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May 31, 2010
tripletmama
simply thick/enfamil a.r./ gas & fussiness - pls help!
one of my 3 month old triplet girls is suffering from silent reflux. she is newly diagnosed and our doctor isnt much help. hes prescribed zantac 1ml 3 times a day. we switched her to enfamil a.r. and that helped alot. lately she doesnt take more than a 30-45 minute nap and today i noticed that she was very gassy when she woke up. i held her, she passed alot of gas, and fell asleep in my arms while i held her. we thought we were having a sleep problem and thought it was separate from the reflux but now i'm thinking differently. could the a.r formula be causing her to be gassy? would thickening regular formula or breastmilk with simply thick help with fussiness/gas? breastmilk is too thin, tho i think she likes it - just not the after effects. the thickened formula has definitely helped but i'm wondering if it's introducing another problem. we are desperate, especially because there are two other precious los to take care of.
May 31, 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.
Enfamil AR has rice starch in it and i noticed with babies that have Acid Reflux, it can take a lot of time for their systems to adjust to just about anything. how long has she been on the formula? i would say give it at least two weeks to let her system work out the kinks. many of our babies just have immature GI systems and it just takes a little longer to "learn" how to digest things.

another thing, Enfamil AR is designed to thicken in the stomach, it can only thicken if there is acid present. while using it with zantac, it could be causing the extra gas and pain. here is an article about it: http://www.ivillage.com/frequent-spitting-should-you-be-concerned/6-n-136664

you could try a non AR formula (you could try a regular milk formula or a hypoallergenic one) with rice or oatmeal added. It will take some trial and error and nothing is going to be a quick fix, i would say many times you have to wait a week or 2 to see real results.

you should ask your dr about using simply thick, i know it is for kiddos with problems swallowing and need thicker liquids but i don't know the over all effectiveness at keeping liquids down. *Good luck!
Jun 01, 2010
tripletmama
Oh - I can't thank you enough for giving me the link to the info about Enfamil AR and Zantac! I cannot believe my doctor doesn't know this information. He was pretty useless in helping me figure out what was going on. Actually, I've done all the diagnosing and troubleshooting. All he did was write me a prescription for zantac. I am going to try not giving her the zantac and just giving her thickened formula. She seemed to be doing very well,except for constipation, before I introduced zantac. I think, in addition to having the irritation from the silent reflux, she really hates the FEELING of having stuff come up. My mom's side of the family has a lot of sensory stuff - very picky eaters, restless leg, particular about sounds or light or touch. So...I think that's half of the problem. I can't tell you again how much you might have helped us!! Thanks!
Jun 01, 2010
sreece5316
Mom to William, 8/04 (perfectly healthy!) and Alexandru, 11/07, with laryngopharyngeal reflux and bronchomalacia
Hi there, we use Simply Thick for my 2 1/2 yo son to help him with his swallowing. We're doing it on the advice of his feeding therapists, and our ped also thought that having fluids thickened might help the liquid volume from being refluxed. One of his feeding people said that she doesn't usually recommend Simply Thick for little ones, only for older kids and adults, because she's seen it cause significant stomach upset (it's a xanthan gum-based gel) and diarrhea. We haven't run into that with my little guy, but apparently these things should be used with some caution. Good luck, and I hope the thickened formula helps! We were advised several times to thicken breastmilk for my little guy when he was an infant but it doesn't seem like there's an easy/good way to do that so we never tried it.
Jun 01, 2010
vigilantmom
Ryan was born May 20th 2008. 9 lbs 2 oz. Ryan’s magic bullet was 30mg of Prevacid capsules mixed with Caracream from Marci-kids (I am forever indebted to the team at Marci-kids), Claratin for the mucos, and Mirlax for the constipation. Within 2 months of this combo he jumped from the 6% to the 50% for weight and continues to climb. Be strong, listen to your instincts. Read his story for more specifics that just might help you too - Karen
Only thing I have to add is you may want to consider changing doctors. I can tell that you are frustrated with yours. Take it from someone who knows... If you dont feel like your doctor is your partner, move on. You will have lots of things that will come up with your little ones and you need someone that you can work with and trust. Better to change now than when you really need them.
Jun 01, 2010
tripletmama
I'll see a new doctor on wednesday. do you know about zantac and similac sensitive?
Jun 01, 2010
vigilantmom
Ryan was born May 20th 2008. 9 lbs 2 oz. Ryan’s magic bullet was 30mg of Prevacid capsules mixed with Caracream from Marci-kids (I am forever indebted to the team at Marci-kids), Claratin for the mucos, and Mirlax for the constipation. Within 2 months of this combo he jumped from the 6% to the 50% for weight and continues to climb. Be strong, listen to your instincts. Read his story for more specifics that just might help you too - Karen
I had very good luck with Similac Sensative with my son. It is a milk based lactose free formula which makes it much easier for their stomaches to digest. Far less gas and gastorintestinal distress. Prevacid and Zantac are both completely fine with it. Even now that Ryan is on whole milk I use the Lactaid brand of whole milk because it is lactose free. Some people have great luck with Nestle brand formula as it is broken down further. My daughter did great on that. Unfortunately it is kind of a guessing game which is no fun. If you decide to thicken your breast milk or formula do a lot of research and procede slowly. A lot of docs will sugget using rice cereal but a lot of kids really struggle with rice. It can be very constipating and gassy. I had better luck with no thickening and working with positioning and the right meds. I kept Ryan upright as much as possible. The Nap Nanny, Fisher Price Soothing Motions Glider, Baby Bjorn were life savers as well as putting a wedge under the changing table pad and 5 inch blocks under crib legs at the head of his bed with a tucker sling to keep him up where he belonged. He basically never layed flat and to this day does not like it. When I change his diaper after eating he insists on having a pillow under his head. One more thought... BioGia Probiotic drops. I swear by them. They really really help regulate their immature GI systems. I get them from behind the pharmacy counter at Walgreens or Target. They are refridgerated. 5 drops a day is all it takes. Amazing stuff.

