Posted By Posting
Mar 02, 2010
natheen
I am confused!
I took my daughter to see a new pedi today as the old was not too concerned with daughter because she was gaining weight and was not helpful. She was gaining weight because of all the forcing I was doing. Now the forcing is starting to die off, she's really pushing the bottle away. Anyways, the new doctor gave some pointers, which is to try the formula Nutramigen. Did anyone try that formula for that baby? My baby tends to have a lot of spit up with that formula and not as much with the thickened enfamil. She is on omperazole, 3 ml per day. It was working great for the past few weeks and now it seems its not working. Could it be that the compound is weaker now?
Mar 02, 2010
emibug
Kathryn, Pager Volunteer and mommy to Emily Mia 02/04/07. 3 years old with GERD. 30mg Prevacid and Pepcid AC. Mylanta needed for flares. Failed prilosec med switch. Tried and failed many med weans but GERD and pain are well controlled. Functional constipation. Reoccurring SBBO. Suspected IBD or autoimmune disease. Resolved issues: MSPI, CSID (acquired), Stage 2 kidney reflux, Chronic diarrhea.
Audrey Meadow 06/20/08. born 34/35 weeks. Still b/f and eats everything! ftt and chronic constipation.
nutramigen was a saving grace for us with emily but it my not be for every baby. emily was a gainer too and we too were side lined on GERD b/c she was categorized with MSPI above all else.

i hope you don't mind but i will give you some info from my research that you can run by your pedi if you have any questions.

nutrmigen is great if your baby has milk soy protein intolerance (MSPI) and can even be great if she does not. Milk is a hard protein to break down and for an infant with GERD milk formula can be kept in the tummy longer and refluxed more. Nutramigen is a Hypoallergenic formula which means it is broken down so it is a thinner formula. It goes through the tummy faster. BUT since it's thinner, for pukers and spitters it will come up.

I know now it sounds like a loose loose situation right? but just keep in mind 3 things: 1) she may be spitting up because she is getting used to the formula switch (which is normal for any baby) and can take up to 2 weeks for the old formula to get out of her body and 2) if she is still spitting you CAN thicken nutramigen. you can add cereal or a non calorie thickener like simply thick. and 3) if she is still spitting but is on a good dose of a PPI, her esophagus is still being protected from the acid. spitting and puking will always be uncomfortable but not as damaging.

keep in mind also that a lot of babies who do not like nutramigen like Alimentum which is a very similar formula. even if a baby does not have MSPI or a milk or soy allergy they my benefit from a formula like neocate for a couple months which is very easy on a refluxers system too.

if you are worried about the price tag on the formula WIC or your insurance my be able to help.

