New with questions about timing meds

[Anonymous]

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!

[hellbennt]

hi & welcome!

good research so far, mama!

you can/should put the beads from the capsules in a tsp of applesauce and wash down w/ some water. the applesauce is needed for the acidity, that’s why breastmilk won’t work (or water alone). you can give the applesauce even w/ a teeny baby- use your finger, syringe in some water, etc. you can do it!

you need to be giving the prevacid on an empty stomach followed by a ‘meal’ 30 minutes later

you can give the zantac w/ or close to mylanta but you need to space the mylanta, just like you need to space the zantac, 4hrs from the prevacid.
the mylanta can be given any time w/o paying attention to meals, you just need to pay attention to when the prevacid is given.

you might see less spitting w/ medicine, it can happen.

[Anonymous]

Hi… I too had horrible OAL and it certainly affected my son’s reflux for the worse. He would struggle to keep up with the flow and then the reflux would start about 5 minutes into the feed.

One thing you can do to help battle this is to take your lo off the breast when your milk lets down and allow it to spray out into a towel. Once the flow has slowed reattach her. It helped us tons. Oh, and block feeding from one breast per feeding (and even multiple feedings) also really helps.

Good luck!

[Anonymous]

Naomi – I’ve been pulling her off when it gets too much for her and yeah it has helped make the nursing more comfortable for both of us. I don’t think it helped at all with the reflux though.

Laura – Thanks for the help. Any idea how long it takes the prevacid, or zantac for that matter, to “absorb” so that you don’t have to worry about the baby spitting it up. I mean, if she spits up 40 minutes after getting the medicine because I fed her 30 minutes after, is she losing all the medicine too?

[Anonymous]

You should be fine. the reason they want you to wait the 30-60 min is so that the medicine can start getting absorbed. If you see purple spit up then you know she isn’t absorbing it. HTH.

[Author]

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