Time to up meds? reflux? Need advice!!

[Anonymous]

Hello all! I thought things were under control, but once again I need advice from you lovely ladies! Sadie (13 weeks) has been doing fine on Zantac so far, even though the dose has never been adjusted for her weight- It was prescribed when she was 7 lbs, and now she is 12 lbs. Well, the doctor wanted to wean her off, so he told me to wait and see if she gets worse, and if not, wean her off. Well, I thought that maybe we were doing fine, as she seemed to be okay, even on such a low dose (.5 ml 2 x day of syrup)-

Well, the past 4-5 days she has not been “herself.” She cries more, and is spitting up a TON more! I mean, she has never spit up this bad, and it seems like EVERY time she eats now, she spits up. So, my first question is: In your experience, do your babies start to get worse and spit up more? sounds like a dumb question, but she has never been this bad- She has DGE, like a lot of refluxers, but now you can almost guarantee she will spit up every time she eats, and before she wouldn’t really do that-

SEcond question: do your reflux babies seem to have gas pains too? Or, I should say, could it really be reflux pain I am suddenly seeing and not gas pain? her formula (goodstart) has been awesome for at least 4-5 weeks now, but suddenly she is crying more and kind of cringing in pain, so maybe it’s not gas, and it’s reflux? I am thinking maybe what I thought was gas pain and tummy troubles is really just relfux, with a coincidence of having gas too (she is always gassy)?

She isn’t refusing the bottle, but her symptoms are basically crying a lot more all of a sudden, spitting up more, and crying after she spits up-But, she sleeps fine at night, at least so far- is that normal? maybe at night she is tired and sleeps through it? Her worst time seems to be after she eats- again, I thought it was gas, but maybe it’s not!? And, my husband just called and told me that she suddenly won’t nap- when she has been pretty decent about it lately-

So, what do you ladies think? I have a call in to our ped, who will probably just up the dose of Zantac, since she is supposed to be getting twice as much as she is right now- I also give her mylanta to help- Do you think this is reflux coming back because the meds are wearing off?

help!!!

[Anonymous]

I do know that I have read somewhere that a lot of times reflux peaks around 4 months (I know you aren’t quite there yet, but you LO’s reflux could be just getting worse to the point where Zantac isn’t helping her anymore…or at least that dose). From what I have read, meds don’t stop the spit up, they just keep it from being painful. Brianna used to sleep the best at night too. My theory was that night sleep is a different kind of sleep than day sleep and maybe she was just sleeping deeper so the reflux didn’t bother her as much. Of couse she could have just been worn out. I know that gas and reflux can go hand in hand, but I can’t remember why. I think Laua has posted on it somewhere. I would try upping her Zantac dose to see if that brings relief. If not, then maybe you can try a PPI. Good luck!

[Anonymous]

Have you ever heard the term “reflux rollercoaster”?…. yes, most of us have experienced periods where things go well, followed by periods where things get worse, and this cycle often repeats itself.

The first I’m wondering about is whether or not she’s coming down with a virus. The spitting up and puking was often the first sign for us that Hailey was coming down with a cold. The excess mucous would cause her to gag and vomit. Also, like Emily said, reflux does tend to get worse around the 4 month mark.

It’s also possible that you’re dealing with MSPI. Sometimes a formula will be fine for a few weeks, and then the proteins build up in the system and all heck breaks loose- the increased gas, fussiness, reflux etc.

Gas can often be a problem for refluxers, often because digestion is off, but also many refluxers are also constipated which can cause a lot of gas and tummy pain. What are her poops like?

As for the sleep, I think it has to do with all babies being different. I know a refluxer who spit up more than 40 times a day, but then at night, he went down and slept flat for 12 hours straight without any problems or vomitting. He was obviously a happy spitter. Many babies with reflux have not had it impact their sleep. I think it depends on the baby. I wouldn’t question it if you’re one of these lucky ones (believe me, the other side of the fence is pretty crummy!).

Given her symptoms, I certainly wouldn’t consider weaning from the zantac. I would try for an increase and see if that helps. If not, then I would actually try a PPI at a decent dose and see if that helps. Hopefully that will do the trick, but if not, then you might want to consider MSPI and a switch to a hypo formula.

[Anonymous]

I agree with Lori…I’d increase her Zantac, or try to get her on a PPI medication like Prevacid or Zantac. To me her symptoms sound like the beginnings of untreated reflux. Fussiness after feedings is a classic sign of reflux, though it could be MSPI like Lori said…but being that she’s probably outgrown her Zantac dose, and you tried weaning I’d venture a guess that’s it’s reflux and work on that first. If there’s no improvment with meds then I’d try another formula like Alimentum.

My first refluxer never slept well, day or night…but Myles (my second refluxer) was never a bad sleeper despite horrible reflux. He was miserable after feedings. That was the first sign for him. Later it progressed to refusing feeds and constant irritablity…but even during the worst of it (before meds) he slept fairly well at night.

Good luck. I hope your little sweetie is feeling better soon.

[Anonymous]

Thanks everyone! I think you are all right- She is showing early signs of reflux again- My ped upped her dose, actually doubled it- finally! So, we’ll see- He is concerned about her DGE (confirmed by a scintiscan), as she is spitting up a ton, and is suddenly not gaining weight as well at all- He wants to put her on reglan- I obviously have mixed emotions about this- I know you don’t know until you try it, but I am scared to death– And, get this- When I asked the nurse what side effects I should look for (and I asked the ped too), they both told me that “there are no side effects!” I said, well, I just read about all of them online all day, and she got huffy and said that they have never had a baby with a reglan problem, and that it’s more serious not to give it to Sadie than to try it- So, I asked again, what I should look for, and started naming stuff, like involuntary movements, etc., and she said “Well, if she does that, call us!”

