sleeping problems! Need advice

[Anonymous]

I posted under Help a week or 2 ago but I’m still having issues and just want to see what people think. My little guy is 4.5 months old, has had acid reflux from day one. I think that I am one of the lucky ones that Zantac made a difference for us and as far as I know is still working….or maybe he is one of the lucky babies that is growing out of it, I really don’t know. So for the last month he has been waking every 10 minutes to an hour. If he is in his bassinet he will crunch up and throw his arms and kick his legs and move his head back and forth and start crying. If he is sleeping on my chest….which is most of the time (seems thats the only way I can get sleep) he will arch his back and start crying. I really don’t know what is going on. He is really great all day, besides the spit up he is happy and totally a different baby then when he was not on the zantac. he naps 3 times during the day for like 45 minutes to sometimes 2 hours. I’m just wondering what is going on at night that is making him this way. A month ago he would sleep for 3 to 4 hours and then another 3 to 4 hours. I did take him to his doctor because I didn’t know what was going on and she said that he was fine and made sure he was on the right dose of zantac.

He is only breastfed, weighs 16 maybe 17 pounds now. His diapers look totally normal….not stinky and no mucus. I have taken out dairy. I wish I knew what was making him wake up so much, is it the acid reflex or does he have gas. And why only at night? We never ever lay him flat, he is always elevated. I know everyone here has the same problems, just wondering if these symptoms sound like your babies or if anyone knows what it could be. Oh and to make matters worse the only way to calm him down is to feed him, so now I feel like he is use to me being his human pacifier. He hates hates hates pacifiers….I try every time he cries and it only makes things worse.

[Anonymous]

Sounds to me that his reflux really isn’t under control. I hate to say that, but he may need something stronger than Zantac. 🙁 I don’t have reflux often but when I do it ALWAYS bothers me more at night and I think that is the case with most people who have reflux. That is when your stomach seems to produce the most acid and when you have less food on your stomach to sort of “absorb” the acid. I might push to try something stronger like Prevacid/zergerid/nexium for a few weeks to see if it helps. Reflux tends to “peak” between 4-6 months b/c of the advances they are making developmentally so you are getting right into that stage. HTH. Someone else may have other ideas.

[hellbennt]

I have to agree. IF you want to ‘just’ continue w/ zantac, then give the highest dose for his weight. Then, divide the dose into two doses and give a higher dose/portion at night. try this for a bit and then you can look into a PPI…
zantac is VERY weight sensitive, so you must adjust w/ every little weight gain.
I am calculating the zantac weight for him being 17lbs.
from the chart here, http://www.sfca.co.uk/match/kilolbs.htm, 17lbs is
7.7 kilos.
the maximum pediatric zantac dose is 10mgs per kilo, so:
7.7 x 10 = 77
that’s 77mgs of zantac a day for your baby
now, your zantac is liquid. go look at the bottle. it will say 15mgs/ml
that means that for every one (1) ml of medicine you give, there is 15mgs of zantac in it.
so, you take 77 and divide by 15 to find out how many mls of liquid to give: 5.1mls a day is the total amount of zantac you can give to your baby.
You can divide that into two ‘uneven’ doses and play around w/ the doses to see how best to help your baby. what I mean is that you do NOT have to make it two equal doses of 2.5mls…

please do not ‘just’ take my word on this!
read here to learn about pediatric zantac dosing:
https://www.infantreflux.org/forum/forum_posts.asp?TID=8288&PN=1

[Anonymous]

Ok so I have a call into his doctor about changing his medicine. Any suggestions on what I should ask for. About 2 months ago I switched him to prilosec (before I found this website) but I only gave it to him for a week because I didn’t know to keep him on the zantac til it kicked in, so my poor little guy was in so much pain I just put him back on zantac and thought the prilosec wasn’t working. I know now that it can take up to 2 weeks to start working.

[Anonymous]

Ok so his doctor just put him on Prilosec. The nurse who called me back said I should stop the zantac when I start the prilosec. Does that sound right? I thought I have read people keep them on both?