Glad to hear that you are seeing a new doc. Finding one that you meld well with can make all the difference in the world. You sound like an incharge and confident gal. I like that. It will serve you well as you look for solutions for your daughter.

Best of luck to you on your journey. Keep in touch with your progress and questions. And Congrats!! Three angels to share your love.

Jun 02, 2010
taurusad
Sleeping & Reflux
i can tell you from my experience that the sleeping issues are directly related to the acid reflux and not necessarily the formula. However, the formula may be contributing to her reflux and stomach issues. I breastfed for 6 weeks and then switched to Nutramigen and although my baby is better than she was, her sleeping issues have always remained in some way or another. (she is also on prevacid which I now believe she is experiencing adverse side effets from and is also causing sleeping issues to get worse again). She gets really bad stomach aches from the medication.
Jun 02, 2010
tripletmama
How can you tell she is having stomach aches? My daughter has a lot of pain where she pulls her legs in, but I thought it was either a gas pain or just reflux pain. Now I'm wondering if it's a stomach ache! We go to a new doctor today. Hopefully that will help. I started her on her old formula - gasease - with oatmeal in it yesterday. I hope it helps. I figure this way the zantac can work better. Her identical twin is starting to have some of the same symptoms now. she was the smaller one, so I'm wondering if the size difference caused the delay in symptoms onsetting!
Jun 03, 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.
it is hard to tell with little ones. but in my experience, if it is gas pains their tummies will be a little rumbley and usually at some point in their crying will let out some gas. pulling legs up to tummy is usually a classic sign of gas/ tummy pain/ constipation.

if it is reflux you might hear some sort of reflux sound in their throats (if they are silent relfuxers) or cry after spit-up or vomit. Other things to look for: arching their necks or backs, sticking their fingers in their mouth, drooling any combination or even just crying. there are other signs but those are the pretty common ones.

tummy aches are a little harder to figure out. one of the best ways to see if something is causing a tummy ache is to stop giving her whatever it is you suspect causing her pain (ask a dr first)

sleeping issues can be totally separate from reflux. even if reflux is controlled sleeping issues can still be there. most of the time they resolve on their own with time, routine or age.

but i do agree that meds can cause tummy pain. most recently we switched Emily to prilosec in hopes it would do better for her then prevacid. she constantly complained of tummy aches and "ickies" in her throat. we switched her back to prevacid and over night all of the ickies went away.

Sometimes a med change is something to consider. most meds are trial and error some work for some babies and other don't work at all.

as for her twin, i'm sorry she is experiencing some problems now too! but it could be a flare from growing. my little one, did not have severe acid reflux but, i could tell during growth spurts or teething she was refluxy. i was able to control her symptoms with mylanta. ,y best advise would be to just watch her and if things get bad and they interfere with her eating and sleeping too much don't hesitate to talk to the dr.
Check with your
doctor first!