Posted By Posting
Jul 24, 2013
rubysdad
12 week old - reflux worsening - time for prevacid?
Our second daughter, Ruby, just turned 12 weeks old today (born May 1, 2013). Our first child was an "easy" baby, and until Ruby, we didn't appreciate just how easy she was! About two weeks after being born, she started crying inconsolably for about three hours every evening. She had symptoms that were consistent with colic, but also acid reflux. Her pediatrician put her on 1 mL of Axid 2x/day, and had her formula switched to Nutramagin (my wife's milk never came in, so she's always been purely formula fed). After that, there were good days and bad days, but she generally trended towards being better. Then after about a month, she seemed like she was getting worse, so the doc upped her Axid dose to 1.4 mL 2x/day, and changed formula to Neocate. Again things started trending in the right direction, and about two weeks ago, she had a week of being almost as easy as her sister was. But then late last week she started getting fussy again, and by the weekend, she was practically back to square one: on Saturday she was inconsolable for about an hour in the evening. So we called the pediatrician, who said to up the Axid to 1.7 mL 2x/day, which we did. I know it's only been a few days, but she's shown marginal improvement, and I'm concerned about how quickly she flipped from happy baby to extremely unhappy baby. We're going to talk to the doctor about switching to Prevacid. After that long intro, we really just want to make sure this is the right next move. From reading others' stories on this site and the Internet in general, I don't think her reflux is as bad as it could be (and we're thankful for that). But she's definitely unhappy, and my wife and I are frustrated. It's hard holding and bouncing her all day while chasing after a 2.5 year old at the same time. We've read Harvey Karp's "Happiest Baby on the Block" book (and watched the video), and feel we are masters of the 5-S calming techniques. Ruby is practically always swaddled, and during the day, almost always being held and bounced. And when she gets bad, we break out the shushing. On the rare occasion we can get her to sleep during the day, we have an infant swing for her. After reading Karp's book, I was actually hoping her temperament was simply due to colic, since he says that usually subsides by three or four months of age. But we're just shy of the three month mark, and she's nearly as bad as she's ever been. This is what makes me think it's more likely to be reflux than just colic. General symptoms/observations of her condition: - Irritability after most (and sometimes during) feedings. It's worst in the evening, and generally her last meal of the day is actually the best (presumably because she's exhausted at this point). - In general the worst time starts around 6:00pm and lasts until she goes to bed for the night around 11:00pm. - She arches her back when upset after feedings. - She isn't constipated, but lately is only pooping about every third day. Stool is black (but not bloody) and like mashed potatoes in consistency (it's been like this since switching to Neocate). - She spits up a fair amount, but not after every meal. Spitting up increases in frequency as the time from her last poop increases. The spit ups aren't huge or projectile. - Based on what I've read, she seems to have "silent" reflux, as she doesn't spit up constantly. But we do see her clearly choking (briefly) on something after feedings. We can see her jump a bit, and hear gurgling in her mouth along with the gagging. When this happens, she immediately starts to wail. - Some wheezing during and after feedings. - During the day, she barely sleeps (maybe a few 10 or 15 minute naps), and requires constant holding and bouncing. Putting her down results in crying that will escalate to screaming if not held. - She generally sleeps well at night. She's actually slept through the night the last two nights. But we suspect that is due to exhaustion from not sleeping at all during the day. - She is consistently gaining weight, and besides her fussiness, is very healthy according to her doctor. Lately she's been eating around 20--22 oz of formula per day, generally across six feedings. Note: I sent an email with similar content via the "Ask a Volunteer" link on this website. If nothing else, just hoping someone else might have seen very similar symptoms and has suggestions, tips, etc. Thanks everyone! -Ruby's Dad
Jul 29, 2013
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.
From what you describe, looking into a change in meds sounds like a good idea to me. Reflux is very tricky when it comes to medication, and many people find they have to experiment with different types and quantities (with the help of their pediatrician, obviously) to find what works -- and even then things sometimes change after a period of working well. It sounds like you are doing a great job under the circumstances!

You may want to speak with her pedi about gastric emptying issues, as it sounds like hers may be becoming delayed, which is not terribly uncommon among refluxers. Have you ever used probiotics for her? Many of us find them to be of help.

Jul 31, 2013
babsil037
Hi there. In reading your post, it sounds eerily similar to my little one who is now 6 months old. His problems started around 6 weeks and after several hospital admissions, they finally diagnosed reflux. He was put on Prevacid Solutabs 15mg daily. After this, we immediately got the tucker sling to help him sleep upright since he would cough all night long because of the reflux. We also experienced the same feeding patterns and could only get about 2-3 oz in him at a time and a good day was 20 oz. He also began only pooping about once every 3-4 days and it was grey. Since your LO is sleeping well at night, I wouldn't mess with her sleeping arrangement. Our guy was lucky to stay asleep for 45 minutes! The gurgling you hear is classic reflux however it does get better the more they can sit up on their own. At the advice of lorenzomama, we also started acupuncture on our guy and that has really worked wonders for his reflux, mucus and constipation. If you have any other questions, I am happy to help!
Aug 01, 2013
rubysdad
Thank you for the replies, I was worried that this site had gone defunct (although we never received a reply from the "email a volunteer" link). lorenzomama: we will ask the doc about gastric emptying. We got the Prevacid, and this morning my wife tried the first dose. She said she used a syringe and it didn't go well at all (we had been giving Axid through a nipple, so she's not used to taking anything from a syringe). From what I've read, compounding/suspension products like ChocoBase, CaraCream, and Buffer Babies seem really popular/helpful, but I can't seem to find where to buy them. Anyone know where these things can be found? Also, side question: how do you get the paragraph breaks to show in the forums? My original post wasn't one big mess of text as it now appears. Thanks again!
Aug 05, 2013
babsil037
Hi Ruby's dad - we could not get our little one to take the Prevacid with a syringe...we asked our ped for the Solutabs and he was much more tolerable to those. we just cut them in half and they dissolve but now that he is six months, he can take the whole tab at once. They also don't cause the stomach problems that the liquid did.
Aug 07, 2013
rubysdad
Based on what I've been reading, we took it upon ourselves to deviate from what the pediatrician said. She said take one solutab once per day. We are instead doing a half-tab twice a day. (Same amount of medicine per day, just split up into morning/night.)

We've now given her three half-tabs directly in her mouth, and it's going much better! We put half a tab in between her lower gum and cheek, let it sit a bit, then give her a bit of water via nipple to make sure she swallows it all down. So far so good.

Check with your
doctor first!