Posted By Posting
Sep 30, 2011
poorhenry
Henry was born 5/12/11 at 5.8 lbs. A peanut, for sure. He was healthy and gaining weight steadily for first 6 weeks, then began refluxing through his nose. By 3 mos. he was projectile vomiting. Trying our 4th attempt at medication and desperate for a good night's sleep.
Is it time for a GI Specialist?
My 4.5 month old is dealing with a moderate to severe case of reflux. We are now on our 4th try with medicine, combining Zantac (2x/day) with Prevacid (1x/day). He was diagnosed around 6 weeks when he started refluxing through his nose. He's since developped into a chucker, spitting-up regularly, sometimes projectile. Each change in medication has seemed to help initially, including increases in doseage of Zantac, but within a week-10 days, he's screaming during nursings, spitting up more and showing a lot of discomfort. His sleep at 2 mos. of age was great; up to 8-10 hours uniterrupted during the night. It has been gradually decreasing for about two months now. He'll give us about 5 hours between his last feeding of the night and his first cries. Pacifiers help soothe for an hour or so, but then he's crying again. Some nights he wakes and cries every hour. We're exhausted. We ruled out pyloric stenosis with an ultrasound at 3.5 mos. Our pediatrician doesn't think an upper GI is necessary, since it will likely be inconclusive and we'll continue to treat as reflux. So my question is... do we take him to a GI Specialist and if so, what differences in treatment can we expect? Is it worth it or should we just continue with the pediatrician's treatment? Thanks in advance for your help and advice.
Oct 01, 2011
lorenzomama
Lorenzo b.4/25/07 1 week in NICU w/ aspirate pneumonia from a reflux episode; diagnosed GERD at 9weeks; Used Zantac for 5months. Currently using Chinese Medicine and Craniosacral Therapy. GERD, Obstructive Sleep Apnea, Sensory Processing Disorder. Ask me about breastfeeding a refluxer! Pic: day 5 in the NICU.
IMO, it is worth going to a PEDIATRIC GI specialist. They are generally more likely to be up on the latest research in pediatric GI diagnosis and treatment, tend to be more aware of additional issues that can create problems for children with GERD and also tend to be able to provide a broader range of potential paths to take when addressing the needs of a child with GERD.
Oct 01, 2011
mangogal
Mom to two refluxers. DS 4.5 years, on prevacid since 5 weeks. Trial wean this summer...fail. Intolerant of dairy and soy DD born Nov 2010. Currently on zegerid. Had stomach malrotation & surgery at 9 months. Avoiding dairy/soy with her while BFing.
Follow your gut...there is no reason you can't ask for a GI referral. Reflux does get worse before it gets better though., peaking between 4 and 6 months. There is lots of trial of various treatments before you find out what is right for your child. Have you tried any diet modifications if breastfeeding or formula changes? My first child was allergic to dairy and soy so I had to cut them out when nursing.
Oct 03, 2011
poorhenry
Henry was born 5/12/11 at 5.8 lbs. A peanut, for sure. He was healthy and gaining weight steadily for first 6 weeks, then began refluxing through his nose. By 3 mos. he was projectile vomiting. Trying our 4th attempt at medication and desperate for a good night's sleep.
I've cut out all garlic, onions, peppers, tomato, chocolate, as much caffeine as possible, especially fatty/greasy foods, peanut butter, various spices and more. I haven't tried eliminating dairy; I didn't think that was to blame and I'm not much of a milk-drinker. A friend's baby had bloody stools that signaled a sensitivity to milk and we haven't had that, so I figured what milk I do consume is OK. Also, my pediatrician says a GI doc will prescribe the same treatment he's already giving, so I'm wondering, aside from some tests, what can I expect to change if we do go to a GI doc?
Oct 03, 2011
mangogal
Mom to two refluxers. DS 4.5 years, on prevacid since 5 weeks. Trial wean this summer...fail. Intolerant of dairy and soy DD born Nov 2010. Currently on zegerid. Had stomach malrotation & surgery at 9 months. Avoiding dairy/soy with her while BFing.
A lot of refluxers are sensitive to dairy and soy. Even if you aren't a milk drinker, there is hidden dairy your baby might be reacting to. My oldest is intolerant of dairy and soy. He never had the classic allergy symptoms. No blood in stool, negative allergy scratch tests when he was over a year. But he vomited when he got dairy when older and as a baby he screamed constantly. Til at 6 months I cut out dairy, he was a new baby that finally slept.

