|Apr 11, 2011|
|He could have silent reflux, where there is no spit up but the acid is still coming up and burning the esophagus. I don't put much faith, personally, in Zantac. I don't know anyone it's ever helped long-term. It's an h2 blocker and the body can easily build up a tolerance to h2 blockers and they'll stop working. I would explore switching him to a proton pump inhibitor (PPI) like Prevacid or Zegerid. PPIs are considered the "gold standard" in treating reflux because they actually stop acid production from happening vs. work to neutralize acid once it's already occurred. They're also very safe b/c the meds never enter the bloodstream. You can learn more at marci-kids.com. Please go there and read all you can.
My advice is to first get him on an appropriate dose of PPI. If you still aren't seeing enough improvement, explore the possibility of MSPI (milk soy protein intolerance) in conjunction with reflux. The symptoms of MSPI look very much like those of reflux, and the conditions often go hand-in-hand. My daughter had both. The good news is that both conditions are usually outgrown. To rule MSPI in or out you'll need to try a hydrolized formula like Similac Alimentum or Enfamil Nutramigen - the proteins in these formulas are partially broken down so as not to cause reactions. I recommend Similac Alimentum READY TO FEED b/c it is the only formula that does not contain corn syrup, which can also be an irritant on little tummies.
If your baby does have MSPI, and is EXTREMELY sensitive, he may need Neocate or Elecare. This is not very likely but something to keep in the back of your mind. Neocate is an elemental formula in which the proteins are COMPLETELY broken down into amino acids, meaning it's basically impossible for them to cause reactions. My daughter needed Neocate. From her first feeding on Neocate she stopped spitting up, stopped fussing with feedings, and started sleeping.
For me the progression would be: PPI (appropriate dose and make sure you give it on an empty stomach 1 hr. before a meal, or use a compounded version), Alimentum, Neocate. And again, educate yourself by reading all you can before your GI appointment on Friday. Marci-kids and the resources on this website are two great places to start.
Good luck and I hope your baby feels better soon!