New with questions about timing meds

So glad to have found this forum – it’s amazing what a difference it makes to know that you are not going through something alone.

I have a 7 week old baby girl who was diagnosed with reflux at 3 weeks of age by ultrasound to rule out pyloric stenosis (ruled out, luckily!)

At first we thought she was a happy spitter but that changed when she started having issues nursing – basically turned into a wrestling match. I also have overactive letdown which just complicates matters. Then we noticed that she became way more fussy and almost stopped napping all together. When we put her down she would spit up tons, and then wheeze and grunt herself to exhaustion. We felt so bad for her.

At 4 weeks she was put on Zantac which seemed to improve things for a while but, like so many others, stopped being effective after a few weeks. About 5 days ago she started on Prilosec. The pedi prescribed the capsules (10mg) and told us to open them and dissolve in breastmilk to administer once a day and also keep giving the Zantac 2x per day. After reading endlessly on this forum I realize that there is so much wrong with these instructions.

– 10 mg/day seems like a really dose (from what I see on marcikids) for a 2 month old 11 lb baby. Should be like twice this!

– The dose should be split up into two doses

– Zantac can’t be given at the same time but they should be spaced by at least four hours

– PPIs shouldn’t be given with breastmilk but with water and those little balls do not dissolve in either! Should wait at least half an hour before feeding after dose.

I’m now trying to adjust for all these things. Am I on track so far? My main question is, with such a spitty baby, how long should I really wait between giving her meds and feeding her? I mean, how long will it take the meds to get to her belly and work their magic? I worry that when she spits (directly after a meal) that all the meds are just coming right back up and we’re getting nowhere fast. How do you handle such a situation with a breastfed baby who eats every 2-3 hours and sometimes more frequently.

Another question is, though I know these drugs are not meant to change the amount of spit up….has anyone seen a change there with PPIs? I feel like I’m already seeing a difference in the amount she spits though she still spits plenty. Is it just a coincidence?

One other thing I’ve found that helps with her discomfort is Mylanta, which I give after feeding her. Don’t know if this is correct though…should I be giving it before or between feeds?

Anyway, I’m sure I’ll have more questions as I go…just hoping to give this LO some relief. Any help, advice, or input is appreciated, even if it’s just sharing your own stories and experiences. Thanks so much!