Is Zantac Not Enough?

[Anonymous]

Hi,

I’m new… I have a 2.5 year old boy who was not diagnosed with silent reflux until after 10.5 months of suffering. He is now still on Prevacid but we are attempting to wean him (so difficult to know if eating issues are from reflux or toddler attitude).

Now we have a 6 week old baby girl and she started showing signs of silent reflux too so we took her to the doctor and they put her on Zantac (today is day 6). We have seen improvement but there are still some issues. She still has some fits of screaming, stiffening her body, and arching her back. It isn’t every feeding but usually one to three a day. I’m trying to be patient but I’m just wondering if we need to move right to a PPI.

Part of the rush is that I have to go back to work in 2 weeks and with my son that is when his eating drastically went downhill (he didn’t start until 16 weeks but his weight steadily went downhill on the charts all the way down to 3%). We have a great daycare but they just don’t have the time/ resources to work with them like I do. Plus, they can’t sit there with my screaming kid trying to get her to eat like I can… I know she wants to but it hurts. I will also admit that it gets increasingly difficult to deal with and to keep cool. I just think back of the first 11 months of my son’s life and I classify his feedings as “traumatic” 85% of the time (I didn’t know that reflux – – let alone silet reflux- – existed). I just want to nip this in the bud if moving on would make things better for us.

Any advise? We give my son Prevacid capsules in yogurt or applesauce so I have no clue about the delivery methods for an infant…

[Anonymous]

Hello and welcome,

It seems from all I’ve read here that most babies don’t do very well on Zantac. It is a very weight senstive drug so babies quickly outgrow their dose and eventually plateau on it and get no relief. PPI’s are much more effective. You can read about PPI meds at http://www.marci-kids.com My son was on Prevacid Solutabs; you just dissolve them in a little water and administer with a syringe.

Since your daughter is so young I’d ask to try Zegerid instead because it can be given anytime. Prevacid has to be given on an empty stomach and then followed up with a full meal 30 minutes later. That timing can be very difficult with a small infant.

Good luck and glad you found us.

[Anonymous]

Christine,

Thanks for the quick response. I obviously did lots of research when my son was finally being treated but things were different because of his age. The Zantac sucked for him because he could fight the dose and he HATED the mint flavor. Anika seems to hate it too but isn’t strong enough to fight.

I agree that Zantac probably isn’t what I want to be on just because it is weight based. We just went through so many struggles with Max that I don’t know if I can handle the idea of having to keep messing around with the dose every few weeks. It’s like I’ll never feel as though things are not “sensitive” as far as eating is concerned, you know. My main concern though is that now we don’t know if it is the right time to take Max off the Prevacid or not… he may have been taking it for way too long now just because we don’t know when he has (or if he has ) outgrown it, you know.

Anyway, I was just over there on that site doing some reading and I read about zegerid. Did you use that with any of yours? I would like to go back to the doctor today and get on that but do you feel that 6 days on Zantac is enough to say, “let’s move on?” Do you think that my son’s history or the fact that she will be starting daycare soon would help encourage the doctor to go this way? There is one specific doctor in the practice that was particularly good with Max about this so I would of course request to see him but I guess I’m just looking for some support to build up the guts to go ask…

[Anonymous]

hi there! i have 3 children that have/had have reflux problems. my youngest daughter had a fundoplication at almost 10 months old for her reflux. my 15 year old twins also have reflux, and i have reflux problems also——definitely seems to run in my family. personally, i think zantac is worthless. if you cannot get zegerid, or if it does not work for you, you can also get prevacid compounded by a pharmacy in a form that works no matter when you give it to them, just like the zegerid—-just don’t have any flavoring put in it. my daughter took it this way with no problem.

[Anonymous]

Thanks! You all have been so helpful. I got a 1:30 EST appointment. But now do you think we are on a rather low dose of Zantac that they will want us to try a higher dose first? She weighed 8 lbs 7 oz and put her on 0.5 ml twice a day…Maxon&AnikaMom2006-9-11 12:8:40

[Anonymous]

Maybe tell them she simply will not take it (they’ve probably heard this before) so can we please, please try Zegerid. Bring the marci-kids information with you.

I did not use Zegerid because Myles’ doc prescribed Prevacid and once he was on the right dose he did GREAT on it. I really would have preferred Zegerid because it does not have to be timed around meals, but since he was doing so well on the Prevacid we just stuck with that.

Good luck. Be persistent. Many of us have had to fight tooth and nail to get our babies on the right dose of a PPI, but once we did it was so well worth it.

As for your son, and whether you should stop the Prevacid, Joel at marci-kids answered my question via email about stopping the Prevacid. He said that Dr. Phillips says it’s fine to stop it all at once and you’ll know in a few days if he still needs it or not. If he has other “toddler eating issues” or any kind of eating aversions, I can see how it might be hard to determine if he still needs the medication. Is he verbal enough to tell you when something is hurting him?

