Posted By Posting
Dec 28, 2011
Low to none weight gain
Hi all! My son is 6mo old, born 4 pounds 12 oz - was an IUGR baby. Started having problems eating at about 1 month. The problem was that he was not eating much. He later started refusing to eat, cry, arch his back and not gain much weight. He is now 10 pounds 9 oz, at 6 mo of age. We were initially told that IUGR babies are a pain to feed and that he doesn't have an appetite. However, I see him hungry, and he tries to eat and he just stops after a couple of gulps. He hurries to take those gulps and his tummy makes some sort of noise and he stops eating. We use Avent bottles and are still using slow flow #2 nipples so that he is able to control the flow. I have to burp him very frequently to get a little bit of food into him. He eats better when he is asleep. He is on breast milk (I pump, ugh) and Alimentum, because i do not have enough milk for him. Our pediatrician put him on Zantac, which initially helped and then stopped working. A week ago we got a prescription for Prevacid - 3mg. The pharmacies here make a compound. I got a print out of what goes in it -- only two things, the drug itself and sodim bicorbonate 8.4%. They told me at the pharmacy that it needs to be given twice a day 1.5 ml at a time, and it doesnt matter when, nor do i need to wait 30 min before feeding him. My son was having big issues taking zantac - it does taste awful, and we kept giving it to him for the first 3 days along with prevacid. He kept spitting it out. Prevacid compound does'nt taste much better, and my son still spits it out. We take several attempts to give him the medication. Past two days have been particularly bad- i am ready to cry each time i try to feed him. He keeps eating just a little bit and then starts crying. So i fed him 8 times yesterday just to get 445ml total for the day. His total daily intake averages about 580ml a day. For the past 3 weeks he gained only 20 grams. We are going to see our pediatrician today. What are we missing? I have read a lot of posts on this board, but i still have questions below. Please let me know if you had similar issues and what you did to resolve them. - Do i need to wait 30 min before giving my son food, after administering Prevacid? - What can i use to give him the medicine so that he doesnt spit it back out? I use a medicine dispenser now, but he puts up a fight every time we give it to him. - Does anyone have an IUGR baby with similar issues? What are your experiences? - Its been 1 week on prevacid, and i am not seeing much of an effect, how dramatic are the results by the time he has been on it for 2 weeks from your experiences? - Zegerid is not prescribed to infants here in Canada, what are my options in terms of meds, if prevacid doestn work? We had x-rays, sweat test and multiple blood test (thyroid etc) that all came back normal. My ped said if prevacid doesnt help with eating and weight gain she will ask to run another test, but doesnt want to do it now as it involves swallowing a radioactive chemical. Thanks for all your help!
Dec 28, 2011
Prevacid is a PPI, and you must administer a PPI on an empty stomach, one hour before a feeding.

3 mg per day seems extremely low to me, especially because babies metabolize the PPI faster than older children and adults.

If reflux is the source of his pain, (and it seems like it might be) the PPI should help, once you get the administration and dosing correct.

I would insist on a higher dosing (at that age my baby was on 15 mg/day but we never got her reflux fully under control until we upped it to 27 mg/day) and make sure you are vigilant about giving it on an empty stomach, at least 1 hr before a meal.

You say he's on Alimentum and breast milk. Are you on an elimination diet? Many reflux babies are also MSPI (milk-soy protein intolerant). The Alimentum is made for MSPI babies, so that's good, but if you haven't cut dairy out of YOUR diet yet, you might give that a shot too and see if it helps. If he's sensitive to dairy that will contribute to his upset stomach.

Dec 29, 2011
Mom to two refluxers. DS 4.5 years, on prevacid since 5 weeks. Trial wean this 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.
ditto, that sounds like a very low dose of prevacid. The next step for my kids was doing an upper GI exam. Avoiding dairy and soy while breastfeeding was also key for them.
Dec 29, 2011
Thanks for your advice. I am giving Alimentum because i dont have enough breast milk. Will do on eliminating dairy from my diet and giving meds on empty stomach. We are doing upper GI in the new year. How do you get your pediatrician to prescribe higher dose? They seem to have strict guidelines, also do the pharmacists here in Canada. They showed me their little book as to what is recommended when i asked. I will talk to my pedi next wed at our appointment
Dec 29, 2011
Jessica, Mommy to Jedd, severe reflux, severe food and oral aversions, Finally G tube free!!! VSD repair 4-24-07 (open heart surgery), hypospadias, repaired 3 times and Ear tubes Visit Jedd at his CB site:
Try to get the RX for solutabs and not a compound. Compounds are unstable and should only be used as a last resort....we had to use one as Jedd was tube fed and completely NON oral.

With the solutab you can put it in a syringe with some warm water, dissolve it and then give it orally that way. (it won't work that way with a feeding tube, we tried, too chunky and clogged the tube)

What do his weight percentiles look like? Is he still following his own curve? Is he falling off his curve?

