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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.
How do I get a 4.5 mo old to sleep better at night?
My son was sleeping great at 2 months old -- up to 8-10 hours uninterrupted each night. It was great. But for the past 2 months, he's been moving backwards. Some nights he wakes and cries almost every hour. The pacifier does stave him off for a bit, I know he doesn't need to nurse as often overnight, so avoid doing that, but we desperately need some sleep around here. His crib is elevated at the head and I have a "nest" of sorts built with towels under his fitted sheet to help prevent him from sliding to the bottom or ending up upside-down. Nurse practioner thinks maybe he's starting to teeth and that's why his sleep is so poor, but I'm not convinced it's not the reflux. He is somewhat under control during the day, so shouldn't he be at night, too? I'm at my wit's end and need advice. Oh, I should also mention that I still swaddle him at naptime and bedtime; it's a physical cue to him that it's time to sleep and he nods right off,. I'm chicken to unswaddle, for fear we'll have even worse sleep. I'm inclined to wait to unswaddle until we have him sleeping better at night, but not sure if being swaddled might be part of the reason he's waking? Probably over-thinking things, but I appreciate any advice anyone can offer. Thanks in advance.
Sep 30, 2011
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
How much is his prevacid dose? Is it solutab or compounded into a liquid. What time of day is his Zantac doses and when is his prevacid dose?
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.
He gets 1.2 ml Zantac 1/2 hr before his firsdt morning feed and 1/2 hr before his last feed of the day (about 6:30/7:00). The 15mg Prevacid solutab is dissolved in water once a day and I give it to him the same time as the 2nd Zantac dose before bedtime.
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.
In my experience, teething exacerbates reflux, and even if the acid is under control, if a baby is refluxing while lying down, even if the reflux is not acidic at all, it can be an very distressing experience -- plenty to wake them when they hit that lighter stage of sleep (which occurs about every 60 minutes in most babies your LO's age). For some people, it seems a fine tuning of meds helps, for some treating teething discomfort can help, but for many, teething is just a period of hell lived through and visited again a short while later when more teeth come in. Sorry if it sounds discouraging, but for many of us, that was the reality, and the value of anticipating it is that it becomes easier to roll with it when it comes if you know to start sleeping every chance you get the moment your LO starts showing signs.

Also in my experience, you just have to sort of experiment with things like swaddling and changing the details of sleep setting, etc. Some things work for awhile, then stop working, and may even work again down the road. It's always nice if you can try a new things when you're well rested, though, so you have some reserves if it doesn't work out. Hang in there -- my son was a legendarily poor sleeper for years, but eventually a perfect storm of us figuring a few things out and his body maturing seemed to improve the situation immensely (although I'd still give my right arm for 8-10 hours of uninterrupted sleep!).

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.
I always remember reading to dose zantc and prevacid separately. I've read between 2-4 hours apart. I've had both my kids sleep on an wedge made by a physical therapist. they were strapped into it and at a really good incline. With my first, when he woke up frequently, he wanted to be nursed back to sleep. My second, feedings just made it worse and she was up for hours at a time. Things change so much during the first year. Teething can make reflux flare for sure. My kids hated being swaddled. They did much better as they got a little older... they could try and find their binkies and put them back in their own mouth when they woke up. Hang in there!
Oct 01, 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.
Which med should I give first at night if I am dosing 2-4 hours apart?
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.
I remember reading that you shouildn't give prevacid after 5:30 pm at night. Anyone else know of this? I want to say I read it from multiple people on another forum. Something about when the proton pumps turn off. I am sure someone else can back this up. I did prevacid before dinner on an empty stomach (or before a late afternoon/early evening feeding) and zantac before bed.
Oct 01, 2011
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
Prevacid and zantac must given a minimum of 2 hours apart from each other. Preferably 4 hours other wise they will cancel each other out and neither one can get in their system. Prevacid solutabs must be given n an empt stomach with a feed 30 minutes later. It is preferred to split the doses in 2 as a baby metabolizes meds so fast. Is you want to use the solutabs I would try 1/2 a tab in the morning before the first feed, Zantac at lunch, prevacid before dinner and Zantac at bedtime. After 10 days the prevacid should be fully on board and then you can experiment with deleting the noon Zantac. If you can get the right PPI and the right timing you should be able to do any with the Zantac all together. If the food/med timing gets to be a pain consider using caracream with OTC prevacid or zegerid.

. Teething and reflux is ugly. No sugar coating that one. Really kicks up the acid level. Careful with Motrin. It is more acidic than Tylenol.