[hellbennt]

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

[Anonymous]

Thanks again for the advise…

Well, the doctor doubled the dose of Zantac and told us to put cereal in her bottles and see if that improves it. He said if it wasn’t better in a week to go to Prevacid Solutabs and he already gave me a Rx for the Prevacid.

It seems as though the cereal may be helping some but then I have no perspective because I know it is filling her up more so a 4+ oz. bottle is no longer a usual feeding. She still squirms, siffens her body, and sometimes screams but now I don’t know if she is truly finished eating or if she needs me to work with her more. Like before if she only took 2 oz then I knew to spend more time burping, etc. to get at least another ounce in her. But now I know it’s filling her up…

And the Zantac… she HATES the stupid stuff so giving her a double dose is even worse.

So… I just dropped the Rx off at the pharmacy to get it filled. I think we are doing the right thing. I mean, chances are we will end up on a PPI anyway but meanwhile with her starting daycare soon I’m really eager to get her eating better. Also, with the way Zantac is weight based, we would always be messing around with the doses but it will take us a while to know that the dose needs to be upped because she will be in daycare all day… but more likely we will just be paranoid over it (like we have been with Max) and always question if she needs more meds.

Christine- I guess I would prefer to not mess around with doses and timing around meals too but out doctor didn’t mention anything about that. He just said it will be once a day (which we like) so we will see how it works. As for Max, yes he can verbalize when he is hurting but we can’t always believe him. For instance, 5 times he has said his ears hurt and 2 of them he had an infection. Or like last week he woke up from a nap crying and I couldn’t figure out what was going on. So I start asking him if he hurts and he mummbles/ whines “yeah…” So then I start asking him what hurts and he doesn’t tell me. Then I ask, “your arm?” “yeah…” “your leg?” “yeah…” “your hand, tummy, nose, eye, hair?” and he says “yeah” to it all. Turns out he just wanted up with Anika and I… But after reading what you wrote yesterday I told my husband we need to just cold turkey him and for minor flair ups just use Mylanta since it seems like some here do that so we will see. I think his last dose of Prevacid was sometime last week.

[Anonymous]

Good news about the prevacid script. I’d probably do the same thing….fill it now and ditch the Zantac.

I hope once per day will be enough for her; most of us have found our babies need at least two doses per day, some even need three.

I hope Max does well without his meds.

Good luck with everything. I love your children’s names. Very cute.

[Anonymous]

maybe ask your doc about changing the dosing to twice or three times a day…once usually isnt enough.

if you read marci-kids.com it will explain why.babies metabolize these meds much faster than adults.

good luck!

[Anonymous]

Christine,

Thanks… “Maxon” actually came quite easy to us (we liked Max and we liked Mason so when we saw “Maxon” in the baby book we were sold) but “Anika” took a while. It still isn’t as unique as Maxon but it fits.

Thank you (and Natalia) about the advise on the Prevacid dose. Clearly I don’t know as much about the Solutabs since Max was on the capsules with the little beads. We liked that SO MUCH BETTER than the liquid crap. Poor kid had been so sick his first winter (always hungry & hands in the mounth = many gastrointestinal issues) that he had more than his fair share of tylenol, motrin, antibiotics, and even water and pedialyte (just to keep him hydrated) forced into his little body that he knew to fight it … especially when it came to the crappy Zantac. You just don’t feel very civilized when you have to hold your kid down kicking and screaming to give him meds… Ugh, I remember having to do it in the airport once. I’m hoping that we can go to capsule with Anika ASAP… like whenever we can get her to eat applesauce or yogurt. Any of you switch like that?

Well, just like I figured, the pharmacy had to have the doctor get “prior approval” for insurance before the Rx could get filled… So I got this not so fun call from the doctor’s office late yesterday giving me a hard time. I HATE having to defend myself with wanting the right med… if it was an ear infection they would quickly be prescribing an antibiotic but this we have to fight tooth and nail for and it sucks. She finally gave in when I told her that I knew that it would take a while to get the Rx because of the “prior approval” thing and that I just didn’t want to be stuck over the weekend because my gut and experience with Max tells me that we will be moving on to that.

Oh, and then I had to defend myself with my mother yesterday too! She goes all into “the crap Americans eat these days..” (uh, when were you not an American too? – – she fed us the same stuff). She starts telling me what Max should be eating and I said that I don’t believe she had my sister and I eating broccoli, steak, green leafy salads, grilled chicken, etc. as 2 year olds. Hell no! Not only that but we never had yogurt or fruit as kids… She also goes into us not giving our babies cereal (like with a spoon) at 2 weeks and that “babies need water.” I told her that they don’t have the swallowing reflux for the ceral (she says, “well, you did!”) and that it can also lead to allergies. I told her that water dillutes minerals in their bodies and that can cause serious problems (like what happened in China when they were dilluting the formula to make it go further) and she didn’t believe me on that either… She gave me a hard time for us giving Max a choice… Good greif, he is a PERSON not someone to be dictated to! I see no harm in asking him if he wants yogurt or applesauce as his side dish. Meanwhile, my Mom used to force me to eat meat… I’d sit there with it all squirreled up in my cheek getting dryer and dryer for up to 30 minutes. I had to stay at the table until I finished. She only stopped that after I choked and she couldn’t get it out. She started running out of the house to the doctor across the street and when I screamed when my foot hit the door the meat flew out. But I degress…

WHY oh WHY do people have to fight us on this? Do they think we just want to medicate our kids for no reason? Let them live a day (after day after day after day) with a screaming reflux baby in pain…

Sorry… rant off.

