Q about giving zantac and PPI combo

[Anonymous]

Hi! We have just started Prevacid and I want to keep giving my daughter (4 months next week) the Zantac until the prev starts working fully. Here’s my question: I know the prev needs to be given 30-60 min before a feed, and the zantac and prev need to be 4 hours apart. Her zantac script is for .6 ml 3 times a day, and her prev is 7.5 mg twice a day. Is there a best order to give these? Yesterday I did prev at 7am and then zantac at 11am, but I couldn’t give the prev again when I wanted to (3pm) because she had just eaten an hour before that so she didn’t get the second prev until 4:15, and then we ran out of time to give another zantac dose because it was bedtime – she was miserable by 6:30pm because she isn’t sleeping well day or night. The prevacid is most important, but I feel like last night was a worse night because she only had one dose of zantac. How in the world do I fit in 2 doses of prev and 1.8 ml of zantac in one day? Shoudl I give the zantac in two .8 doses? Should I give some zantac during in the middle of the night when I have to go in and resettle her anyway? Shoudl the prev be given 12 hours apart to do the most good, or can it be the first two doses of the day, then zantac the rest of the day??? It’s so complicated, and she’s so hurting and frustrated during breastfeeding and I’m so tired I could cry!!!! Plus, totally unrelated to these questions, I’m sorry, but I think I just diagnosed her with sandifer’s, which until yesterday I didn’t know existed but I read about it on this website and went “Oh! That’s what she’s been doing all these months!” which while I feel better knowing that there is probably nothing neurologically wrong with her, is still a scary thing to experience in your baby! But really, I’m just asking about the meds, not the sandifer’s.

Tired and overwhelmed,

Rachel

[hellbennt]

rachel, (ACK. I cannot get rid of the underlining at the bottom part of the post, sorry!)

hi & welcome! you’ve found a great place!

the key to all of this is RESEARCH and, of course, support!

http://www.marci-kids.com is at the FOREFRONT of research of PPI use and dosing in infants/todders. You might want to start there to see if PPI dose is ‘proper’

then, hop back here to learn HOW to get that proper dose, if need be, and what FORM of PPI and HOW to administer…

Prevacid 101(last post on the page): https://www.infantreflux.org/forum/forum_posts.asp?TID=1936&PN=0&TPN=1

unfortunately the majority of drs & pharmacists don’t know…babies metabolisms’ are much faster than adults, so the drugs work differently with them…

after medication, you might then want to look at diet…

I have a LOT MORE TO SAY! and most of it is here:Groupie Intro: https://www.infantreflux.org/forum/forum_posts.asp?TID=853

it’s looong, but PLEASE read/skim/scroll through it & refer back to it, as it TRULY will help you!

so glad you found us!

~laura

ps: sandifer’s will lessen and go away w/ the proper meds, so your questions actually are related.

unfortuntately a lot of this is trial & error. I would give the prevacid in am and in pm and try to work the zantac in anyway you can- you don’t HAVE to be strict w/ the 4hrs seperate from the prevacid- if it comes down to it and it’s only 2 hrs, give it a try. our ped GI said 2 hrs & it was fine w/ my son. I’ve been on this board 6 (!) yrs now & the drs basically say anywhere from 2-5hrs, so when i tell people 4hrs it’s bcse it’s the average and to be ‘safe’ but by all means, try different hours spacing of the 2 meds.

I would figure out hightest zantac dose by weight which is 10mgs per kilo & divide this into 2 doses- these zantac doses do not have to be ‘equal’ so if you need more coverage at night, give a higher dose at night

you can also give mylanta cherry supreme- it’s the adult kind- look at the various liquid antacids and look at the ingredients- you might have better luck finding CVS brand or someother store brand- the thing to look at is that there is no aluminum

you can give im 1ml doses up to 5mls over the course of a day

you can give WITH the zantac but needs to be spaced from the prevacid

so if you give a squirt before a feed it might help calm things down…

hellbennt2009-05-17 21:08:50

[Anonymous]

Hi Laura~ Thank you for responding so quickly! I feel better knowing that I don’t have to follow the 4 hour rule quite so exactly, but after reading through a bunch of the links you sent me, I have a few more questions:

1. If I give the mylanta right before a feeding, how far away from the prevacid does it have to be given? Two of her feedings a day (one in am, one in pm) will be given 30 or 45 minutes after giving prevacid. Is this far enough away, or should I only use the mylanta for the feedings that don’t follow the prevacid?

2. I know the prevacid needs to be given on an empty stomach, 30-60 min before a feed, but what constitutes an empty stomach, i.e., how long AFTER the last feed must it be given?

3. I was reading about overactive letdown, and while I never really thought that pertained to me, I actually experience many of the “symptoms” of OAL. Would you be the person I ask about this, or should I ask in another place? If I do have OAL, I don’t think it is directly causing the reflux symproms since she was diagnosed at 5 days with an upper GI with moderate to severe reflux. However, I’m sure the OAL isn’t helping things!

Thanks!

[hellbennt]

3) you can ask about OAL, lol. But you most certainly can ask in another, new post, too. what might be good as well is to

browse through some old posts, go back pretty far, too, to learn from people who no longer post here bcse there babies are all better…

if you find a thread that suits your situation, you can post there and hope that people who have posted in the past are subscribed to the forum and will get an email notification that the thread has been updated…you can also send them a PM (private message) w/ a link to a thread you’ve posted on and ask them to please respond to it. To send a PM, click on the underlined screen-name of the person & another window will pop up. Then, under ‘communicate’ click on the PM button.

you could also call la leche league for free w/ your questions questions: The La Leche League Breastfeeding Helpline w/access to toll free breastfeeding help 24 hours a day. Just call 1-877-4-LALECHE (1-877-452-5324)

ok to answer your questions:

(to be quite frank, I would just get bufferbabies (link is from Prevacid 101) so you don’t have to worry about timing of meds, etc. continue as you are until you get it, etc…

1) mylanta needs to be spaced ‘far’ from the prevacid. so again, the 4 hr rule (but you can play with this, like the zantac- not less than two hours). mylanta can be given WITH the zantac- it actually helped me get the zantac into my son, lol.

2) breastfed babies digest breastmilk fairly quicky, so I would think that an empty stomach would be 2 hours after finishing a feed, to be safe? you can do a search for this, or ask someone else…

(when doing a search, go to the upper right-hand corner of this page, click on ‘search’ and on the right for a choice choose 6 months and OLDER (the default is newer).

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