PPI doses are adequate. Some moms have found that they get the best results using the PPI twice daily and an H2 Blocker like Zantac at bedtime. I think Pepcid Complete would be even better. Dr. Phillips has been saying it’s ok to give it to babies. Maybe you can email him and ask his opinion about your situation. I’m thinking maybe you can give him the Zegerid twice a day and Pepcid Complete at bedtime. I use it myself and it works very well. Here’s his email address phillipsjo@health.missouri.edu
April 22, 2007 at 10:36 am #31175InactiveDianne-
there is a glitch with the dosing calc as far as the 40 mg packs. i would email dr phillips directly, he will explain it to you. because of the buffer issues, the child will require more of the medication than they would if there wasnt a buffer issue. its sort of confusing. my son was started on 30 mg (dr phillips recommendation) a day at 3.5 months and 11 pounds, and we have gone up from there.
anyway, i was getting irritated with the zegerid costing so much, and the fact that he was needing 60 mg a day. it was just sort of crazy to me. he didnt have any side effects, but we were spending close to $500 a month on it, and we couldnt do it anymore.
we are now on prevacid with caracream (which is the original zegerid) and i am very pleased with it.
as far as the pepcid, there are no allergens in there, and we dissolve half a tablet in a teaspoon of water. we give it 4 hours after the last prevacid dose.
April 22, 2007 at 11:50 am #31180InactiveDianne wrote:
I do like the idea of trying Pepcid Complete. I wonder if I should use that as the Zegerid buffer instead of the Mylanta. (I give him equal volume of Zegerid and Mylanta.) And I assume, since you’re using it successfully with Trace, that Pepcid Complete is milk/soy/ and gluten free?? How much Pepcid Complete are you giving him?
Thanks!
Dianne-that wouldnt work. you cant combine an h2 blocker and a PPI. it will make the med ineffective-i believe the PPI.
April 22, 2007 at 2:14 pm #31187InactiveI will email Dr. Phillips. He’s responded in the past to two of my questions that I posted through Marci-Kids contact form.
If the recommendation is Zegerid twice a day and an H2 blocker at night — or if the recommendation is Zegerid three times a day — what sort of schedule do you recommend that I follow? He normally wakes for between 7:30-8:30 AM and we put him to bed between 8:30-9:00 PM. So, meds at 8:30 AM, ___, and 8:30 PM, right?
April 22, 2007 at 2:20 pm #31189InactiveI think you would just have to make sure the Pepcid complete is given 4 hours after the last Zegerid dose. So maybe Zegerid at 8:30 am, 12:30 pm (if he’s to have 3 doses), and 4:30 pm, and then Pepecid Complete and 8:30 pm. If he’s on two Zegerid doses than you can give the afternoon dose a little earlier.
Good luck. I hope Dr. Phillips has some helpful advice for you. Please let us know what he says.
ndrose2007-4-22 14:21:22
April 22, 2007 at 2:28 pm #31190Inactivedr phillips recommends to do a PPi twice a day and the h2 blcoker at night. if you are not doing an h2 blocker than the PPI 3 times per day.
April 23, 2007 at 10:11 am #31211InactiveThanks, Natalia.
April 24, 2007 at 7:15 pm #31366InactiveOk. I got a response from Dr. Phillips. He said:
“I would do the PPI BID (Mornign mid afternoon) and the Pepcid complete at bedtime use 10mg.”
So I went to the store just now and got Pepcid Complete chewable tablets Berry Flavor. The active ingredients in each chewable tablet are:
- Famotidine 10 mg
- Calcium carbonate 800 mg
- Magnesium hydroxide 165 mg
Dr. Phillips said “use 10 mg”. What does that mean? Is that one tablet (due to the 10 mg of the one ingredient)? Any ideas? (I hope some of you are reading posts tonight!)
I really want to give this to him tonight since I gave him one dose of Zegerid in the AM and the other one at 4:00 PM. I want to give him the Pepcid Complete before bed.
Thanks!
April 24, 2007 at 8:22 pm #31381Inactiveyes, that sounds like one tablet. good luck!
April 25, 2007 at 9:57 am #31406InactiveSounds like you can give him a whole tablet. I hope it works well for him.
May 2, 2007 at 12:05 am #32029InactiveI thought I’d post an update. We’ve been using Pepcid Complete for 8 days now and haven’t seen a shimmer of difference in him. It is so hard waking so many times night after night after night. I’m desperate to find a solution.
So, my dh and I talked about it this morning and decided to finally fill the Reglan prescription the ped gave us back in February. We don’t like the possible side effects that are listed for it, but maybe it will help. We gave him his first dose tonight before bed. I do feel that my ds has DGE. He isn’t spitting up anymore but back when he was spitting up (even just a month ago), he would spit up food that he had consumed 5-6 hours before. So, maybe the Reglan generic will help with the DGE and that will help my ds sleep without waking.
It is so sad to see him in the dim light at night. He is lying there thrashing around and crying with his eyes closed trying to sleep. When I pick him up, he’s dead weight (fully asleep) yet crying. Then he wakes a bit as I try to help him burp and give him Mylanta. As soon as he gets about 1cc of Mylanta, he instantly falls back asleep – even before I put him back in the crib. I wish I had one of those infrared cameras that let you videotape in the dark. While my ped says he believes me that Andrew’s wakings are not just “mommyitis”, I think he’d really be convinced if he could see just one of these nighttime wakings.
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