Maxon&AnikaMom2006-9-13 12:53:53

[Anonymous]

Please don’t apologize for the rant….I’ve shared plenty of my own. You just get sick of people who haven’t been there telling you it’s not that bad, or insinuating that somehow it must be your fault.

Is your prescription for the solutabs? If so, I think you’ll like them. They are very easy to give and they don’t taste bad so she may not fight it. I never used the capsules, but I think the solutabs would be easier. Just remember to give it on an empty stomach (at least two hrs) and follow it up 30 minutes later with a feeding. Myles’ doctor never told me that, and neither did the pharmacist.

Good luck. I hope she’s feeling better soon.

[Anonymous]

Christine,

Thanks for the info on admistering the solutabs. It is frustrating that the doctor and the pharmacist don’t mention that. Isn’t that what they, especially the pharmacist, are there for? What is the best time of day to give it then? Maybe first thing in the AM as long as we can wait 30 minutes to feed. Did your kids end up taking the solutabs pretty well? I guess I’m just used to Max who got “programmed” to refuse anything liquid because he had so much in his first year. For us giving him a spoonful of applesauce or yogurt was more civilized in our house. Are the solutabs time released? I know the capsules are so we could give it once a day.

Well we still don’t have the Rx. I suppose the doctors office could be delaying the paperwork so that we give this route a chance. As long as I have it before the weekend… Honestly, I do see a bit of improvement after 3 days of the higher dose of Zantac and cereal in some of her bottles but it is not consistent nor is it anywhere near where I know it can be… It just sucks. We ended up so tense after what happened with Max but the first month of Anika’s life we were so relaxed. Forget that now. It just makes me sad. My pg with Anika was so horrible that I need a positive time right now, you know… I just wish I could delay going back to work too but I can’t. I can’t afford it financially nor is work prepared for me to stay out any longer (our company isn’t doing well).

OK… now I”m really ranting… Or just thinking out loud. Thanks so much for listening. It is so nice to know I’m not alone. That I’m not crazy or a bad mother who just can’t feed her kids or simply can’t handle being a Mom. Sometimes I do feel like I can’t handle it and then I just thank God that I have such a good husband that that at least he sees what’s going on and supports me.

[Anonymous]

Myles was resistant to the solutabs initially, but he had a serious oral aversion for a while due to the reflux pain. Once he was feeling better and his oral aversion improved he started to take the solutabs easily and even would open his mouth when he saw it coming. One advantage of the solutabs is that you can dissolve them in a very small amt of water. I used less than a teaspoon, so there’s not a whole lot to administer.

It’s really not true that you can give the capsules (or any PPI) once per day….Adults can take them once per day but infants need to take these meds two to three times daily because their metabolism is 3 -4 times faster than an adult’s, and therefore they (babies) metabloize and eliminate the drug much faster than adults. I was intially told to give Myles his Prevacid once per day (and not told about the emtpy stomach/30 minute rule). Doctors and pharmacist just don’t seem to be well informed about PPI medications for children. These drugs (like the majority of others) are only studied in adults, and doctors don’t seem to be going out of their way to educate themselves.

Myles did not improve until he was on the proper dose and was getting it three times per day. It was a long, horrible five months. I hope you get it worked out much sooner than I did.

Good luck. Keep persisting. I know how hard it is, but the right medication and the right dose really does turn things around.

[Anonymous]

Well, we did end up splitting Max’s Prevacid into 2 doses (I think that idea came from the GI). I’m not even sure what dose of solutabs we were given but I can’t even split it into 2 doses can I? Because of daycare we really can only do 2 doses a day…

I hear you on going through long horrible months. That’s how we were with Max since he wasn’t diagnosed until 10.5 months old. His was definitely a silent reflux and I think that is more painful because they just swallow it back and it causes double the pain. But I think because he was not spitting up a lot and he was gaining weight (because I sat with him so long), the doctors didn’t even think of reflux… and we didn’t know it existed.

Well, if you don’t mind, I may be leaning on you some over the next few months… I can’t really get into the boards much now but I’m sure when I get back to work on the 25th I’ll be screwing off on the net in no time and will be able to get around on here more. Again, I really appriciate your responses.

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