[hellbennt]

KEEP THAT BABY ON BOTH.
sorry to scream!
but we learned the HARD way- no one told us and so when we switched it was as if my baby was on no meds at ALL. he screamed/howled/shrieked so long and so much that he LOST HIS VOICE. finally I heard from the ped GI to try the two meds for a while…it was day 12 for us w/ the PPI. it was THAT obvious!
give the zantac, too, at the dose I figured out for you and make sure to space the zantac from the prevacid FOUR HOURS apart.
I would just TELL the dr you want a rx for prevacid capsules and then I would contact marci kids and get bufferbabies and then you mix the rx’d prevacid w/ the bufferbabies and voila! you have a nice liquid you can give your baby at any time w/o having to time around meals (you still need to space 4 hrs from the zantac)
make sure you are getting the PROPER dose of prevacid, too.
FAX your doctor what you are requesting. make it short and sweet.
no asking. lots of thanking.

[Anonymous]

So does the prilosec not work??? I did start him on it friday night and i’m still giving the zantac 4 hours apart. I really hope it works! I know it will take some time to kick in.

Also on a side note, and I hope no one takes this the wrong way. I will do ANYTHING for my child, so if he needs to eat every hour to make his pain go away then so be it that is what I will do. But in the last week or so it really does seem that he is waking out of habit of eating every hour or 10 minutes given the night. If his dad helps out it seems he will go back to sleep, but if I am anywhere close to him he will scream until I feed him. I am a first time mommy and I feel I know the difference between a scream of pain and just a cry. Please any advice would be great. I do not believe in letting them CIO but why is he ok when dad picks him up but won’t stop til I feed him. What do I do? Last night was really bad, seemed he was attached to me all night.

[hellbennt]

I would take things one thing at a time. right now concentrate on the medication. he is eating to soothe himself, most likely. you’re breastfeeding, right?

anyway: the prilosec should kick in – it might take up to 14 days. might. you may see it working sooner.

BUT unless you are using Bufferbabies, I rather doubt that the prilosec you have is made correctly. I hate to be a bummer, but it’s the truth 9.8 times out of 10…I would contact marci-kids and find out proper dose and get Bufferbabies

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Dr.
Philips: [email protected]

Office Phone: (573) 884-0672

[email protected] is the contact person for Buffer
Babies

573-884-0672

Prevacid 101 (has prilosec info, too, and link for zantac dosing too)- go to last post- it’s purple:
https://www.infantreflux.org/forum/forum_posts.asp?TID=1936&PN=0&TPN=1

hellbennt2010-01-10 14:15:52

[Anonymous]

I just have a couple more questions. Connor has been on the prilosec since friday, I just want to make sure this is normal.

1. His poop tonight was green

2. He has never had diaper rash before, but it looks like he has some sort of rash on his little butt.

Is this normal?

[hellbennt]

I don’t know. HOW is your prilosec being made????
IF it’s being made at the pharmacy, being made into a liquid, then please please read Prevacid 101- it is about PRILOSEC, too
https://www.infantreflux.org/forum/forum_posts.asp?TID=1936&PN=0&TPN=1

[Anonymous]

Yeah the pharmacy has made it into a liquid. I will try to give them a call to see how they make it. It does taste very nasty and it is so very hard to give it to connor. It will be interesting to see if they added any type of flavoring.

One thing I forgot to ask was last night and this morning right after giving him the prilosec he spit up….its not his normal spit up…its thick and looks like white mucus. Now I’m afraid that hes not getting the medicine because it is right after he swallows it. So confused.

[hellbennt]

hmm…I don’t know about the mucous/spit up I really don’t…

I wish I could help you- but if the prilosec isn’t effective then it’s ‘just’ exacerbated reflux…

anyway: I would not only concentrate if there is flavorings or not, but also the DOSE keeping in mind the CONCENTRATION of each dose-
If it is not the way you want:
1) FAX your dr and TELL dr to write the RX exactly this way (then you put how you want it) and give dr the pharmacy’s contact info
2) after you’ve accomplished getting the PPI compounded properly, then TELL the dr you ‘just’ want an rx for capsules, then get in touch w/ marci-kids and buy some bufferbabies and then make your own stable compound…

HERE IS HOW TO TELL THE DOTCOR/PHARMACIST HOW TO MAKE THE COMPOUND from here:
https://www.infantreflux.org/forum/forum_posts.asp?TID=4505

1. Make sure that your pharmacist does
   not put any kind of flavoring agent in the compound.

2. Make sure that the concentration is
   between 2 mg/mL and 4 mg/mL. This means that for every milliliter of
   suspension, you are giving between 2 and 4 milligrams of drug.