And, on top of it all, my ped WILL NOT refer me to the ONLY specialist that my insurance covers UNTIL I try reglan- he said that if upping the zantac and reglan do not work, THEN he will refer- can you believe that? I just don’t know what to do..Do I risk hurting Sadie by trying Reglan, or do I allow her to keep spitting up and lose weight? She is not eating a lot during 24 hours, now that she sleeps at least 8 hours at night, so her total intake is low- and, on top of it, as the day progresses, she spits up more and more…

So, thanks for all of the advice- I hope the zantac at least makes her comfortable, but I am just so torn about the reglan…I guess we have to wait and see! how horrible!

[Anonymous]

Your doc sounds arrogant! I couldn’t trust someone who lied to me about medications and their potential effects. Can you find a new doc?

What’s a scintiscan? Hope the zantac helps.

[Anonymous]

I agree with Lori. I’d have a hard time trusting this doctor. I’d look for another ped and try to work with him or her….and get a referral to the gi from the new ped. There are other meds for DGE…erythromycin has been used successfully by some of the babies on this board. Maybe you can talk to another doctor about trying that instead of Reglan.

[Anonymous]

Avery wrote:

And, on top of it all, my ped WILL NOT refer me to the ONLY specialist that my insurance covers UNTIL I try reglan- he said that if upping the zantac and reglan do not work, THEN he will refer- can you believe that?

what a pr*ck!!
i would NOT accept that! and there is no way i would ever give my child reglan!

[Anonymous]

Avery wrote:

When I asked the nurse what side effects I should look for (and I asked the ped too), they both told me that “there are no side effects!” I said, well, I just read about all of them online all day, and she got huffy and said that they have never had a baby with a reglan problem, and that it’s more serious not to give it to Sadie than to try it- So, I asked again, what I should look for, and started naming stuff, like involuntary movements, etc., and she said “Well, if she does that, call us!”

I’m glad you got your dose increased (the dr obviously has some nouse). But I was really concerned about the above information. To not give side effects is unethical (not to mention all those other things people have said in the previous posts). I’m not sure what I would do in your situation…but I guess i would probably worry what else they might not tell me.

[Anonymous]

Hello all- thanks for the advice and for joining me in my frustration! I don’t know why most peds are defensive when they deal with moms who are educated and ask questions! I mean, I am not going to just give my baby medication without questioning it!

An update: we increased her Zantac and today she seems better, not doing the screaming she did yesterday, so I am hoping she’ll just continue to get better with the increased dose. We talked it over all night (my dh and I), and talked to my sister, who used to work in the NICU and is a physician assistant, and decided to try the reglan. I know some mothers on here said that they absolutely think it’s horrible, and maybe it will be, but I feel like I have to try it, because we’ll never know if it could help her if we don’t try- She could be one of the lucky ones with no side effects, and she could react horribly, in which case I have to find comfort in the fact that it has a quick half-life and will get out of her system as soon as we stop giving it, if need be. It was a tough decision, and I know some moms will disagree with me, but, as many of us know, when you are desperate to help your baby, and know there is a drug that might help, sometimes you just have to have faith and hope it works out. So far, she is doing fine, but we’ll see. I am still going to find another doctor and try and see a specialist, as we still don’t know the cause of her DGE, and that is what bugs me the most.

So, thanks for your thoughts, and support. You have all been great. I hope some of you don’t judge me too harshly for trying the reglan- it was not an easy decision-

[hellbennt]

you are not judged! you are the best advocate for your baby & you’re here (& everywhere!) doing your research so who is to judge?

fingers crossed!!

~laura

[Anonymous]

Everyone is entitled to make their own decisions for their child. And sometimes you can’t know what decision you would ACTUALLY make until you’re put in that position. No one is judging you!! and I hope that this works well.

Good luck.

[Anonymous]

Good luck with your decision. I’m sure it was a difficult decision for you. Other moms on this board have used Reglan without any difficulties. Hopefully it will be helpful with no side effects for your little girl.

I’m just wondering, are you using the Reglan in hopes of stopping the spitting up, helping her pain, or both? The reason I am asking is that Myles also had DGE he and spit up or threw up alot…I mean constantly, but his pain was perfectly controlled on a good dose of Prevacid. So the spitting and throwing up was more of a nuisance than anything else. He was growing and gaining weight despite how much he threw up…so his doctor thought it was best to treat his pain but not treat the the DGE as long as he was growing and gaining. (Forgive me if I’ve already posted this….I don’t mean to be redundant or pushy…just trying to give you another perspective to consider things by).

As for DGE, my son also had it and his doctor said it’s very common in reflux babies and that most of them outgrow it as they get older. For Myles it began to improve almost immediately after his reflux was gone (around 9 months) and it (the dge) steadily improved until it was seemingly gone by about 13 months. I’m not sure if there is actually a known cause, but it does seem to go hand in hand with reflux for many babies.

Anyway, I’d still try to find a doctor who will prescribe a PPI for her. Zantac doesn’t have a very good track record for success…at least not long term.

Good luck and please keep us posted about your little sweetie.

[Anonymous]

Thanks everyone, especially for understanding how hard this decision was. To answer your question, they wanted to put her on reglan because her weight gain is starting to suffer- she spits up so much, and so often, that she went from gaining 2 lbs in 3 weeks to .2 lbs in a week- the doctor was worried about that, and so am I, since Sadie was premature to begin with (she is now 11.8 lbs at almost 14 weeks)- So, this is why he wants to try it, just to help keep more food down, and to hopefully help her gain- If she was still gaining, I wouldn’t even consider it, but now it seems to be affecting her-

I will keep everyone posted! thanks again!

[Anonymous]

Good luck.

[Author]

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