Not sure what to do next!

[Anonymous]

Hi everyone! I’m hoping that you might be able to help me! I have a 5 month old son, Jacob, who has had issues with reflux since day 1. He was put on Zantac at 3 weeks old. At 2 months, his painful symptoms had gone away and he was a happy spitter. Then they got worse over the next month, so we put him back on Zantac and then on Prevacid.

We are currently being seen by a pedi GI and he is on 7.5mg prevacid solutabs 2x a day. About a month ago, his crying at the bottle was worse than ever. My husband suggested mixing all the formula in a pitcher the night before and for some unknown reason that really worked! Jacob was eating well for about 3 weeks. I was on cloud 9! But in the last week or two, with no changes to his diet, he has gone back to crying on the bottle. He eats about 2-4 oz and then freaks out. We’re offering him a 6oz bottle every 3-4 hours. He STTN, so our pedi GI said to offer this amount to him in the hopes that he would keep STTN and would get his oz in during the day.

He is awake from about 6am-7pm and in that time he gets 5, 6oz bottles. As I said for the past 3 weeks, he was a happy little eater and recently he’s been crying a lot.

The next step that our pedi GI suggested was to start reglan. He does have delayed emptying. He is spitting up from one bottle to the next. We tried erythromycin for a bit and that didn’t seem to make any difference. But, I’m not sure if reglan is the right move. I’m waiting for a call back from our doc to discuss.

Jacob has always gained weight well, but our pedi GI taught us how to make 25 cal/oz formula (2 scoops to 3oz of water, rather than 1 scoop to 2 oz of water). This is so that there isn’t the additional pressure to have him eat a large number of oz in a day.

Anyway, I guess I’m just looking for some advice or personal experience that might steer me in the right direction. I know that I’m lucky that he does eat, STTN and is generally happy. But I don’t think I can handle this crying at the bottle any longer. This has been a struggle from day 1 and I would just like for him to be happy/content when he eats. I know he has it in him…he did it for 3 weeks and it was pure bliss!
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[Anonymous]

Have you been giving the prevacid on an empty stomach followed by a “meal” 30-60 minutes later? This is key. Also, does your LO show any symptoms of intolerance or allergy? How are the stools?

Could he be teething? My DD started teething @ 5 months and has been a MISERABLE teether every single time.

As far as reglan goes…it varies by baby. Some do well & others have severe reactions. We did emycin w/my DD & it helped. So, maybe the dose was low?

I don’t mean to scare you, but recently I’ve seen ads for lawsuits in regards to reglan. They say it causes Tardive Dyskinesia. http://www.schmidtandclark.com/reglan

It’s something that I won’t touch, but my cousin gave it to her DS & it worked fine for him.

HTH & Welcome!

[Anonymous]

We do give him his prevacid about 30-60 minutes before meals. I spoke with the pedi GI today and she wants to start him on erythromycin. We tried it once before, but only for a couple of days. She wants to try this again before the reglan.

We was tested for a milk protein allergy with his stool and it came back negative. He’s been on Similac Sensitive RS since about 7 weeks. For some of that time, and as recently as a week or so ago, he eats well. Our doc said that we can try Alimentum or Nutramigen, but that we should try the erythromycin and reglan first. We tried giving him Nutramigen a couple of times and he simply wouldn’t drink it.

I’m not sure about teething. I check his gums and they don’t look red or swollen. Not sure what I can do about it if it is teething. But, it mirrors all of the last reflux symptoms so I’m thinking that he must be in pain again.

Thanks for your post! I wish this was easier. He’s a pretty happy guy otherwise…and I am starting to lose my patience after 5 months of him crying at most bottles!

[Anonymous]

I would definitely try the e-mycin one more time, give it a little longer this time around.

As far as the stool test being negative…Well, you have to hope that they tested the right “spot.” It may not be all throughout the stool and so the test could be negative if the right spot wasn’t tested. KWIM? My DD’s stool testing was negative, but it took us changing her to an amino acid based formula before she ever improved. She has just recently been able to eat yogurt w/o having issues. Maybe something to consider?!

He may not be teething. 🙂 I was just trying to run through all possible scenarios.

If he’s pretty happy most of the day & is in pain w/feeds. Then maybe re-examine his dose. Have you taken a peek at marci-kids.com? They have a dosing calculator that determines what dose your LO should be on based on weight/age & med. He may need an increase!

[Anonymous]

Definitley give the emycin time to work…my DS was on it for DGE and it took about a week for it to fully take effect and for us to notice a difference.

I hear ya on the repeat of reflux symptoms, but here’s some other things to try and think about also. Have you tried a different flow of nipple? If you’re using a slow flow, he might be getting frustrated and wants a faster flow. They all get busy and frustrated around that age too. I’d try to stay away from the Reglan too, if you can. they tried my DS on it for a short time and I was terrified every time we gave it to him, and it started making him lethargic so we pulled him off and put him back on the emycin.

It does sound like you have a good GI to work with, that’s great!!

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