Posted By Posting
Aug 12, 2011
New Here - Questions!
Hello. I'm new to this forum and had a few questions. First, my son is almost 5 weeks old and we recently visited a gastroenterologist because he has symptoms of reflux. He was prescribed Prevacid (1.5mL 2x daily) - it is in compound form. The doctor also said that if the Prevacid does not help after a couple of weeks that I should look into a possible dairy or soy intolerance. Here are a few questions I have: 1) How long did it seem to take before you started to see improvements using Prevacid. Also, did your doctor recommend a certain time period to wait before feeding your infant after administering the Prevacid? It seems that a child with reflux would just spit up the meds if don't too close to a feeding. 2) For those of you who have children with dairy or soy intolerance, are there symptoms specific to intollerance that would indicate an allergy vs. reflux for are the symptoms extremely similar? Right now, I haven't eliminated anything from my diet as the doctor recommended I see if the Prevacid helps and, if not, I should start eliminating soy/dairy. 3) Do your infants with reflux dislike being on their backs? My son does not like anything that involves him having to be on his back, including his swing or basinette! This has been SO difficult because I know that babies are not supposed to be on their stomachs to sleep so I find myself sleeping with him on my chest each night, all night so that we can get some sleep! Did any of you experience this and did the reflux medication help with this??? 4) Do any of you thicken your breast milk or formula? My doctor didn't tell us to do this for now. If so, what age was your infant when you started thickening? 5) Currently, I'm breast feeding. I have thought of switching to formula because I'm wondering how much of what I'm eating may be irritating his reflux. I know that there are definite health benefits to nursing, but I'm also wondering if any of you changed to formula and noticed a huge difference in your infants reflux symptoms/behavior - for better or for worse? I'm struggling a lot with knowing what to do. I know this is a lot of questions! I'm just trying to make sense of all of this and hopefully help my little guy feel more comfortable. Thank you so much in advance for your responses:)
Aug 12, 2011
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 can answer some of the quick stuff and will be back tonight to give a more thorough answer.

Prevacid- Must be given on an empty stomach with a feeding 30 min later. It is best to give it before the first morning feeding and before the last feed of the day. It can take up to 14 days to see results. The compounded Prevacid can be very very tricky. It has to be made by a really good compounder or it will become ineffective after a week. The instructions are listed below. I would go to a compounding pharmacy or a hospital pharmacy. I found it easier to just od it myself by buying caracream from and mixing it with OTC Prevacid. Then I knew what I had. It also eliminated the timing need.

1.Make sure that your pharmacist does not put any kind of flavoring agent in the compound.

2.Make sure that the concentration is between 2 mg/mL and 4 mg/mL. This means that for every milliliter of suspension, you are giving between 2 and 4 milligrams of drug.

3.Ask that your pharmacist make the compound with 16.8% sodium bicarbonate if the total volume of each dose is less than 7 mL. If the total volume of each dose is greater than 7 mL, ask that your pharmacist make the compound with at least 8.4% sodium bicarbonate.

It is do not recommend that you give less than 3.5 mL of a PPI suspension at any concentration. This is because doses smaller than 3.5 mL do not provide enough buffer to adequately protect the drug from being destroyed by the acid that is present in the stomach.

If you want to make it easier on yourself you can tell the doctor you want the prescription changed to Zegerid powder packets. It already has the sodium bicarb in it already. You mix it with water and thats it. You have a fresh dose each time.

I would hang in there with the breast feeding while you figure out the meds... I regret having stopped, but I thought it was my milk... it was not. It was 100% not having the right meds on board but there was no going back. : (

Yes, my son HATED being on his back. I got the Fisher Price Soothing Motions Glider. Perfect angle and no crunching of the stomache. That is where he slept. It was a life saver.

Thickening are tough. Their systems are mature enough to digest what you choose to thicken it with. In my opinion, it better to eliminate the acid and live with the pukes as long as they are not asperating. The pukes will stop and then it will be more like silent reflux. They will regurgetate but it wont come out. The key is to get the acid out of there so it does not burn and do damage to the ears, nose, and throat.

Aug 12, 2011
Hi and welcome,

Sorry to hear your baby is suffering but it sounds like you have a decent GI, and that's a good start.

Reflux and milk soy protein intolerance (MSPI) look very similar, and often go hand in hand - the symptoms mimick each other and it's quite common for reflux babies to also have MSPI. My own daughter's issues were never fully under control under we got her on a high enough dose of Prevacid, eliminated dairy (including hidden dairy) from her diet, and put her on Neocate. You can learn more about MSPI at: Check out everything under the 'Parents' tab. (Keep in mind, even if your baby does have MSPI, Neocate isn't the first step. If you're up for it, you could try an elimination diet yourself and keep nursing. If you decide to switch to formula, you'd want to try Enfamil Nutramigen or Similac Alimentum to start, which can be bought in stores. These are "partially hydrolized" formulas, whereas Neocate/Elecare are elemental, or 100% hydrolized, formulas. You would only go to Neocate if your baby did not improve with these first options.)

For what it's worth, if it were me I'd give the Prevacid a little time, cut some dairy out of your diet, (and things like caffeine, etc. - the major irritants), and see how it goes before giving up breastfeeding.

PPIs (like Prevacid) need to be given on an empty stomach, 1 hour before a meal. You can learn more about how they work here:

My baby started sleeping on her stomach at 3 months when she learned to roll over. Swaddling helping tremendously until then. The best swaddle is the Miracle Blanket. (Trust me, we've used them ALL!) The Woombie is also very good. We used the Tucker Sling for a long time too - even after she was sleeping on her belly. This allowed us to elevate her mattress to a high angle by putting several yearbooks under the legs at the head of her crib. She also liked the feeling of being "tucked in" in the sling. We were very happy with it.

Good luck and let us know how things go. Oh, just FYI, if you want to make paragraph breaks in your entries, put < p > (no spaces) between each paragraph.

Aug 12, 2011
ps. I am with VigilantMom - the pharmacy compound is tricky and we make our own compound at home, which is stable for four weeks and allows us to give it any time, without regard to an empty or full stomach or mealtimes.

We use Buffer Babies, which is a sodium bicarbonate suspension we mix with the Prevacid. (We buy the BB from - part of Marci Kids and the University of Missouri - and the Prevacid capsules from the store. Cut open the capsules, mix the beads with the BB, and you're done.)

I know it sounds kind of strange and intimidating, but you can always ask your doctor about this option. Both our pedi GI and pediatrician are on board and knew about Buffer Babies before I even brough it up. For us it just makes everything easier...I'm confident the med is going to get to her stomach, protected from the acid so it can do it's job. I don't have to fret over timing it right and making sure her stomach is empty.

So, just something for you to consider!

Aug 12, 2011
Thank you so much for responding. I'm sure hoping that the Prevacid compound works. I may consider doing what VigilantMom and dcd suggest and mix my own. I looked at the Prevacid compound and it looks like the concentration is 3Mg/ML. However, I'm not sure what percent of sodium bicarbonate was used. His dosage is only 1.5mL 2x daily, so I'm hoping that's enough to help?

I'm trying as hard as I can to continue breastfeeding. I've been a little frustrated because I have read so many different opinions on what foods are considered irritants and I'm constantly feeling like I'm eating something or another that will cause his reflux to be worse:(

Oh, I wish I would have known about the Fisher Price Soothing Motions Bouncer! I just bought this Fisher Price Rock and Play that's inclined, but I'm hoping it doesn't crunch his tummy. I may post and see if anybody has used the Rock and Play with or without success since I already bought it.

Check with your
doctor first!