He's got reflux… right?

[Anonymous]

HELP! My Pediatrician isn’t taking me seriously and I don’t know what to do. I have read up on everything and swear he has reflux.

My 8wk old son has been on every kind of formula known to help with the constant vomitting that started from birth. We started on regular Enfamil then went to Gentlease then to Enfamil AR, then to AR with rice cereal and now on Similac Alimentum. He vomits at least once an hour, usually more and a lot! Before the switch to Alimentum I knew he was in pain because he’d cry when he puked but now with the Alimentum he not only cries but gags so badly that he either holds his breath or stops breathing completely before/after he vomits and then wails for a bit until he is soothed by me or a pacifier. The other day we had to hit him on the back to get him to start breathing because he started looking pale grey/blue. My doc finally put him on Zantac (.4ml 2x/day) only because I swore it was reflux and not just a ‘formula allergy’. He’s been on it for 2wks now and no change. He is still very miserable and fussy/colicky. Am I crazy or is this reflux? If so, what do I have to do to get some help? I think because he is gaining weight fine (which I’m not sure how since he vomits a ton!) my doc doesn’t seem to think it’s a problem. Help me, please!! TIA!

Edited to add later…I forgot to mention he also has failed all his hearing tests due to fluid in the ears which the ENTs say will get better when his vomitting gets better. He also has hiccups at least once a day…usually more and is always sneezing which I understand is also sx’s.

jas840472007-08-21 18:08:02

[Anonymous]

Definately sounds like reflux to me 😉 . Reflux is just the simple act of refluxing.. which he does spit up. Wether or not he needs meds is based on if you think he is in pain.. which clearly he is. So.. this is what I would do.. go back and DEMAND prevacid ..to put it lightly 😉 .

Many many babies do tons better when they are on a PPI vs. an H2-BLOCKER (Zantac). I would ask for atleast 15 mg’s prevacid and go up from there. Many ped.’s underdose and start off at only 7.5 mg’s or even less. So i would think 15 would be a good starting point..and give it 2 weeks to see how he does.

If it doesn’t help I would probably go to a more less allergenic formula such as Neocate that has no dairy/soy protiens. The meds might end up helping alone..and it might not be a allergy/intolerance issue causing the reflux.. or it might be a combo of both.

[Anonymous]

i totally now how you feel our ped. said to me that michael was just spitting up just like all babies wrong wrong wrong he had reflux ask for more studies maybe an appt with a gi specialist and ask for a different med…. as for the formula well my little one is on enfamil A R since he was 3 months old and he still does spit up at least once a day, i have learned that just goes away with time………..i hope every thing goes well

[Anonymous]

Hello and welcome,

I’ve had two reflux babies so I sure know how hard it is. Like Lauren said, most babies seem to do better on PPI meds versus the H2 Blockers like Zantac, so I’d ask to try a PPI like Prevacid or Zegerid. You can read about some current research into PPI meds for infant reflux at http://www.marci-kids.com

The PPI or H2 Blocker will not stop the vomiting. They stop or reduce acid production so that the baby is not in pain. That’s just something that they outgrow with time. My son was a huge puker, so I know how frustrating it is. As long as he’s gaining weight I wouldn’t worry about it. The important thing is that his pain is under control with some meds.

Laura’s intro link (stickied in the Introduce Yourself forum) has lots of valuable information which may help you.

I’m glad you found us and I hope your little guy is feeling better soon.

[hellbennt]

J

Groupie Intro: my intro: https://www.infantreflux.org/forum/forum_posts.asp?TID=853&PN=1&TPN=1

[Anonymous]

Hi there. I know how you feel- we were also dismissed over and over again, while my daughter screamed 24/7 in pain and refused to eat b/c her reflux was so painful. My first piece of advice is either to get a new doc, or to go see a ped GI. In Laura’s intro stickied under the introduce yourself forum, there’s a link about finding a ped GI and people from this site have made referrals to some good docs. Whereabouts are you located? Maybe someone here can suggest someone. Clearly your son has reflux. If he’s not bothered by it and gains well, then it’s not necessarily a problem other than a mess, which is why so many docs dismiss it. If he’s in pain, which it sounds like he is, then it becomes a problem. My daughter was also gaining, but she was miserable to a point that even the doc thought was insane, and she NEVER slept, and was impossible to feed, but they still refused to take the situation seriously. Needless to say, I had to find a new doc.

