Posted By Posting
Nov 07, 2010
rownen
Keep weaning or put back on meds
Hi everyone, Here is a little background since I am new here... My son Rownen was diagnosed with silent reflux at 7 weeks. We put him on Zantac and that seemed to work well. He seemed symptom free for a while. We stopped Zantac when he was 4 months because his ped said he should have outgrown it by now. Well, from 4 months to 6 months he refused to nurse while awake, I had to dreamfeed him all the time. He developed a hoarse voice and would sometimes spit up 2 hours after a feed. I took him back to the ped and she prescrived Omeprazole - 20mg (split twice a day). Within 2 weeks, he was a changed baby! We had flare ups and such, but he never refused to nurse again. Solids is still an uphill battle... but we are trying at least. He just turned 10 months and all seemed well, so we started to wean him. We took out the morning dose 10mg, so he is only getting the night dose. After 2 days, he started to nurse less. He is still willing to nurse, but will stop shortly after the letdown. He is not spitting up at all, but he has developed a hoarse voice again. It has been 8 days since the lowered dose and the hoarse voice seems to be getting worse. After all this, my question to you loving moms is... do you think this is caused by an acid rebound, in which case, should I wait it out... or should I consider this a fail and put him back on the morning dose? I was so hopeful that he may be better. I wanted to give it a chance. By the way, we did try a wean at 8 months and after 7 days, he threw up 2 feeds in one day so the ped said to put him back on full strength. He stopped vomitting the next day. I am just so confused.... Thanks!
Nov 07, 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 would put him back on the meds and try again at his first birthday.
Nov 07, 2010
dcd
I agree w/Karen. Sounds like he's not ready.
Nov 08, 2010
rownen
Thank you for the input. I guess my gut is telling me he is not quite ready either. I am so conflicted though because I am convinced that the Losec (Omeprazole) got him really constipated. He was constipated from the moment he started the meds. His poop this past week on the lowered dose was so much better and as a result, his appetite is bigger. His nose is really stuffed up right now. I am not sure if he is having that because of a cold or because of reflux. The symptoms are oddly similar. My husband has a cold right now, so maybe its a cold. I am going to give it one more week and see. I hope it won't do too much damage if it is indeed reflux rearing its ugly head. If any of you wonderful moms have weaning experiences to share, please do. I really don't know what good results look like. Thanks again.
Nov 08, 2010
dcd
Have you considered trying a different PPI? If the Omeprezole doesn't agree with him, why not switch to something else and see what happens?
Nov 08, 2010
rownen
I never even thought about a different PPI. That's very interesting. My ped seems to only use Losec. What do you think about me switching the LO to Zantac. He responded well to it when he was young. Do you think it would be a good alternative to PPI for moderate silent reflux? Is it hard to give Zantac to a 10 month old?
Nov 08, 2010
dcd
Just my opinion - I wouldn't switch to Zantac. Zantac is an H2 Blocker whereas Prilosec is a Proton Pump Inhibitor. The two classes of medication work in different ways - i.e. H2 Blockers block some of the signals that tell the stomach to start producing acid whereas PPIs completely shut down the system that produces acid. And PPIs are more effective. (The body can build up a tolerance to H2 blockers.) You can learn more about the different meds and how they work here: www.marci-kids.com and other places online.

I don't think it's unreasonable to suspect that the Prilosec is causing the constipation issues - if you read through these boards you will see that different kids sometimes respond differently to different meds. You have to find the one that suits your baby. You might try Prevacid (lansoprazole) or Nexium (esomeprazole). Be sure to read up on how to dose and administer these meds because if they are administered incorrectly (i.e. with food instead of an empty stomach, etc.) they will not be effective.

What I really think you should do is request a referral to see a pediatric GI. A specialist will be more knowledgeable about infant reflux and will be able to partner with you to build the best plan for your son.

Also, you are right that chronic congestion can be a symptom of reflux. Although it could just be a cold. And keep in mind that if you DO decide to add Zantac again, you will need to be careful about when you give it to your son - if an H2 Blocker and PPI are given too closely together they can cancel each other out. A pediatric GI would probably be able to explain all this to you better than a regular pediatrician.

I hope he starts feeling better soon!