Oct 02, 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.
Good to know about the motrin vs tylenol. We've been using a store brand ibuprofen since its efficacy is longer than Tylenol, but I suppose we should switch. Fouled up dosing today with his naps, so will definitely try the new schedule beginning tomorrow. Doc had said we could split tab in 1/2, but I figured a bigger dose at nighttime would be better. Gonna give it a try; anything's better than what we've been doing. Anyone have any thoughts on weaning him from the swaddling for sleep? We do it night and naptime and he falls RIGHT to sleep almost 100% of the time. I am so chicken to give it up, but wondering if some of his waking might be due to him wanting more mobility. Just not sure how to go about getting to sleep as easily and keeping him asleep. He refluxes through his nose and I suspect it's in his ears, too, so he swipes at his face all of the time, making swaddling easier on keeping his hands away from his face/batting the binkie out, etc.
Oct 02, 2011
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
Ryan had to be swaddled forever. Even in the carseat. His sister called it his straight jacket. : ) If he likes it, I would leave him be. Ryan was a silent refluxer too and it was in his ears and nose. He had a continuous scab on this nose for months from him attaching his face all the time...until I got the meds right. Really watch his ears and adenoids. If he starts getting fluid in the ears or ear infections, get tubes right away. Dont mess around with the 4 infections first minimum thing. Go directly to the ENT.
Oct 03, 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.
You might experiment with weaning from swaddling by leaving just one arm out at first, and see how it goes.
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.
We have a great friend who is a nurse prac. in ENT at CHOP here in Philly. She will totally help us out there. In fact, she's the one who thought a trip to a GI Specialist is in order. He really loves his swaddle. My DH calls it the straight jacket, too! Spacing out Prev & Zantac last night bought us about an extrahour sleep, so hopeful for changes with med. sched.
Oct 03, 2011
dcd
I agree that the key to getting reflux under control is the proper dosing and administration of the PPI. Definitely make sure you're giving the Prevacid on an empty stomach, 1 hour before a meal, and that you space it out from the Zantac. Babies metabolize PPIs faster than older kids/adults, so you may ask the GI about upping the dose. My daughter's reflux did not get under control until we put her on 27 mg/day (split dose, once in the morning, once at night). Reflux is way worse at night. Laying down means it's easier for the reflux to come up. (During the day he's probably much more upright.)

I was terrified to stop swaddling too. It was my daughter's cue to settle and sleep. As she got older, we experimented with lots of different swaddles. The Miracle Blanket is amazing through about the third month. And we LOVED the Woombie in months 4 and 5. (It's awesome - allows the baby to move a bit more but still feel snuggled in tight.) When she started sleeping on her belly, she didn't need the swaddle any more.

Good luck to you. Once you get the PPI dosing right, if he's still having problems, look into MSPI (milk soy protein intolerance). MSPI is quite common in babies and often goes hand in hand with reflux. Reflux was half the issue for my daughter, and MSPI was the other half. She did a 180 once we got her on the right dose of PPI and switched her to a hypoallergenic formula/cut all traces of milk out of her diet.

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.
Isn't it funny how "scared" we can be of a tiny 4 or 5 month old? I will have to look into the Woombie. We are using a Swaddle Me blanket with all the velcro fasteners and it's been great thus far, but I do think he's getting a little big for it. What do you think a GI doc would do differently than our regular pediatrician at this point? Our GP said outside of some tests, which are hard on baby and parents, that the treatment will likely end up being the same. Although he also told me it was OK to dose Zantac and Prevacid at the same time, so...
Oct 03, 2011
dcd
GI should be well-versed in reflux, MSPI, and other GI issues whereas pediatricians typically are not. GI should definitely give you better direction on how to dose the PPI (Prevacid). And he/she may prescribe an increased PPI dosage (over the standard recommended), whereas a pedi might not be comfortable doing that. GI may not even waste time with Zantac. Zantac is an H2 blocker. It's incredibly weight-sensitive and not only that, the body can quickly develop a tolerance to it and it will just stop working. PPIs are the gold standard in treating reflux b/c they actually stop the body from producing acid before it starts. I would focus on getting that dose/administration right. It will do the most good.

To read more about reflux meds and how they work, go to www.marci-kids.com. If you find you need to, go to www.neocate.com and read everything under the "Parents" tab to learn about MSPI. I found these resources invaluable when we were going through it.

Ha, yes, I remember the swaddle fear well. I simply couldn't imagine her EVER falling asleep without it. Def check out the Miracle Blanket and Woombie! She also slept on her stomach in the Tucker Sling for a while, after she was done with the swaddle. It allowed her to elevate her crib mattress to a high angle, which is helpful for nighttime reflux.

