Should I switch Meds or Increase the dose?

[Anonymous]

I have been doing alot of research since joining this group. I now know that my daughter does have reflux issues worse than I thought she did. Everyone keeps telling me she is a baby and she is going to do these things, but I have decided after doing some research that I either need to talk to my ped about changing her reflux med or changing the dose. I think she already takes the recommeded dose for a child her size (Prevacid) so should I talk to him about changing the med itself. What have you experienced with your children. I have also noticed that many of your children take more than one med. Is this something that most reflux babies have to deal with? I appreciate the help!

[Anonymous]

Have you looked at the information at http://www.marci-kids.com ? There you can read about some recent research into PPI dosing for infant reflux. Most doctors underdose because they are not aware that babies metabolize PPI meds 3-4 times faster than adults. What dose and what form of Prevacid is your daughter on? (Solutabs, capsules, compounded?)

Generally speaking most babies should do fine on just one drug, especially if it’s a PPI and properly dosed, but some babies do better on a combination of a PPI (Prevacid/Zegerid) and an H2 Blocker (Pepcid/Axid).

If your daughter is not getting relief from Prevacid it’s quite possible that her dose is too low, or that it’s not being prepared or administered properly. Let us know what form and dose (with her age and weight) and then we can better help you. Also please let us know what her symptoms are, and what she is eating.

For some babies formula is part of the issue. Some reflux babies also are MSPI (milk/soy protein intolerant) and they need either a hypo formula like Alimentum or an elemental formula like Neocate. If you are nursing eliminating dairy and/or soy may help.

Glad you found us and hope we can help.

[Anonymous]

From our experience, I tend to think that if a baby is still showing signs of the pain, then the dose typically needs to be increased. The other possibility is that the med isn’t being given correctly- the solutabs need to be given on an empty stomach and followed up with a meal approx 30 minutes later. Good luck. What dose is your little one on?

[Anonymous]

Sorry this is so long.

Just to give you a little bit more info. Ashlyn is 3mo. She is appx. 13lbs (She hasn’t been weighed in awhile) We have had her on prevacid since she was appx. 3-4wks old. As much as I hate to admit it, I’m not sure of the dose. I know we give her one of the solutabs every evening (I think they are 15mg). We also thicken her bottle with cereal at night. The ped didn’t like that idea much, b/c he didnt want her to get too many calories so we started just putting it in her night bottle. We tried AR formula b/f we started prevacid. (Made spit up appear to be worse) She is on Similac formula. She does not take well to switching formulas. We haven’t tried any soy or lactose free formula yet though.

Her symptoms are all over the place. She is a comfort eater, severe cold symptoms (Cough, congestion), sudden fussiness, hiccups, very frequent spit up (Even two to three hrs after her bottle), she screams when we burp her, she arches her back alot, excessive drooling and is pretty gassy most of the time. I thought that she may have had a cold once a couple of weeks ago, b/c I had a bit of a scratchy throat but this will be the second time she has been sick (if that is what it is) in the last month and a half. Someone mentioned to me that it sounded like reflux and I began wondering if her meds weren’t working for her. We give her prevacid to her 2.5 hrs after a feeding and 12 hr b/f her next feeding every evening about 6:30pm.

I make her sound like she is a horrible baby… She really is a happy baby inbetween all of these quirks. She loves to be held upright and talked to. She just goes from happy happy one minute and the next minute she screams and crys like she is in pain.

Thank you all for your help!

[Anonymous]

Most babies require at least two doses of Prevacid a day, and marci-kids recommends three doses. The solutabs come in 15mg and 30mg. My guess is she’s getting 15 mgs, but you can check the package. You can try dividing the solutab into two doses, but 15 mgs for the whole day is a pretty low dose. You may have to ask her doc to raise it.

http://www.marci-kids.com has a dosing caluclator. According to it your daughter should be getting 7-9 mgs three times per day. Some babies do fine on lower doses, but my son definitely required the marci-kids dose.

Don’t worry…we know you don’t think you have a horrible baby. You’re her mommy and you know she could be happier and more content. We’ve all been there so we understand completely. My first refluxer was so miserable I used to joke that I “survived” her infancy. My second was not as bad but he was definitely in pain and uncomfortable until we got him on a good dose of Prevacid.

If you want to try another formula I would not try soy or lacto free. Most reflux babies who do have problems with formula have difficulty with the protein in milk, not the lactose. And many who can’t handle the protein in milk also cannot handle the protein in soy either. The hypo formulas like Alimentum address this issue by breaking down the proteins to make them easier to digest.

I’d address the meds issue first….try to get her on a higher dose of Prevacid.

I hope that helps some. Good luck and keep us posted.

[hellbennt]

Babywearing: https://www.infantreflux.org/forum/forum_posts.asp?TID=1044&PN=1

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

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