Nov 09, 2010
rownen
Thank you so much for the information. Unfortunately, my ped doesn't think my son needs a referral to a pediatric GI. She said that by the time we get an appointment, he would have outgrown the issue. Here in Canada, the waiting time to see a specialist is very long. We would have to wait a full year to get in to Sick Kids' GI dept. On the other hand, our Osteopath thinks that the hoarse voice is coming from his mouth breathing because he is so congested. She said that he clearly has a cold and that may be the cause of all the symptoms, rather than reflux. I don't know what to think anymore, I guess I have to give it another week and see. I just hope I am not causing any more damage to his little system. He is also teething again, so that will mess things up too. Its such a roller coaster. I don't know how you amazing moms cope.
Nov 09, 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
A few thoughts for you...

PPIs can cause constipation. Some feel that it is because magnesium needs acid in order for it to be absorbed into the body. A decrease in magnesmium can lead to constipation. Nothing proven.. just a theory. None the less, constipation can do a number of reflux and their appetite. Ask about adding Miralax to your arsenol. I know you probably dont want to add another med to fix the side effects of a different one, but you have to do what you have to do.

Ryan always lost his voice when his reflux was out of control. The acid was damaging his larnex.

Teething wrecks havic on their systems, especially on their reflux. I never considered weaning off of the PPI until he was done teething.

I like DCD do not have a lot of faith in Zantac. It fine in the beginning ot help you diagnose if reflux is your culprit and for the wean down process, but outside of that... well I guess I have not seen too many moms have good luck with that.

Now all this said, you are his mom and you know him best. Follow your own instincts. It certainly never hurts to try Zantac and try weaning. You will never know till you try. Good luck!!!

Nov 12, 2010
rownen
update
I wanted to give you a quick update. My little boy still has a hoarse voice and now he has a full blown cold. I have never seen a cold this bad. He had two colds before and both were very mild. He seems miserable with this one. We took him to see his ped and she insists that the hoarse voice is from the upper respiratory infection that he is having and that there is no connection with reflux. She doesn't think reflux will make a cold worse or cause a cold. I guess I just have to ride it out and see. His appetite has been alright. What we need to do now is to split his meal into 2 phases. He will take about 10 spoonful of food at the first sitting and then get really fussy and uncomfortable. We will have to take him out of the highchair and let him play a bit (he sometimes burps during this time, but not always) and then 15 - 20 minutes later, we can put him back in the high chair and then he finishes his meal. Sounds a lot like reflux to me... BUT, if we give him cheerios, he will eat that all day long without a fuss. Has anyone else experienced this kind of eating arrangement? Oh and to vigilantmom - I saw in your profile that Ryan was at the 6th percentile.... when did he drop to that point and how long did he stay there. My son started out in the 25th percentile and since he started crawling, he has steadily declined in percentile and is now hovering around the 10th percentile and still dropping. He hasn't dropped in actual weight, but weight gain since he was 7 months has been really really slow. He is 10 months now and has only gained 1.5 lbs. I am convinced that he has the capacity to be larger (meaning he is not "just small" as the ped insists). Just wondering how you knew that your son should and can gain more weight with the right combination. Thanks again!
Nov 12, 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
Ah.. so sorry that Rowned has a cold. The strain going around right not is brutal!!! A hoarse voice is part of this strain so hopefully that is your culprit. Time will tell. Did you put him back on the 20 mg of Omeprazole or are you sticking with the 10?

As far as the crazy feeds... yes, unfortunately we have all been there. Its tough. You know in your head you should not let the crazy cycle start but you really want to do what ever it takes to get them to eat. I finally went with the theory of "Do what you have to do and deal with the fall out later." : ) It was worth it to save everyones sanity.

As far as Ryans weight... He started at the 97th percentile and ever month he dropped on the chart. I wouldnt have cared where he was on the chart as long has he stayed consistent with his own growth curve. He was not though, he was falling off of it. He was a big baby at birth, and I was a skinny pregnant woman so his size was not from my eating habits. Most importantly, every single feed was a nightmare, even as a brand new baby in the hospital. It was obvious that his intake was not enough and it took its toll. When he bottomed out and the talk began about a feeding tube is when I contacted the University of MO. I am only 5 hours away so I would have made the drive. They told me to try Caracream for 2 weeks first and if that didnt work then to make the drive. It was his magic bullet. He was 14 months at that time.

Check with your
doctor first!