The GI doctor when I went with my second at 4 months first off recommended a total elimination diet. Dairy, soy, gluten, spices, onions, etc, etc. My pediatrician was ok with marci kids med dosing so the GI doctor didn't change meds around. But did recommend further testing if symptoms didn't get better. So a few months later, we did an upper gi and found that she had an anatomy problem.

Just so you know, it can take a long time to get into a GI doctor. We live near a children's hospital and it took 2 months each time to get an appointment. My son who is already a current patient, it took that long too. It doesn't hurt to get a second opinion.

Oct 06, 2011
poorhenry
Henry was born 5/12/11 at 5.8 lbs. A peanut, for sure. He was healthy and gaining weight steadily for first 6 weeks, then began refluxing through his nose. By 3 mos. he was projectile vomiting. Trying our 4th attempt at medication and desperate for a good night's sleep.
Thrilled to be able to tell you I got an appointment with a GI doc at CHOP for Monday the 17th. Cannot wait to get in there and get a better game plan. I feel like we're flying by the seat of our pants right now, trying anything and everything possible with little in the way of positive results. I plan on bringing a detailed history with me and a long litany of questions. What can I expect? Anyone have ideas? Thanks, again, for the support. I feel like I've been dominating the questions since joining here earlier this week. But you ladies are Godsends with you information and experiences. Thank you!
Oct 11, 2011
bellymom
Isabella 10/04 Severe reflux, nissen fundo, g-tube, mito disease, epilepsy, DGE, asthma, aspiration, allergic to milk and soy
Good for you!! Chop clinic isn't easy to get into to. Are you in the pa area. We deal with jeff and Dupont. IMO we never had any luck with zantac as many other moms didn't either. Always go with your mommy instincts as they are usually right. let us know how it goes.
Oct 21, 2011
poorhenry
Henry was born 5/12/11 at 5.8 lbs. A peanut, for sure. He was healthy and gaining weight steadily for first 6 weeks, then began refluxing through his nose. By 3 mos. he was projectile vomiting. Trying our 4th attempt at medication and desperate for a good night's sleep.
We saw our GI for the 1st time on Monday. CHOP was great; they spent a ton of time listening to me, taking notes, going through a complete history of meds, feeds, sleep, etc. They have ordered an upper GI series (to rule out an issue with his anatomy), which we are having done on Tuesday and changed his medicine back to Prilosec (it was our 2nd med try). His dose is now 3ml 2x/day, which I understand is a pretty strong dose. (Even the pharmacist called CHOP to be sure they wrote the script right because it was so high). The GI doc did say that if we can get his feeding comfortable during the day, but his nights are still bad, that reflux may not be to blame for his sleep issues, but he also said Prevacid can make them irritable and we were dosing at night, so it may have been the problem. I am elated to report that last night was our best night in months. He slept nearly 6 hours uninterrupted (I feel like a new woman!) and when he woke the 2nd time, he was "talking", not crying. I couldn't believe it. I am very optimistic that this is the beginning of a real turn-around and hope we get another good night's sleep tonight. The GI doc eliminated Zantac altogether; called it a "weak" drug. He said Prevacid, while a good medication, is not good for infants because it is so hard to dose properly. He said breaking it in half isn't good because you're never getting it exactly in half and you're likely losing granules when doing so (apparently the drug manufacturer says you aren't even supposed to be able to half it). Dissolving it in their cheek isn't good because of the choking hazzard. And dissolving it in water would actually take 4 oz of water for the right concentration and that's too much water for a 5 mos old to drink (I was dissolving in 3 ml of water, clearly not enough). So we're back on Prilosec. He absolutely hates the taste of it, but the pharmacist gave us a little cherry suspension that I'm giving him a taste of right before and right after dosing the Prilosec to help kill the taste. He's still fighting it, but not as bad as he had been when we were taking it a couple of months ago. Finally, the GI doc said to add 1oz of prune juice to the AR bottle we're feeding him first thing in the morning to help with his constipation. He said the magnesium in the CVS-brand mylanta could actually bind him up. The prune juice is working well and is much cheaper than the pear nectar I'd found, too. He is still crying during some of his feeds, but not nearly as hysterically. He is also still refusing his "2nd helping" at the breast when feeding, but seems to be staying longer before pulling off to cry and burp. There's definitely improvement. Our goal is to make feeds comfortable and peaceful for him so he can feed longer and hopefully gain better. We're now 13.3 lbs in the 10% for his age. So, I feel like things are looking up. I know we still have a long road ahead of us and will likely experience some set-backs, but after last night I am encouraged and hopeful. Thank you to all of you for your advice, suggestions, encouragement and prayers. Please keep them coming!
Check with your
doctor first!