Worse on Prevacid – won't eat or sleep!

[Anonymous]

Help,

I am new to this forum but have been reading threads for advice. My 5 month old son has been diagnosed with Acid Reflux since he was about 3 months old. He would spit up quite a bit we noticed a presistant cough. He had a chest xray and the while the radialogist thought he had bronchitis (he had no other symptons) the peditriction felt it was AR. He was put on Zantac .8ml 2x a day. He was 12lbs 1oz at three months. At four months he was 12 11ounces. The pedi was concerned about slow weight gain and wanted my wife to stop breastfeeding and supplement with Formula. We weren’t comfortable doing that. My son is not a good eater and not a good sleeper. While he is generally happy and very active and alert, he will often scream pulling off the breast and refuse to eat even when hungry. We have been giving him one bottle or forumla before bed – he’ll take anywhere from 4-7 ounces. His weight is likely at 14lbs now (5 months).

Our new pedi took him off the Zantac and put him on Prevacid. We are now on day 6 giving 15ml solutabs 2x a day. He seems a lot worse…eating and sleeping less. Is this normal? I’ve read prevacid takes time to work but this is really hard – especially with a slow gainer you want them to eat. Should we wait, go back to Zantac or both? Is there a proper way to give both to give relief. This is really tough on my wife and I. Any help would be appreciated

Thanks,
Adam

[Anonymous]

If you still have some Zantac, I would use it along with the Prevacid. It can take several weeks to get full relief on a PPI, so the Zantac could help in the meantime. Just be sure to give it at least 4 hours apart from the Prevacid so they don’t interact. SInce it takes awhile for the Prevacid fully kick in, this could be why he seems to be worse. It’s a bit like, he is on no medicine at all right now. Also, some babies react to the aspartame and lactose in the solutabs which can cause some stomach cramping. Usually this subsides after a week or so. Are you giving the solutab 30 min-1 hr. before a full feed? This is also essential, or the medicine will not work properly.

His nursing behaviour sounds like both my son and my daughter. And while they both had/have reflux, the biggest cause of the pulling off and screaming routine was that I had overactive letdown and my milk was spraying out so quickly, they were gulping air and it was making the reflux even worse. Could you wife have this? If so, there are many ways to help with this. My children both responded differently. My daughter would pull off and would refuse to go back on the breast. She learned to suck her thumb and she gained weight slowly, like your son. My son, however, I was able to coax him back on the breast (probably because he was on a good dose of a PPI) and he was a porker!

Best of luck to you. I hope some other will chime in with more advice.

[Anonymous]

Thanks Bensmama. We have often thought that an overactive letdown could be a problem. Are there any strategies you used to deal with this? Did you pump before every feed?

We have been giving the prevacid 30mins before eating however if that particular feed does not go well, it pretty much eliminates the usefulness of the prevacid right? Why does it take time for the Prevacid to work?

When would be the best time to give the Zantac? We give the prevacid between 6-7 in the am and 6-7 in the pm.

Thanks,
Adam

[Anonymous]

For overactive letdown, I would advise against pumping, as typically that will lead to the oversupply of milk, which can only make matters worse. What I recommend is block feeding.. ie. feeding only from one breast at the feed. This is uncomfortable for a bit, but the body will adjust. This way, your son will be able to stay on the breast long enough to get the hindmilk which is fattier and not so hard to digest (doesn’t cause gas issues like the foremilk can). Some moms even use one breast for several feeds in a row.

Also, as far as combating the letdown issue… I would take my son off the breast when my milk let down and let the milk spray out into a cloth. Once it stopped spraying, I would put him back on. He hated this, but he was much more comfortable eating. Also, she could try nursing him while lying down or even nursing him with him on top of her. The gravity issue helps to slow the milk down.

Prevacid actually starts working fairly quickly, but it can take several weeks for an erosions in the esophagus to heal. This is often thought to be the reasoning behind why it takes time. Hopefully, once the OAL is under control, the feeds can be more fruitful and help him fill up his tummy.

I actually never used Zantac with my kids, but following the 4 hour rule, I would give it sometime in the middle of the day and then maybe again in the middle of the night (if you’re up – hopefully not!)

Hope this helps!!!

[hellbennt]

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

about OAL (overactive letdown):

http://www.users.qwest.net/~fsdebra1/refluxoal.html

OAL:Gaining, Gulping, and Grimacing?

http://www.wiessinger.baka.com/bfing/trouble/gulping.html

Mspi/allergy info(‘main page’):

https://www.infantreflux.org/forum/forum_posts.asp?TID=2697&PN=1&TPN=1

[Anonymous]

Uggh, I feel your pain! My daughter had a feeding aversion, starting with the breast, exactly as you described with your son. She’d pull off, arch, kick, come back frantically for more, scream, cry, etc. We were told it was OAL, and it was really reflux rearing it’s ugly head. It progressed and got gradually worse, and the same feeding problems persisted with the bottle.

Her feeding aversion was so bad that we could hardly feed her and so the prilosec/prevacid really wouldn’t work… we couldn’t give it and time it around feeds. She wouldn’t feed on demand.

If I were you, I’d consider prevacid in CaraCream. It’s immediate release so it works irrespective of timing around meals and feedings. You mix it yourself with the capsules. The good thing, is that you’ve got a good dose for his weight, so you should see some improvement if you’re able to give it correctly and if it’s purely a reflux issue. You can contact marci-kids for more info on caraCream. When we started using it, it really turned things around for my dd, though the taste was kind of funky for her so that was a challenge.