3. Ask that your pharmacist make the
   compound with 16.8% sodium bicarbonate if the total volume of each
   dose is less than 7 mL. If the total volume of each dose is greater than 7
   mL, ask that your pharmacist make the compound with at least 8.4% sodium
   bicarbonate. We also do not recommend that you give less than 3.5 mL of a
   PPI suspension at any concentration. This is because doses smaller
   than 3.5 mL do not provide enough buffer to adequately protect the drug
   from being destroyed by the acid that is present in the stomach.

It is important that the pharmacy does not add flavoring to the
compound as it will almost certainly cause it to lose its stability
much more quickly. It tastes pretty aweful this way, I know, but it’s
better than the alternative.

Remember, Dr Phillips and the MARCI-Kids team do not
recommend the use of compounded PPIs of any kind for infants or
children. We do recommend the use of immediate-release Zegerid Powder
for Oral Suspension. The makers of Zegerid currently hold a patent
which covers any combination of a buffer (such as sodium bicarbonate)
with a PPI (such as Prevacid or Prilosec), and it is a violation of
this patent for pharmacy to make such a compound.

In addition to this, there are no studies that have been done to show
that such compounds made by pharmacies are effective or even safe. This
is another reason why we cannot and do not recommend them.

If you have any questions, please contact the MARCI-Kids team: [email protected].

[Anonymous]

The prilosec may take a little while. It worked for my little guy in about 4 days in terms of reflux but stopped his cough and stuffed nose right away. The next day that was better. The thing about prilosec is that it helps his esophagus heal and that takes some time. When it’s healed, you’ll see a difference.

Green poop while breastfeeding is interesting but I wouldn’t worry about it too much. Maybe he’s adjusting to the medicine… I’d give it a couple of days. If you took him off his meds to go on the prilosec, he could have acidic poops which could give him the rash. The aveeno diaper cream is great. I used it with my little reflux guy.

Don’t let him cry it out! And they just aren’t going to sleep while they are in pain. I totally agree with hellbennt, he’s comfort feeding. My guy was constantly on the breast while he was in pain. He would eat all night. And Daddy doesn’t have the breast so no point in you little one asking 😉 My first born was a happy spitter, I did let him CIO, he was on a routine, no problems, etc etc. My second one is my little refluxer and at 1 yr we have not let him CIO. He can’t. He doesn’t try to stay awake or anything like that, he’s in pain. And a lot of relux babies do have poor sleep habits. They can’t help it. We have to respond right away. But each kid is unique and has what works for them. I think reflux babies need more touch, more comfort, and also just need to be held up more. As they grow it gets better, slowly, but it does. Good job breastfeeding and changing your diet!! Hang in there Mom! You’re doing great!

[Anonymous]

Thank you all so much!!! So Connor has now been on the prilosec for a little over a week and so for no real change. He only had the green poop that one night and the rash cleared up after one night. We took him off the zantac after 4 days because his dad thought we were giving him to much medicine, I tried to tell him why but he really didn’t agree so we took him off and there was no change in connor so thats good. I think that maybe he is sleeping a little better but now I just keep him in bed with me and he sleeps pretty much attached to me so when he wakes up its right there.

Ok now one more question and this has me soooooo confused. So Before the Prilosec, Connor would spit up all the time even 2 hours after a meal……NOW you can hear it come up but nothing come out. Whats going on????? Is this what people call silent reflux…..so is the prilosec making things worse. Again he seems the same as when he was on zantac. It sounds so gross.

Breastfeeding is the greatest thing ever!!!! I’m so glad I am able to do it. I don’t know what life would be like right now if I had to run and make a bottle every time he woke up.

[hellbennt]

if he’s the same as when on zantac, then maybe the prilosec isn’t helping?? maybe it’s not stable?
can you try adding in the highest dose of zantac for his weight, making sure to space it 4 hrs from the prilosec?? I know your dh doesn’t want this, but if it helps then you’ll know that your baby needs more meds/med change, etc.

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