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  1. #1
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    Default Anyone Heard of this for Reflux in Infants?

    So my 5 week old DS has spit up a ton from the beginning, but over the last 3-4 days, it's become projectile several times a day. So I took him to the pedi today, who sent us for an upper GI series. Got that done (fun, spur of the moment with an almost 5 year old along, over lunch time!) and he does not have pyloric stenosis (Yay!) and they didn't see any reflux, but they admitted that he could still have it, it just didn't show up that fast.

    So after the report was sent to the pedi, I talked with him and he thinks it's just strong reflux causing the projectile vomitting and that the options are:

    *thickening his milk (hard to do when breastfeeding!)
    *using some sort of medicine that empties his stomach faster (don't know the name yet)
    *possibly switching to formula if the meds don't work

    I would be fine thickening his milk, but I'd pretty much have to pump or formula feed, however, I've never heard of a med to help empty the stomach and I guess I'm a little leary of the idea, although I don't have a clear reason why. Is this common practice? I should mention that DS has been on Zantac for a couple weeks, but I haven't noticed any real difference.

    Why wouldn't we try something like Prevacid first/instead of Zantac or the new med? (I never think of these questions when I'm on the phone!)

    Any thoughts/BTDT?

    Thanks,
    Christina

    By the way, when I say projectile, massive amounts (I'd guess at least 4 oz. at a time) shoots out his mouth and nose, sometimes with no warning, sometimes with a lot of fussing beforehand.

  2. #2
    brittone2 is offline Blue Diamond level (20,000+ posts)
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    Thickening milk w/ rice cereal? I thought that had been debunked as a treatment for reflux? I think it stops it from coming out as much but can cause irritation without anything actually coming out? (eta: basically masking the symptoms which would make it harder to gauge whether meds were helping, etc. I would think?)

    http://www.kellymom.com/babyconcerns...#thickenedfeed

    eta: many good links at the bottom of the above thread too. I am far from a reflux expert but hopefully you can get some advice from BFing moms that have BTDT.
    Last edited by brittone2; 08-21-2009 at 03:53 PM.

  3. #3
    o_mom is offline Pink Diamond level (15,000+ posts)
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    The med to empty the stomach is probably Reglan. It's been around for a while, but that should help your searching.

    I would look at the infant reflux group that someone here is a mod for (can't recall at the moment who). Zantac may not be the med for him - I know many peds start off with weak meds at the very lowest dose and then say "well the meds didn't help, it isn't reflux", but many babies need higher doses or stronger meds.
    Mama to three boys ('03, '05, '07)

  4. #4
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    Ah, if it's Reglan, then I'm at least familiar with that. I took it while pregnant with DS, ironically because he made me throw up so much!

    Still don't know how I feel about it. Or the thickening. This wasn't my regular pedi (she wasn't in today, though I like this guy). I just hate not knowing what to do or how to help. I've already cut out dairy, the Zantac doesn't seem to be helping and the spit up is now projectile. I just want some more concrete answers, but there are so many differing opinions.

    Ugh, I was hoping the GI would give us some answers, not more questions.

    Thanks,
    Christina

  5. #5
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    KpbS is offline Red Diamond level (10,000+ posts)
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    I would try a different reflux med. like prevacid before any of the other options. It is very unlikely to see the reflux happening during the test they sent you for. That is what we were told after ours It does NOT mean that your DC does not have significant reflux.

    Is your DC having any exposure to dairy through nursing? I remember you were trying to eliminate it from your diet... Allergies can cause significant reflux and projectile vomiting in addition to reflux. He may be allergic or sensitive to a number of things.

    Feel free to PM me.
    K

  6. #6
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    My DD takes a very, very low dose of erythromycin to aid in stomach emptying. Our GI doc did not prescribe Reglan because it has apparently had some negative press lately about potential side effects.
    I should add that DD is 2 1/2 yrs old but has dealt with reflux since early infancy (we had no clue!) and she learned self-limit her milk/food intake to counterbalance the irritation of the reflux.
    Only recently have we helped her increase her food intake and as a result, she too has had frequent episodes of vomitting. The erythromycin does help. She has less emesis and is gaining weight.

    All this being said your little guy may not have this exact issue. But we, too have had DD on Zantac and I've felt its done nothing at all. Only the erythromycin seems to help her keep food down.

    Amy

  7. #7
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    I would be hesitant to use reglan or erythromyacin unless they have a documented delay in stomach emptying. Prevacid is the drug of choice for reflux (after Zantac...which is about worthless).

