Was He MisDiagnosed?

[Anonymous]

Hi everyone. My name is Erica and I have a 1 month 5 day old son. When he was born the hospital put him on Similac of course. When we returned home we switched him over to Parent’s Choice with Iron. At 3 weeks we thought he was developing colic. After talking to others who went through Colic and doing some online research, we decided to switch his formula over to Parent’s Choice Gentle.

He was doing much better. He would nap great during the day and only wake up at 3am for his feedings with his last one being at 1130pm and then his first morning one at 630am

Well, he has his 1 month well being check up. Things were going good, but he is only in the 10% and lower percentile charts for his height and weight. He was born at 6lbs 8oz and at his appointment on Monday he was 7lbs 14oz. I myself am just 4′ 11″ and his dad who is just 5′ 8″ only weighs 135lbs. So it isn’t like we are big people ourselves.

Anyway, as I was getting him dressed at the end of his appointment, he was acting as though he wanted to get out of my arms. He was aching his back.

The doctor immediately said he has Acid Reflux and gave me a prescription for Zantac and told me to switch his formula to Good Start Natural Cultures.

Now since Monday he hasn’t been sleeping… at all. The other day he was up for 8 hours straight! Yesterday it was 6 hours! He his now up every 1-1.5 hours at night, very fussy and nothing will soothe him. He was not like this prior to his appointment

I feel horrible for making the changes the doctor suggested because now my baby isn’t happy. Couldn’t he had just really not want to be held at the time? Is it always a sign of reflux when an infant arches their back?

esimonsen2007-07-12 13:32:07

[Anonymous]

Hello and welcome,

A few thoughts….

Both of my refluxers were absolutely fine intially and began to show symtoms at around 4-6 weeks which gradually worsened until their symptoms were unbearable by around 8-10 weeks. So it’s not that unusual for a baby to seem fine initially but to begin exhibiting signs of relux later on. My daugher went from sleeping 11 hours a night at a month of age to being up every 20-60 minutes all night long by 12 weeks of age due to untreated reflux.

Arching is a classic sign of reflux. However your son seems to have been fine until you changed his formula and started Zantac. Unless I’m missing something. Was he arching at home, or only that one time at the doctor’s office? Being in the 10% for height and weight is perfectly fine unless it’s big drop from where he was at birth. Someone has to be in the bottom percentiles, and you said you and your dh are small, so it makes sense that he will be too.

If he was sleeping fine, eating well, and generally content before the formula change, I’d assume it was the formula.

Good Start Natural Cultures is a brand new formula. I think it’s only been out a few months. I doubt many docs or parents have much experience with it yet. Some babies just don’t tolerate certain formulas. For instance not too long ago they came out with the DHA/ARA formulas and everyone thought it was great; and maybe it is good for babies, but some babies simply cannot tolerate it and they get very uncomfortable from it. So, I’m wondering if it might make sense to go back to the formula he was doing better on (Parents Choice Gentle). Also it’s generally best to make one chage at a time so if there’s improvement or no improvment you will be able to figure out what works and what doesn’t.

As for whether or not to continue with Zantac, I guess you’ll have to use your mother’s intuition on that one. I’m not sure what I would do, but I think if he was fine before that one arching experience at the doctor’s office, I’d probably just go back to the previous formula and see how he does first, and if he still seems unhappy and is not sleeping well then I’d try the Zantac again.

Now about Zantac; some babies do fine on it but some do not. Zantac is a weight sensitive drug, so dosage is very important, and babies quickly outgrow their dose as they gain weight so they generally need dosage increases in order to continue getting relief. The working dose for Zantac is 5-10 mgs per kilogram of body weight.

There are other drugs for infant reflux which are not so weight sensitive and tend to have a better track record for effectiveness. These are called PPI meds. You can read about some recent research into PPI meds for infant reflux at http://www.marci-kids.com and mabye ask your doc to try one if you determine that your son does have reflux and the Zantac does not improve things for him.

Be sure to check out Laura’s Intro link (stickied in the Introduce Yourself Forum). It has lots of valuable information which may help.

I’m glad you found us and I hope your little guy is feeling better soon. (I hope I haven’t added to your confusion).

[Anonymous]

Thanks for the feedback.

No, he wasn’t doing any arching at all at home. After being examined at the clinic I picked him up to dress him and had his head on my shoulders with him facing out and he arched and the doctor immediately said he had reflux and prescribed Zantac and told us to change the formula.

He was only 6lbs 8 1/2 oz when born, 6lb 8oz when we left hospital and was 7lbs 14oz at 1st month check up. She was very concerned that he was so low in the percentiles and hadn’t gained much weight.

How much should a baby gain in one months time. I thought he was fine, now I am totally paranoid that he is not gaining enough weight and that things will turn worse 🙁

[Anonymous]

I’d also like to add, that regardless of wether he has reflux or not, some babies can’t tolerate the Zantac itself. Dagney has reflux, and was diagnosed right at 9 weeks, when her symptoms became much more apparent to us (I didn’t know she wasn’t supposed to move around so much when I was feeding her!). Once we started giving her the Zantac, things got even worse. Some kids, like my lo, have bad reactions to Zantac, and the Zantac itself can cause tummy aches and sleeplessness. I would try cutting out the Zantac completely and seeing how it goes, or if you think he may still have reflux, tell (don’t ask!) your doc that you want to switch him to Pepcid (anther liquid med like Zantac), which didn’t do much for Dagney, but also didn’t give her those adverse reactions either, or switch him to a PPI like Prevacid or Zegerid. Dagney seemed to improve within a day or 2 if I remember correctly once we stopped the Zantac. Good luck and I hope this helps!

[hellbennt]

I’m not sure how much weight a baby is supposed to gain, but

http://www.askdrsears.com is a great resource- maybe there’s something about this there…

[Anonymous]

I think if a baby follows there own growth curve, eg always on the 5th percentile visit after visit then that is classed as OK. So if he is tracking along at the 10th percentile then I’m thinking that he is OK. There was a very little bub in my mums group and they only got worried when she started to drop percentiles. She is still tracking along the 5th percentile now and no one is overly concenred (her mum is a triplet and is also tiny like you).

Like Christine’s bubs, Alana was fine for the first few weeks (when on a combination of EBM and formula) and all hell broke loose a little later, so it can certainly happen that bubs get diagnosed with reflux later on. But given you saw not signs and weren’t conerned prior to this Dr visit I would be tempted to go back to what you were doing before.

Goodluck.

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