Posted By Posting
May 25, 2009
heather13
nursing on demand with carafate
Last week our pedi prescribed carafate 3x daily for my 10 month old who was Dx with reflux about two months ago. We're also on Prevacid now (1/2 solutab 1x daily) after trying two others that didn't work. I didn't realize until I searched here that carafate should be dosed 2 hours after meals and 1 hour before - does this apply to breast milk too or is there a shorter window since it's more easily digested? Does the amount matter? Is it even possible to nurse on demand (which is about every 2 hours)? FWIW, her reflux during the day is non existent since we started Prevacid (actually Zantac took care of that as well), but at night she still wakes one or two times around 11 pm and 4 am in severe pain.
May 25, 2009
slimfast13
This is our dd, Alessandra. Dx with GER 10/07. Ran the gamut with meds and now done with them (crossed fingers). Using magnesium, probiotics and prebiotic supplements. With the exception of teething and general sassy attitude, all is well now. They really CAN grow out of it!
The fun of timing meds and feeds. Unfortunately, Carafate coats so well (aas it should) that even if she does eat, she's absorbing basically no nutrients and the Carafate is rendered less effective. I know BF is usually on-demand, but you may have to try a schedule to make sure she's getting the most benefit from both the BM and the meds. An hour after last feed may be enough time for it to work, but I'd ask the MD or pharm.

That dose sounds awful low for the Prevacid - we were on a full tab (15 mg) at 4 months old and low on the charts. You may want to ask about that, and perhaps dosing her at night or splitting the dose of half morning and half night. And the Prevacid is also dosed the same way (1-2 hours after last feed, at least 15 min before next, and no other med should be given within 2 hours either side of the Prevacid dose to make sure it's fully absorbed). Lots of fun, huh? HTH

May 25, 2009
heather13
Thanks, that does help. Funny you say that about the prevacid dosing. My firstborn also took prevacid and was given those same dosing instructions by a different pedi and the RPh. This time the pharmacy told me it didn't matter when she took it, and the new ped's staff didn't have any specifics either. I initially tried to stick with the rules I remembered but I've been lazy about it lately. They also told me I could give the Carafate at the same time as the Prevacid. Yes or no? We can't get into a pediatric GI until July 1 (we've been on the wait list a month), so I'm grateful for any advice and insight!
May 25, 2009
jeddsmommy
Jessica, Mommy to Jedd, severe reflux, severe food and oral aversions, Finally G tube free!!! VSD repair 4-24-07 (open heart surgery), hypospadias, repaired 3 times and Ear tubes Visit Jedd at his CB site: www.caringbridge.org/visit/jedd
FWIW as well, don't dose the Carafate and the PPI at the Carafate at the same time span.

We were on tube feeds when we used both and our schedule was kinda like this:

6:30a.m. PPI 7:30a.m. Caratate 8:00 first tube feed.

Continued on a 3 hour schedule through out the day with Carafate 30 mins prior to each tube feed.

At night we just did the PPi 30 mins prior to his nighttime pump feeds at 8:00, feeds started at 8:30p.m.

May 25, 2009
jeddsmommy
Jessica, Mommy to Jedd, severe reflux, severe food and oral aversions, Finally G tube free!!! VSD repair 4-24-07 (open heart surgery), hypospadias, repaired 3 times and Ear tubes Visit Jedd at his CB site: www.caringbridge.org/visit/jedd
We posted at the same time last time. As far as a Pharmacy knowing when to dose coordinating meds together, I'd call the DR who RXed the med and get there take on it first. It would all depend on whether you talk to THE pharmacist or on of the techs. VAST difference there BTW. THE pharmacist should be able to tell you correct info whereas the tech will not and is not trained medically to do so.

I will say that THE pharmacist is a GREAT resource for med doses though. I have given them a call before to find out what the doses should be and asked to prescribing DR to adjust accordingly. They can also give you doses for any OTC med as long as you have a current weight and age.

May 26, 2009
heather13
Thank you so much for the advice. That schedule is very helpful. I can definitely work with that, especially seeing the PPI dosed 1.5 hr before a meal and still fitting in carafate. Saw our pedi this morning and DD has gained only 7 oz this month - a slight improvement over the last two months but still not ideal. I asked again about the timing of meds and she said not to worry too much about it. since she's not a GI specialist though I don't expect her to know all the nitty gritty. she's pulling some strings so we hopefully can see the GI in the next week or two.
Check with your
doctor first!