    My son's GI recommended rice cereal to thicken, but also told us it may/may not work...try it if we wanted to. It helped DS, but doesn't help everyone.

  8. #8
    mecawa is offline Platinum level (1000+ posts)
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    Quote Originally Posted by Indianamom2 View Post
    So my 5 week old DS has spit up a ton from the beginning, but over the last 3-4 days, it's become projectile several times a day. So I took him to the pedi today, who sent us for an upper GI series. Got that done (fun, spur of the moment with an almost 5 year old along, over lunch time!) and he does not have pyloric stenosis (Yay!) and they didn't see any reflux, but they admitted that he could still have it, it just didn't show up that fast.

    So after the report was sent to the pedi, I talked with him and he thinks it's just strong reflux causing the projectile vomitting and that the options are:

    *thickening his milk (hard to do when breastfeeding!)
    *using some sort of medicine that empties his stomach faster (don't know the name yet)
    *possibly switching to formula if the meds don't work

    I would be fine thickening his milk, but I'd pretty much have to pump or formula feed, however, I've never heard of a med to help empty the stomach and I guess I'm a little leary of the idea, although I don't have a clear reason why. Is this common practice? I should mention that DS has been on Zantac for a couple weeks, but I haven't noticed any real difference.

    Why wouldn't we try something like Prevacid first/instead of Zantac or the new med? (I never think of these questions when I'm on the phone!)

    Any thoughts/BTDT?

    Thanks,
    Christina

    By the way, when I say projectile, massive amounts (I'd guess at least 4 oz. at a time) shoots out his mouth and nose, sometimes with no warning, sometimes with a lot of fussing beforehand.
    Well with DD2 the first thing they did was start Zantac, that didn't work at all (she had the projectile thing going on just like your DC, full bottle woluld come right back up) they switched her to prilosec which worked better but still didn't solve everything 100%, they then thickened my breastmilk with rice cereal (1tsp. per ounce) so I was pumping into bottles so I could thicken it, that helped some but still not much, we then found out she had a milk and soy protein allergy on top of the reflux, I tried elimintating these things from my diet, didn't work, it was strongly suggested I try nutramigen, so I did because at this point I couldn't put her to breast anymore anyway. Nutramigen worked really well, we then weaned the rice out of her bottle, and she was and currently is on Prilosec and Nutramigen formula, and she has had not one episode of reflux since then.

    About changing the med, I would definitely bring that up to your doc. Zantac does not work for everyone.

  9. #9
    Melbel's Avatar
    Melbel is offline Diamond level (5000+ posts)
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    DD2, my little over achiever, has had severe reflux (silent variety) since early infancy. Neither Zantac nor Axid (in the same class of drugs) helped us much at all. We did better with Prevacid (a PPI), but not great. We have had the greatest success with Zegerid (Prilosec, another PPI), but had to buffer it with Tums Cherry Supreme and gas drops to help her keep it down. From what I recall, Reglan is more controversial due to side effects. I found the following sites to be very helpful:

    www.infantreflux.org (you will find tremendous information on the site and message boards; Laura (hellbennt) is a moderator)
    http://www.marci-kids.com/ (great information for infants with reflux; my pedi GI personally knew one of the doctors which was great; consulting via email, they assisted us with Zegerid dosage and buffering)

    I actually do not know how we would have survived without these resources.

  10. #10
    mecawa is offline Platinum level (1000+ posts)
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    Quote Originally Posted by brittone2 View Post
    Thickening milk w/ rice cereal? I thought that had been debunked as a treatment for reflux? I think it stops it from coming out as much but can cause irritation without anything actually coming out? (eta: basically masking the symptoms which would make it harder to gauge whether meds were helping, etc. I would think?)

    http://www.kellymom.com/babyconcerns...#thickenedfeed

    eta: many good links at the bottom of the above thread too. I am far from a reflux expert but hopefully you can get some advice from BFing moms that have BTDT.
    Yes, it was debunked, and the American Academy of Pediatrics is in fact very much against it. However, a lot of GI docs are still doing it. That was the second course of treatment for DD2's reflux and I have a friend who has a son who has the same thing and they were told to thicken his bottles with Oatmeal. It helps it from coming up so easy, but doesn't solve the problem at all. We decided to wean her from the rice after finding the right med and having her switch (reluctantly) from breastmilk to Nutramigen.

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