I’d also ask for a PPI. Check out http://www.marci-kids.com to read more about PPIs. Have an idea of what kind and what dose you want (marci-kids is more aggressive dosing, but it works) to start with before you go see the doc. That way you know what an acceptable range is as most docs underdose. Also, the reason that he may be spitting more on the alimentum is that the consistency is different than some of the other formulas- we found the powder to be thinner, and also caused more spitting in Hailey. The RTF was a bit thicker, but still not as thick as some of the other formulas. You might want to try neocate if you think it’s because of a milk allergy. It is thin though. If he still spits so much on the neocate, it might just be due to an immature LES, which is the most common cause for reflux and they usually outgrow that cause the fastest. Good luck.

[Anonymous]

One other thought, my older daughter did the same thing that you are describing with the choking and turning blue. We discovered that it was actually the Alimentum that was causing her to choke. It has a slightly different viscosity (sp?) than other formulas, so it is stickier. We switched her to nutramigen and the problem went away.

[Anonymous]

Thank you everyone for your great responses. Well….it took me calling my doc telling him again about choking and turning grey/blue for him to take me seriously. He sent me straight to the Children’s Hospital. He had an Upper GI with the barium stuff (he actually liked it??!) and he got a clean bill of health with the exception of SEVERE Reflux. DUH! (The doc wanted to rule out pyloric stenosis and something with the intenstines bunching up). He has prescribed him Pepcid 40mg/5ml suspension .3ml 3x a day and Metoclopramide (is this Regulan?) 5mg/5ml syrup .5ml 4x a day. I’m so excited to get these new meds into him and see what happens. I still have to go to that site you all referred me to to check out how agressive these dosages are/aren’t. I have 5 cans of Alimentum left and then after those are gone I’m gonna try switching to Nutragamin. I just barely gave him the first doses so how long do you think it’ll take to see any difference if it’s gonna work? How do you remember to get all the doses in? I can’t even remember my own pills more than once a day! Plus, I have a babysitter during the day since I work. Any more suggestions? Thanks so much you guys! I am so glad I found ya’ll!

Julie

[Anonymous]

I went to the marcikids website and it doesn’t give dosage info for anything other than PPIs and he’s only on the h2/Reglan. What’s your opinions on his dosage? TIA!

[Anonymous]

I am assuming here, but it probably is too low. You can always try to increase it yourself if it doesn’t seem to help, but honestly like the other ladies have said a ppi is best. I know what a struggle this is because drs. usually don’t want to do a ppi and even if they do they don’t give a high enough dose. We are here and will walk you this as much as we can. I will prepare you that you might be in for a fight. Most drs. in my opinion give meds to get the moms off their backs, but really plan for baby to just outgrow it which can take at the least 6 months. I tell you this because it is better to know it now than later. The longer baby is in pain the more problems that can arise. Not to scare you, but prepare you. You are your babies voice. You go mamma! I do hope for your little one that these meds help and even the dose works.

[hellbennt]

reglan and zantac/pepsid/tagament/axid seem to be the first meds prescribed by peds, “Just Because.” It’s probably just what they were taught and that’s that. Jonah was even prescribed reglan in the nicu and they had DONE testing and they pretty much knew he didn’t have DGE. Personally, in retrospect, I think they gave it to him to cover their butts legally- he was having apnea episodes (stopped breathing) and rather than have a dead newborn on their hands, they figured the possible risks of reglan, and the help it MIGHT provide, sure outweighed the apnea episodes.

anyway, there’s a lot of bad hype about reglan, but it has worked wonders for some babies, with diagnosed/VERIFIED DGE, in small doses. there ARE other motility drugs out there such as bethanecol (sp?) and erythromyacin (sp?) (there have been a lot of positive posts lately about htis drug)…I feel that if a baby has been given the stomach emptying scan (this is not just an Upper GI- it’s a specific test looking for DGE) and doesn’t respond well to other drugs, then by all means trying reglan is worth it…

[Anonymous]

Well my son was finally put on Prevacid! His ENT told us it would be wise to try a PPI and when I told him my Pediatrician was being overly cautious and not giving us one and sticking with the Pepcid and Reglan he prescribed it to him. My question is though…Shouldn’t he not be taking the Prevacid and Pepcid together? He said to do all 3 for now but I read on here or marcikids that you can’t do the PPI and H2 together. What do ya’ll think?

[hellbennt]

you CAN do them together, you just have to space the doses 4 hrs apart. many many babies have been on both, mine included.

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