The total amount being taken in per day is very low. Has anyone talked about tube feeds at all? It would all depend on how he is following his curve or not.

Dec 29, 2011
Thanks Jessica, i will also ask my pedi about Solutabs. My son seems to have issues swallowing the compound meds, he holds it and spits it out, so i try small drops in the back corners, that works sometimes. From what i read Solutabs are tricky to administer too. The compound they made has no sugar and expires in two weeks, although we got a refill faster since he spits out a lot and we have to give it again. He is off the growth chart, less than 5%, and he was following his curve up until 3 weeks ago when he lost some - 20 grams, not much but still a loss. Yesterday's visit showed a 100 grams gain (1 week gain), so that is good. The pediatrician mentioned tube feeds, but said it is the last resort. She said he doesn't vomit, milk doesn't come up through his nose, he has no bloody stools or has any allergic reactions, he is a happy baby when he eats, but obviously, when he refuses meals he doesn't gain or loses weight and that is a concern to all of us. I am def bringing up the dosage and Solutabs to my pediatrician next Wednesd - i wish Marcikids or any other info was available for me to print out and bring to my pediatrician. I hope it makes sense to the dr.
Dec 30, 2011
Sebastian's parents. Baby stopped eating at 4 months.
I agree, our son is on 15mg a day. Even 7.5 was not working on him. He completely stopped eating because we found that he was so scared to eat because of the pain that he had forgotten to suck, swallow breath. I don't know if you can but try to read my profile. We went through almost the same thing. Now we know he has allergies. Like others said, the stomach must be empty an hour before and then 30 min after the feeding. The other thing is that type of medicine. If the pharmacy made it liquid for you instead of the pill make sure you shake the bottle very well. Try to feed him when he is relaxed and getting sleepy.
Jan 02, 2012
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 have heard that the solutabs are being discontinued so you might have a tough time getting your hands on them. The good news is that many places have signifiicantly improved their compounding of PPIs. It is a matter of calling around. I will dig up the post on what you are looking for from a prior post and respost for you.
Jan 12, 2012
Same Issues...
I have a very similar situation and still have little answers or results. My baby girl was born a healthy 8lbs. 11 oz. and dropped 1 lb. within the first week and at 4.5 months old is only 12 lbs. She only gained 6 oz. in the last 20 days so we've been experiencing the same difficulty. We spent this whole week having a series of tests, including an upper GI study and working with a feeding and speech therapist. This was most helpful to me, because she was able to watch my baby eat (breast and bottle) and see that she is hungry, eats a few gulps but then is in so much pain won't continue. She's recommending we try to use a high calorie formula to supplement with my breast milk. Has anyone tried this? Otherwise they are recommending a g-tube, which scares me. She is on the same dosage of Prevacid as your child and has not seen any results. It sounds like we should increase the dosage, too. Additionally, I was on a very strict elimination diet for months because of blood in her stool. I didn't realize the two issues might be related. I integrated dairy back in over the holidays, and now feel terrible because it has definitely made her reflux worse. You might consider eliminating some of the common allergens from your diet? I'm not sure this is helpful, but I know how difficult this is. I'll keep you apprised of how we move forward and how it works. We have another appt. with the GI tomorrow.
Jan 12, 2012
One more thing....I agree about solutabs. We tried to give our baby the compound and it was a miracle if she'd take it at all. Typically she spit it right up. The solutabs are cherry flavored. I crush them up, put the medicine on my finger and she enjoys the taste and takes the medicine that way. It might help!
Jan 12, 2012
Hi, thanks for all your responses. We are still working through this, but it is not as bad. Prevacid compound seemed to work after two weeks, my son started eating a little better. The compound is the only thing available here. He used to spit it out, but i give him the dose in very small amounts, 3-4 ml, in the corner of his mouth and he swallows that. I also wait 30 min before feeding him and shake the bottle very well. He did gain weight in the past two weeks, last week being a record ever, 200 grams. We are still struggling through feedings though, as he seems to swallow a bunch of air and i have to burp him every 20 ml or so, so it takes a while to feed him. We introduced rice cereal last week, but i think it is messing up his stomach. I give him a teaspoon of rice cereal mixed with breast milk or alimentum in the am. He eats fine, but then afternoon feedings are awful, he seems to be gassy, and refuses to eat although i can tell he is hungry - he grabs the nipple and tries to eat. What are your experiences with reflux and introducing solids? My son is 6.5 months now. We have Upper GI next monday, as he still seems to be choking on the bottle and i literally hear air gulps going down his belly. TO LEIGHD -- we tried fortifying breast milk/alimentum and we had no luck with it, we used Nutramigen. It made him gassy and he ate less so we stopped.
Jan 13, 2012
i meant to type 0.3-0.4 ml at a time
Check with your
doctor first!