Home › Forums › Infant Reflux Information › Medicines › What to think about more arching?
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April 12, 2006 at 1:09 am #5964
Anonymous
InactiveDavid just started on Zegerid 11 days ago (5mg 2X/day). I realize I’m not to day 14 yet but am wondering what to think about increased arching.
I think I noticed some positive changes even after a few days. He started taking one day time nap which he’s never been able to do laying down before. (He used to always wake screaming in a few minutes.) He also seems to be having trouble with fewer feedings a day.
One other new thing that puzzles me though is that he is arching like crazy. I was seeing that with several feedings a day previously but I am seeing it much more now. Not just with feedings but often throughout the day. Could this just be a stage he’s going through and have nothing to do with reflux pain or should I be concerned?
Kara
April 12, 2006 at 1:09 pm #6007InactiveKara,
There are two problems that I see:
1) Zegerid contains a buffer that is designed to neutralize the acid that is in the stomach, protecting the drug itself in Zegerid (omeprazole). But if each dose is not large enough, then it will not contain enough buffer to neutralize all of the acid, leaving the drug vulnerable to degradation. According to the laboratory studies that we have done on Zegerid, you need to give at least 7 mg (3.5 mL when mixed at a 2 mg/mL concentration) per dose in order to provide enough buffer. If the acid destroys the drug, then it will be like your child is getting almost nothing at all.
2) Even without the buffer issue, that dose is not high enough to significantly help a baby’s acid reflux. Since infants metabolize PPIs like Zegerid at a rate 3 times that of adults, they need to be given higher doses with greater frequency. If you give me your child’s current weight, I can tell you the dose of Zegerid that Dr Phillips (the inventor of Zegerid) would recommend for him.
You should also visit our website http://www.MARCI-Kids.com for more information on dosing, mixing and administering Zegerid and other acid reflux medications to infants. If you have any questions for me, feel free to email me: andrewsjj@health.missouri.edu.
April 12, 2006 at 1:42 pm #6011InactivePlease, call your doctor with the information from Joel and Marci-kids and get your little guy on the right dose of Zegerid. My poor son suffered for months on a dose that was too low, until I found this site and Joel told me the correct dose for him. It took me weeks to convince my doctor to increase his dose. I had to print the information from marci-kids.com and send it to her. Then she finally agreed and put him on the right dose (10mg/3x’s per day).
He improved and is doing great on the correct dose. I hope you will be seeing the same improvement in your little guy soon.
April 12, 2006 at 11:00 pm #6055InactiveJoel,
Thanks for your reply. I will fax the doctor about higher dosing.
David’s weight is 14lbs 9oz.
I have gone through the info at http://www.marci-kids.com/ . I really appreciate the effort that has been put into making this information available.
I have a couple of questions:
1. Is there a very short and to the point explanation geared towards doctors for the PPI dosing?
Maybe something with excerpts of the listed studies? I have seen the dosing chart and the explanation for parents. I’ve also looked through the info listed under physicians. (I think I’ve been through everything on the site). I find myself doubting they would take the time to look up the studies. I printed a handful of the listed info from the site and took it with me to the appointment with the ped. GI and they were not interested in looking at it. I also tried finding the studies myself so I could read them and was unable to find those specific studies.
2. Does mixing Zegerid up with less water than the 2mg/ml dose make the medication less effective?
The only way I can get this down him is to take the appropriate amount of powder and add as little water as possible. When I was mixing as per the directions on your website he would spit so much of it out that I couldn’t tell if he was even really getting any. I can really only get about .5ml down him reliably.
3. If we are able to get the correct dose will we be able to use our 20mg packets?
Zegerid was not on our plan so I paid a hefty sum for what we have thus the concern about being able to use it.
Thank you,
Kara
April 13, 2006 at 3:10 pm #6092InactiveKara,
In answer to your questions…
1) I don’t really have any other resource to point you to that more succinctly states why these higher doses are needed and safe. If your doctors are unwilling to educate themselves on the latest information, I would recommend that you look for new doctors, as stressful as I know that can be. Unfortunately, I cannot provide you with the studies themselves, as this would constitute a copywrite infringement and we could get sued. If you get help looking for the articles at a medical school library (if you have one nearby) you should be able to find what you need. Email me if you are desperate for this, and I will see what I can do.
2) The higher you raise the concentration of Zegerid, the more viscous it becomes, which makes it stick to the inside of containers and also makes it harder to swallow. This is why 2 mg/mL is the highest concentration that we recommend for mixing up the 20 mg packets of Zegerid. Have you tried mixing the dose with a small amount of his milk or formula? You can do that, as long as you give him an amount that he will finish completely. Do not mix it with anything acidic like juice.
3) Yes, you should definitely continue to use the 20 mg packets of Zegerid. At your son’s age and weight, Dr Phillips would recommend a dose of 8 mg of Zegerid given three times per day, for a total of 24 mg/day.
If you want to reach me, you can either email: andrewsjj@health.missouri.edu or call: (573) 884-0672.
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