Infantreflux.org | Question about increasing dose

This topic has 8 replies, 1 voice, and was last updated 19 years, 3 months ago by Anonymous.

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July 23, 2007 at 6:25 pm #39779

Anonymous
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How do you know if your child needs to have their medicine dose increased again? Brian is now 10 wks old and he started on 15 mg Prevacid in one dose which wasn’t helping so we upped it to 22.5 mg and he gets 7.5 mg in the am and 15 mg in the pm (both given 1/2 hour before a feeding on an empty stomach). He’s been on 22.5 mg for almost 2 weeks. About a week after increasing his dose, we had the issue of him only taking an ounce or two each feeding and refusing to eat anymore and that is when the GI put him on Carafate for a month in addition to the Prevacid. After a day, he was back to taking his full bottles again. All was good for about a week. Now, in the past 2 days, he has been fussier again during and after feedings, crying more when he burps and waking up crying after only 20 minutes during daytime naps. He is still sleeping pretty well at night, going 3-6 hours at a stretch. I am wondering if we should ask the GI about doing 15 mg in the am instead of 7.5 and see if that works. That would put his total daily dose at 30 mg. Or do I need to wait longer to see if things improve or get worse? I am so terrified of going back to the days of inconsolable crying and/or refusing to eat and I’m not sure if my fear is driving me to seek an increase in his dose or if he really does need it. Does anyone have any experiences to share or insights to offer? Did anyone else increase from 22.5 mg to 30 mg on Prevacid and see a real difference? Thanks for any advice!

July 23, 2007 at 7:10 pm #39780

Anonymous
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Kelly,

Ah, the dosing guessing came rears it’s ugly head First of all let me say that I TOTALLY understand your frustration and your insecurity about wondering if you’re increasing the dose out of fear or necessity. Go with your gut is my advice. Your mommy instinct is more reliable than any PH.D

Kate started at 15mg of prevacid(solutabs)and we increased to the max dose of 30mg. Now for her, she never improved even on the max dose. I was soooooooo frustrated and exhausted of timing with meals and doing this for almost 6weeks without any improvement. For her, the prevacid just didn’t help.(big sigh) BUT, prevacid has helped a TON of babes on this site. Since you’ve waited two weeks I’m wondering if maybe you should try upping the dose to see if that helps……..but having said that maybe you’re JUST on the threshold of it working? I HATE these meds sometimes It’s soooooooo infuriating when you wait and are patient helplessly watching your baby in pain clinging to the hope that in the morning the med will start to work…wow have I been there. I guess my non-doctor advice()is to increase the dose b/c maybe the 22mg isn’t cutting it. I’m sure someone else will also have some great advice though too,I’m new at this too . Hang in there and trust yourself! You’re an awesome mommy who is doing everything possible for your little one and you know Brian better then anyone!

July 23, 2007 at 7:58 pm #39782

Anonymous
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30 mgs is what finally put an end to reflux misery for my little guy. I can’t remember if we tried 22.5 or not, though. I just remember lots of increases until we finally hit 30 mgs and finally things improved.

Have you considered three doses instead of two? marci-kids does recommend three doses. I’d ask for 30 mgs and split it into three 10 mgs doses. That’s what turned things around for Myles.

July 24, 2007 at 3:07 pm #39808

Anonymous
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Thanks for your replies! It’s so nice to know there are others out there who can relate and understand!!!!!!! I really appreciate the support.

The 3 doses a day is a good idea. My older son was on Nexium and his was split into 3 daily doses and he did wonderfully on that. The GI who put my son on Nexium moved out of state and the soonest I could get in to see his colleague was mid-August and I made that appt like 6 weeks ago. Crazy. In the meantime, our pedi put Brian on the Prevacid and then upped the dose to 22.5 mg. I also saw a different GI who put Brian on the Carafate. My follow up appt with that GI is in 4 weeks. I guess I will wait another week or so and see how things go and if they aren’t better, I will see if I can get in earlier to see her and ask for an increase to 30 mg split into 3 doses and see what she says. I just want Brian to feel better!

July 24, 2007 at 4:09 pm #39810

Anonymous
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We started on 7.5mg/day, then to 7.5mg 2x day and when I asked our doc about going to 22.5 (7.5mg 3x/day) he told me I could do 15mg 2x/day which was more than I had asked for but I took it and ran and we have been doing great until we go our most recent ear infection, but his reflux is still under control. I do remember a mom recently that went up to 30mg/day and it didn’t work well. So upping meds isn’t always the best option but for us it worked. I would talk with the doc after the increase has been for a full 2 weeks.

July 24, 2007 at 8:43 pm #39829

Anonymous
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Kelly, just a thought, but is you little one on formula? Perhaps he is reacting to it? Could he be MSPI?

July 24, 2007 at 9:25 pm #39830

Anonymous
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it was me(maybe it wasnt me that you were thinking of, but it did happen to me too 😉 ).. my son did NOT do well on 30 mgs.. i think it caused cramping… we did the 30 mg’s for about 5 days.. until i couldnt take it anymore, and went back down to 22.5mg’s. I THINK we are the minority here.. and i would try a dosage increase.. if he doesnt do well, you could always go back down.

July 24, 2007 at 11:10 pm #39834

Anonymous
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Just a thought, you could always try mylanta, tums, or gaviscon and see if it helps. If it does then you probably do need an increase. Like someone else said too it does take a few days for an increase to work and the formula could be bothering your baby too.

July 24, 2007 at 11:16 pm #39836

Anonymous
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Thanks everyone! How do you know if your baby is MSPI? My older son John had reflux but not MSPI. He was on Good Start formula the whole time and did fine with it so I opted to use Good Start with Brian. What are the signs/symptoms of MSPI and how are they different from reflux?
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