Don't Know What to Do

[Anonymous]

Okay, Ds is a little over 11 weeks old. He has had reflux since week 2-3. He also has a dairy intolerance (seems okay with soy so far).

We started with Zantac, which I am fairly sure wasn’t helping much and may actually have been contributing to sudden projectile vomitting (which stopped after we stopped the Zantac).

We then spent a full month on Axid (15 mg. twice a day). At first it seemed okay, then not so much. Upon further reflection, I think it never really totally controlled the reflux, based on the symptoms.

Last week, we switched to Prevacid solutabs (7.5 mg) once a day. (Ds was 11lbs. 9 oz. as of Sept. 21). I would say that we have not noticed a difference, and perhaps things are worse. (I have read and read and read tons here…I know this can be normal and what Marci recommends regarding dosing).

Here are my Ds’s symptoms. I guess what I’m wondering is, based on what I’m observing, are we definitely talking about reflux, is it particularly bad or just more average….

Nursing Ds is like wrestling at least a good 80% of the time. Sometimes he’s perfectly calm and it’s “easy”, most of the time he stiffens up, then relaxes, arches his back, throws his head back, straightens his legs almost like he’s trying to push off something and then back to trying to nurse….over and over again. He will also fuss and thrash around.

Sometimes he will gnaw on his fists when I know he’s hungry and it’s physically hard to turn his head toward the breast.

He chews on his fist all the time, more and more lately.

He will arch his back/stiffen up when burping and sometimes just while sitting/being held, sometimes with fussing, sometimes without.

He is sometimes hard to maniulate into a sitting position and will sometimes stiffen from that to a standing (supported of course) position.

He has been increasingly hard to get to sleep. I used to be able to nurse him to sleep, then lay him down and walk away and that was it. Now, it can take several attempts to get him to stay asleep. That being said, he will sleep (on a crib wedge) in his crib very well at night. He usually only wakes once, maybe twice, to eat over night.

He also chokes/gags/coughs and spits up (sometimes still projectile) all throughout the day, particularly at feedings.

I honestly think he has a lot of the signs of Sandifers as well as reflux and I am planning to try to videotape a feeding session to catch these behaviors. I’m planning to see my pedi again to discuss all this (yet again…so far she’s being great) and I’m willing to show her this website and their research, but I have to be perfectly honest here, I don’t even know how I feel about it. I want Ds to be healthy and comfortable, but I am also cautious and trying to do what is best for DS.

Add to this that the Prevacid that Ds is currently on is hard to get him to take (I see little beads on his face all the time as he spits some of it back out) and the timing is so hard. He wants/needs to eat every 2 hours during the day, sometimes it’s more often. Trying to find one time when his tummy is empty to give him the Prevacid is hard enough, let alone forcing him to wait 30 minutes to eat when he’s hungry. At this age, there’s just no rationalizing and not enough to distract.

Any thoughts/ Any Been there, done thats? I don’t really know what I need, just mostly to get all this out somewhere.

Thanks,

Christina

Ds #2, 7.5 mg. of Prevacid as of a week ago (previously tried Zantac and Axid) Have done an upper GI to rule out pyloric stenosis; refused Reglan

[Anonymous]

i had forgotten about how nursing could be like a wrestling match!!!! sounds like he need a higher dose of meds—-he sounds like he is very uncomfortable when he eats.

[Anonymous]

I agree w/Christine. The dose is low in addition it’s best given in multiple doses. It sounds like definite reflux, if not severe.

When administering the tab maybe have a bottle of water handy to help distract from spitting out the meds. I use to give a very small amount(less than an oz) right after dosing my DD and it helped distract her from spitting it out. Maybe give it a try?

Also BF babies empty their stomaches a lot faster than formula fed. So, at 2 hours he should have an empty stomach. I know waiting those next 30 min can be hard, especially when that little.

I hear ya on being cautious. I felt the same way at first too, but when the increase HELPED then I knew it was necessary. You could always go back to a low dosage if you don’t see improvement(atleast 2 weeks), JMO.

Good Luck!

[Anonymous]

Not to sound like a broken record, but his dose is very low and he probably should be getting at least 2 doses/day. and like Amber said it can take up to 2 wks to see the improvement. I see that you say he has a dairy intolerance and even though you say he seems fine on soy many reflux babies also have MSPI (milk/soy protein intolerance) so it might help to try changing formula as well. Many babies on here have to be on nutramigen/alimentum or even neocate/elecare b/c of the MSPI even with meds.

about the waiting 30 minutes we all know how hard it can be. It does get easier as they get older! That is the good thing. I don’t know where you live but being outside always helped my little guy b/c he was so distracted by everything else that those 30 mins flew by if we were outside. Good Luck. It does get better and there is a light at the end of the tunnel, just can’t tell you when you will get to the other side.

Good Luck, you are in the right place.

[hellbennt]

you’re breastfeeding, right? so when you say he’s fine on soy, you mean you have not cut any soy from your diet, but you have cut out all milk proteins, including ‘hidden’ ones as in ingredients in things (ex: whey, casin, rhennet,etc)?

if I were you I’d give the axid (or zantac, whatver you choose) ALSO.
make sure to give 4hrs seperate from the prevacid. I know it sounds like we’re trying to medicate your baby here, but from what I’m reading it sounds like reflux to me. My baby had Sandifers and it took a proper dose of PPI to stop those symptoms. anyway, you can find the link for proper axid dose and zantac dose from Groupie Intro and also from Prevacid 101. We can help you calculate the doses.

If you don’t want to medicate, by all means try adjusting your diet.
I do want to tell you that if it is MSPI then it is very RARE to stop the reflux by diet alone. I only know of one case (Erintx, she’s on this board) where the mama successfully addressed reflux/mspi by diet alone and, to be honest, she eventually had to medicate her baby at various times during his reflux journey/rollercoaster…

the things that usually point to protein intolerances in breastfed babies:
rash, foul-smelling gas, straining to poop and then when baby finally does poop it comes out soft.
also: mucousy poops. mucous can look like jelly, snot, curds like cottage cheese, stringy like the inside of a banana peel.
breastfed baby poops should be yellow/mustardy seedy. SOME green poops are perfectly normal, as are SOME mucousy poops. but, if poops are frequently green and/or frequently mucousy, then this might just point to MSPI…

there is also Over Active Letdown, also known as foremilk/hindmilk imbalance. this can lead to watery green poop, foamy green poop like shaving cream…you can research more at http://www.kellymom.com

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