Ehlana requires a very exact custom dose. For a few months I did not think any ppi was working for her (we tried prevacid, losec and nexium), because she was always burpy, gassy, arching etc. Even with Dr. Phillips dosing recommendations. One day after we were away from home and forgot her ppi dose for the day, we noticed that she did fine for a few hours past the time of her normal dose. After several weeks of experimenting, I found that she did best (though never “normal), on a dose between what her GI recommends and what Dr. Phillips recommended. She was 5 months at the time, and the dose was 2.46 mg/kg losec (just to show how exact the calculation has to be). I have spreadsheets to track her dosage and symptoms.
With metabolic changes and weight changes, I have to constantly adjust her dosage, and Caracream allowed me to do that with precision as I could titrate it exactly, compared to pills/capsule. Ehlana is actually pretty good at swallowing the 10mg Losec pills, but then I cannot get exact dosing, as she seems to need.
Her current value is 3.17 mg/kg (again at odds with Dr. P’s research that says that amount needed/kg decreases with age – but Dr. Eric Hasall’s research says around 6-9 months of age, reflux/all babies often experience a surge in the amount of acid required – speculatively because around that age they start solid foods, and the body starts to produce more acid in anticipation).
I am going to drive to Buffalo this weekend, and get some OTC Zegerid. There are instructions, apparently with Dr. P’s blessing that suggest adding 1 20mg losec/Prilosec to a 20mg Zegerid packet with 1/4 tsp of NOW brand Calcium carbonate to provide needed buffer. That makes it closer to the 40 mg Zegerid prescription and reduces the sodium content per dose compared to the 20mg OTC zegerid.
http://community.babycenter.com/post/a29899039/zegerid_20mg_packets?cpg=-1#c2363674250
At least this way, I can try to get something closer to caracream, and be able to dose more precisely.
Keeping my fingers crossed :).
btw for any mums out there who have found that ppi’s don’t work, your LO may be the same as my girl – requiring a very exact dose. When we first started her on prevacid she responded very well for about a week and then started deteriorating. For weeks I believed that the ppi had stopped working. I now believe that is because the drug built up in her system and when she is “overdosed” she is gassy/burpy/vomits (similar to her regular reflux symptoms).
When “underdosed” she tends to be burpy, gassy and throws up chunky solids close to the time before her next ppi dose is due. When she is “overdosed” she tends to be burpy, gassy and throw up liquidy vomit a few hours after her last ppi dose. It is not much to go on, and often difficult to tell, but it is the only pattern I have noticed. And when I can get it right, she is only a little burpy and can sometimes nap for an hour at a time.
Even at the best we can get her, she gets up 5-6 times per night. On bad nights, it is more like 10-12.
….My son did not outgrow his reflux for 6 years, so I am terrified that she will be like him – or worse…….
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you can try emailing him again/please keep me/us posted!