If things don’t improve, you might want to consider MSPI- maybe something in your wife’s diet is causing a reaction.

Good luck.

[Anonymous]

I was under the impression that CaraCream was no longer available. Can you get it in Canada?

Thanks

Adam

[Anonymous]

I’m not totally sure, Adam, but I know several moms use it. I think they just order it directly from Marci Kids. http://www.marci-kids.com

[Anonymous]

I’m sure this has already been said, but basically what happens is when you take your baby off the zantac to put them on the prevacid they are not really on any meds until the prevacid kicks in. So, it is best to keep the baby on the zantac for the two weeks that it takes the prevacid to kick in. That time for us with the pepcid and prevacid was the best my son ever was. My ped wouldnl’t go for it long term though. So, we did zegerid and it worked pretty well, but the sleep never improved. Caracream or zegerid are best since you don’t have to time around meals. My son breastfed and I know how hard it is to time around the meals. If your wife can handle it, Do not stop breastfeeding. The breast milk has enzymes in it that help with the reflux. The milk also calms mom and baby which is what both need. There are just so many benefits to it. I hope things are better soon.

[Anonymous]

It’s not supposed to be available, you’re right. If you call marci-kids though, many people from the forum seem to be getting it. Especially to use with prevacid, since that’s not the same med as what’s in zegerid. Ask at marci-kids. It really is easier.

[Anonymous]

YES you can definitely get Caracream in Canada, we are in Ontario and I ordered with a guy at U Missouri named David Stock yesterday.

Reflux Solutions can be reached at 573 884 0672

You can get it in Canada because Zegerid is not available here. I think they can still ship anywhere but the US.

[Anonymous]

Hi let me first say that I am no doctor and that I’m only trying to help.

We have had 3 kids with gerd, the youngest being 1 month old right now and we are trying to find the right medicine dosage for her with not much help from the idiot doctors here (but that’s another story).

I just wanted to let you know that she absolutley could not tolerate the “solutabs” that your child is taking. I think all 3 of my kids have had mspi, which is mik/soy protein intolerance and it severely aggravates the reflux symptoms. Apparently something like 60% of infants with gerd also have mspi so look into that when you get a chance. The solutabs definitely have lactose in them among other ingredients that maybe your child is sensitive to as well.

Our kids did great on the Neocate formula with a high dose of losec in caracream. I desperately tried to breastfeed but in the end the formula was a lifesaver. Like I’m talking going from crying 5-6 hours a day and sleeping less than an hour at a time to NEVER crying and sleeping 5-8 hours at a time. No kidding.

Your medicine dosage sounds great, I’d try and get “Zegerid” though if you are in the states.

Also, if you do change to hypoallergenic formula we found that it still took 5-7 days on that to see a real difference.

Good luck

[Anonymous]

Adam, since your little one is already on prevacid, I would try prevacid in CaraCream before trying zegerid. You CAN get it these days directly through marci-kids even though I don’t think that they’re technically supposed to. I think they found some way around it and are supplying it without advertising that, kind of on compassionate grounds, it seems. That’s just my opinion though, only b/c it’s the same med. We also had really good success with CaraCream once we could get my dd to take it- she really wasn’t fond of the taste, but timing around feedings wasn’t an option for us b/c of her feeding aversion.

I’m not trying to dissuade you from going to formula, b/c in the end, I think that everyone has to make the decision that’s right for them. I just wanted to let you know that we switched to formula for my dd because her feeding problems were so severe. I had hoped that it would be the answer for her, and was sad that it wasn’t. I stopped bf before I found out about the elimination diet and other things that I could have tried. I’m not big on having regrets since we can’t change the past, but I just wanted to let you know that if your child is MSPI, the elimination diet is an option (though I’ve heard that it’s not easy). Formula isn’t the only solution, and in our case, it wasn’t even a solution- she actually didn’t like the taste of the formulas after having been BF and ate even less. I hope that you find a solution for your little one soon. Good luck.

s&h’s mum2007-11-27 19:52:49

[Anonymous]

Thanks so much for the advice. My wife and I really don’t want to stop breastfeeding for the reasons you suggest lori. What if forumla doesn’t help and all we have done is stopped the benefits of breastmilk. We have thought of MSPI but wouldn’t there be other symptoms other than a feeding adversion? His bowel movements look normal (he has always been fairly regular with one a day but over the last little while we are averaging 2x a day). There are no traces of blood, the colour is normal. He has no fever or rash. In truth, his spit up is frequent but not bad in that he doesn;t cry or projectile vomit. The spit does tend to be mucussy however.

He does sometimes take a bottle of formula at night – about 5 ounces. He will take it and his night time spit is rare. We have tried forumla sometimes during the day and its not like we have had anymore success. So right now I suppose he get a little of both. My wife has eliminated all milk products as of yesterday.

The thing is he seems to want to eat more but won’t. How did you overcome the aversion?

[Anonymous]

Overcoming the feeding aversion was a long road, but hers was a very severe feeding problem (not to depress you). My dd started feeding therapy at 8 months old, and was in therapy until 15 months old. She had a bottle aversion and an aversion to eating. What I would suggest is to try and see if the caracream helps. If that doesn’t do it, don’t discount MSPI just b/c the only symptom is reflux- for some babies that is the only symptom. It’s worth a try. Good luck.

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