i know with the compounds some of them become less effective after 2 weeks, also if she is gaining you may want to consider asking for a dosage increase. if that is not possible ask if you are able to add in mylanta. if you have any other questions please feel free to ask!
Mar 02, 2010
natheen
Thank you so much for your information. I will definitely take this information with me to the pedi. what is the difference between omperazole and prevacid?
Mar 02, 2010
isobel'smamma
Sara, Mom to Isobel 10/01/08 Dx Silent reflux @ 6 wks. Prevacid 22.5mg split in 2 doses. Pepcid .5ml twice a day. Diagnostically confirmed milk protein, egg and cat allergy. Suspected corn, pea and squash allergy. Trialed Alimentum and Elecare without success, currently on Isomil Advance RTF with moderate success. Barium Swallow and UGI 3/08 Pondering a ph probe and endoscopy.
They are both PPIs - proton pump inhibitors. They actually stop the acid from being produced in the stomach by about 75-80%. Since they reduce the amount of acid in the stomach, it reduces the amount of damage to the esophagus and the amount of pain. Omperazole is also known as Prilosec - it is not commonly Rx'd for infants in the States because long term use can cause intestinal polyps. Every body reacts slightly differently to medications which is why there are so many PPIs on the market. Prevacid seems to help a lot of kids here on the forum - from what I've seen it's the most popular. It's also available in a solutab which makes it very stable and easy to administer. HTH.
Mar 03, 2010
michelle&aurora
Aurora born March 17, 2007
3 years, 8 months old
Weighs 25.8 lbs
8 lbs 11 oz at birth.
Recovered Chronic Projectile Vomiter
Prevacid Free since September 08
Egg allergy diagnosed Jan 26/09
Has a Pectus Excavatum
Has an Epipen
I wanted to add that you should generally try to only change one thing at a time. She should have at least two weeks on the Nutramigen before changing her medication. I know it might be difficult, but it will give you a better idea of what is working and what is not. We tried Nutramigen, but only made it 5 days because my baby would not drink it. The reason they want you to try Nutramigen for two weeks is to decide if she has a milk protein intolerance. If she gets better on the Nutramigen, you will have an answer. But if you switch her to prevacid before the two weeks, and she gets better, you won't know if the prevacid is working or if the Nutramigen is working. You might say, well as long as SOMETHING works, what's the difference?? The difference is that you might find that she'll do well for 2 or 3 weeks, and get worse again....and then you'll have to make decisions again, without any answers about what was working the best. I also wanted to say that the fact that your baby is gaining weight is a testament to how well you are doing managing her reflux, so good work, mum! (((HUGS))) Now you have to make sure she continues to gain, and try to manage the feeding difficulty. A mums work is NEVER done! There will be many many challenges to come as she gets older....just think, we are actually lucky that we get a head start on learning how to deal and cope with those challenges.....you'll be a better, stronger mum for it :)
Mar 03, 2010
natheen
We tried my baby on Nutramigen just on one feed and she spit everything out. She is used to a thickened formula and was struggling after the feed, I could see the milk was trying to come and she was gagging a bit, perhaps I should have tried another few more feeds. But isn't a milk thin as Nutramigen going to cause a lot of reflux? Thanks, I've lost so much weight out of caring for my baby. Many people are suprised to see that my baby weighs this much. Poor baby, I feel guilty after feeding her and its a lot of work. Just 2-3 weeks ago she was doing great and it has to happen all over again.
Mar 03, 2010
isobel'smamma
Sara, Mom to Isobel 10/01/08 Dx Silent reflux @ 6 wks. Prevacid 22.5mg split in 2 doses. Pepcid .5ml twice a day. Diagnostically confirmed milk protein, egg and cat allergy. Suspected corn, pea and squash allergy. Trialed Alimentum and Elecare without success, currently on Isomil Advance RTF with moderate success. Barium Swallow and UGI 3/08 Pondering a ph probe and endoscopy.
Maybe try thickening the nutrimigen? I assume the ped recommended that formula to try and rule out milk protein intolerance. The PP was right in telling you that it will take two weeks to get all the milk proteins out of her system. MPI can look just like reflux but is resolved when the offending proteins are removed. I'd give it a go- it's a starting point at least.
Mar 03, 2010
natheen
Right, I need to be a bit more patience and try things one at a time. Thanks
Mar 04, 2010
emibug
Kathryn, Pager Volunteer and mommy to Emily Mia 02/04/07. 3 years old with GERD. 30mg Prevacid and Pepcid AC. Mylanta needed for flares. Failed prilosec med switch. Tried and failed many med weans but GERD and pain are well controlled. Functional constipation. Reoccurring SBBO. Suspected IBD or autoimmune disease. Resolved issues: MSPI, CSID (acquired), Stage 2 kidney reflux, Chronic diarrhea.
Audrey Meadow 06/20/08. born 34/35 weeks. Still b/f and eats everything! ftt and chronic constipation.
if she is doing bad on unthickend formula call the pedi ask if you can thicken with a milk and soy free cereal like rice or oatmeal if you are not able to get simply thick. the cereal may cause gas or discomfort so add in some gas drops to the bottle or after the bottle too if you wish.

i would also ask for a swallow study to be done. she may have something else going on in addition to reflux that can be found on a swallow study. Try to keep her upright durring feeding and at least a 1/2 hour after a bottle. try small frequent feeds, 4oz or less at a time or if she has to have a larger bottle try to burp her in between or try a slower flow nipple but not too slow she has to suck to hard. Dr. Browns bottle are super great for reflux!
Mar 04, 2010
natheen
I am hoping that my daughter gets to see a specialist soon and at that time, I would definitely ask whether more testing should be done. She already had the barium ultrasound done. Thanks for the info.
Mar 04, 2010
mom2halleyann
Donnessa, mom to Halley born 3/10/07
Reflux (mostly) resolved at 14 months
and Addison born 8/17/09. Currently exclusively bf and on 7.5mg Prevacid
You may want to gradually wean her over to the Nutramigen. My daughter took it just fine, but I don't think she liked the taste initially. We started with a 1/2 oz of the Nutramigen and used 3 1/2 oz of her old formula. We added an additional oz of Nutramigen every few feedings until she was on solely Nutramigen. Also, you can try Alimentum (basically the same thing - just made by Similac). My dd HATED the Alimentum but took the Nutramigen just fine. May be worth trying Alimentum if she absolutely refuses the Nutramigen.
Mar 07, 2010
natheen
Hi, We're trying to get my daughter to drink Nutramigen. At the current moment she is drinking really less, not becaue of the formula because she started this hunger strike yesterday. She only drank 9.5 oz the entire day and had to go to ER. Today she is at 11.5 oz. Did anyone have days like this where they're child drank barely anything?
Check with your
doctor first!