Oct 03, 2011
dcd
ps. If you're not totally happy with your pedi treating his reflux, and are kicking around the idea of seeing a GI, keep in mind that seeing a GI does not necessarily mean he'll need to undergo any testing. (Like your pedi spoke of.) They usually don't start with testing - they usually start by getting the meds right and seeing what happens from there. They can diagnose reflux easily based on your report of his symptoms.
Oct 03, 2011
dcd
pps. I should add that although I saw a pedi, GI, and allergist many times during my daughter's first year, none of them were very helpful. I basically figured it all out on my own via internet research, and they mostly served to confirm my positions on treatment. They also signed off on me compounding my own Prevacid using Buffer Babies, which made a big difference. Give the specialist a shot if you're not happy with your pedi, but do your own research and never underestimate your mommy instincts - of course always running any change/questions/ideas past your doctors. I felt so alone that first year, but in the end the months I spent informing myself was worth it because we finally got her comfortable.
Oct 04, 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.
@Karen--wondering if we should make it Zantac in morning, 1/2 Prevacid in afternoon, Zantac early eve and Prevacid at bedtime. Since Prevacid is the more effective med at reducing acid? It was a tough night. I left an arm out of his swaddle and he woke more frequently than usual and was up from about 1-5 just screaming and uncomfy. He didn't poop all day yesterday, so maybe that was part of his angst. Please let me know what you think. I think I may call the GI specialist and see how quickly we can get in. In 2 months his issues may have resolved themselves, since they say most cases resolve around 6 mos or when they can sit independently. I feel like I'm wishing his little life away!
Oct 04, 2011
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
Changing the timing around cant hurt. I would also swaddle him back up. I would try to only make one change at a time other wise you wont know what is helping and what is not. Also know that constipation and reflux tend to go hand in hand. My guess is that is has something to do with less magnesium being absorb in their system. Pear NECTURE... not pear juice can really help with that. One oz mixed in with the bottle should do it. If not you can use CVS aluminum free Cherry Supreme antacid. (Generic Mylanta Cherry Supreme.) While it is an antacid it also helps with constipation because of the magnesium and no aluminum. Works great.

OK.. now this is the part that you get to get really mad at me..... Please don't get your heart set on him out growing it at 6 months. That is typically just for happy spitters. Not GERD babies... at least non that I know. More typical is 18 months. OK.. you can hit me now. Just trying to properly set your expectations. Now this does NOT mean that things will be tough for 18 months. You WILL figure out the the magic combo before then he will get comfortable. Its hard though because you feel like you are in a constant science expiriment and your child is the lab rat. Hang in there!!!

Oct 05, 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.
Karen, you're right. I realize I shouldn't have played with the swaddle, too. Am totally going to invest in a Woombie; I want one for myself! ;) But I think it's a good transition for him. I also think I am going to go back to giving the Prevacid in one dose at bedtime. The past two nights now we've had hours of painful, piercing, endless crying and the only thing I can figure is he's not getting enough med at bedtime. We were out for our anniversary dinner last night and our POOR baby-sitter was beside herself. Nothing worked to soothe him. It was a very restless night from there on; waking beginning at 1:15 about every hour and not being able to settle right away with the pacifier. Finally, I was thrilled to be able to get a GI doc app't at CHOP on Oct. 18. Thought for sure I'd have a 2-3 month wait. But these 13 days of waiting are going to seem like forever! And I know the 6-month mark is wishful thinking. My other two refluxers were about 6-8 mos, but they were nowhere near as bad as their baby brother. Don't worry, no cyber hitting coming from me. :)
Oct 05, 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.
Also, found the CVS Antacid. How much should I give him? How often?
Oct 05, 2011
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
So glad you got in so quick! Thats great!! Tell them you want to trial Zegerid powder packs. I think you will find it to be way more effective than the solutabs. I have lost faith in the solutabs. Seen too many kids, my own included, not get the relief they need while on those.

On the CVS antacid... Is it the aluminum free Cherry Supreme? Ask your pharmacist on the proper dosing. Its been a really long time for me. In the meantime I will do some digging around to find the dosing chart. I really wish Marci-Kids would get their website back up! I know the dosing info is there.

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.
I've been trying to check their site, too. Please do let us know if you see it back up or find the dosing chart. We had a better night with him having the full Prevacid tab at bedtime. He was still up quite a bit, but not the constant, unable to soothe wakings and none of the piercing screams, thank God! Will keep you posted about the GI doc. Thanks again for all of your insight and advice.
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.
I posted a detailed explanation of our GI app't on Monday, but as far as sleep goes, I am blaming Prevacid for his sleep issues. I looked back at the log I keep and it really deteriorated once he started Prevacid. The GI doc said it can make them irritable and we were dosing at bedtime. On our 4th day of Prilosec at a high dose (3ml 2x/day), little man had his best sleep in months: nearly 6 hours uninterrupted. I am thrilled and hopeful that we're about to turn the corner. Praying fervently that tonight will be just as good. All that sleep last night felt so good! Will continue to keep you posted and thanks again!
Check with your
doctor first!