Constipation + Reflux = Nutramigen or Alimentum??

heyitsme

OK this might get long, but I really need some input.

I'm Top-8 free and nursed DS until he was 6 months old (he'll be 7 months tomorrow). I wanted to go to 1 year but my limited diet was affecting my milk supply and I was back at work and not pumping enough. ANYWAY at 6 months I started introducing formula, and he's been on 100% formula for about a week now.

So before 6 months and 3 days old, he'd never had any exposure to milk or soy. Despite that, he's had reflux since he was born (my older DD did, too, and DH has it badly), and around 5 months we started battling constipation issues. 

DS's ped's response to the reflux was to prescribe Zantac and then whenever I would tell her he was still spitting up a lot or was getting uncomfortable, she'd increase the dose. When he had the constipation issues, she prescribed a suppository and also said to try prunes/prune juice/p-fruits, etc. to try to get things moving.

We started him out on GS formula and he got "stuck" so we moved to GS Protect. Which helped him be more regular--he'd go every day although sometimes still grunting/straining and producing hard BMs; occasionally he'd go 2 days without going. And right now we're on Day 3 of no poop.

So I called the ped because 1) We're on Day 3 of no poop and he's uncomfortable, and 2) He's still spitting up and he's a "happy spitter" during the day, but at night he spits up/coughs, etc. and seems more uncomfortable (tummy and reflux).

At first she mentioned increasing his Zantac dosage (why she doesn't try a new med is beyond me) at night (right now he's at .7 2x/day, she said to go up to .8 at night). Then she said we could try adding oatmeal cereal (not rice because it's binding) to his bottles at night to help with the nighttime reflux and maybe keep him regular. I asked her if she thought maybe switching formulas would help (although these things were presenting themselves before he was ever introduced to formula), and she suddenly suggested we try Nutramigen or Alimentum. She said they would help with the constipation and reflux probably.

The thing is--I'm not really sure it's necessary. I'm familiar with both ends of the food allergy spectrum (I have IgE and IgG allergies, so I know about anaphylaxis and also about GI-related allergies), and I really don't see this as allergy-related. A sensitive tummy, yes. (DH and DD both have stomach issues--it runs rampant in DH's family.) A food allergy? I just don't think so. These things were present before he was ever exposed to milk and soy, so to say they're caused by it seems odd. Worsened, maybe, but caused by it? No. And he's a HAPPY kid. Seriously, happy-go-lucky ALL THE TIME. The only signs of discomfort come at night when he's laying down.

So I guess what I'm asking is would you try other things (like thickening bottles, increasing med dosage, maybe even trying a different formula like Similac Sensitive) before trying Nutramigen or Alimentum, or would you just go ahead and try it and see...? 

magdusia

Im probably not going to be much help since you're obviously very knowledgeable with allergies but I don't like all the medicine the doctor is constantly giving and increasing. (personally).

I never knew reflux can be generic. I would personally get a second professional opinion and see what someone else says.  Maybe put him on the prescription formula since it's much more gentler for a bit and see what happens

for constipation have you tried prune juice? avocados? (if he can have it).. We have a constipation issue right now too.. my son hasn't gone in over 4 days except for a few pebbles a day which are hard as a rock and black (TMI).. and won't drink prune juice.  So i have a call in to his pedi and hopefully she'll give me some good ideas (other than meds.. i'm not a fan of meds other than the epipen)

what kind of solids is he eating other than the oatmeal? 

I wish i could help.. i'll be watching this to see what everyone else says

Jen748

DD was much the same with the reflux and constipation. We moved her to Nutramigen and within a week she was a different person. She was eating more and more regularly and sleeping better and pooping!

mamanduchess

Reflux can run in families. My daughter has it, her father had it as a child, and I suffer from it as an adult. Her zantac dosages were much higher than your son's are (.8mg 3x's daily until she gained enough to merit 1.2mg 3x's daily). Our ped referred us to a pediatric gastroenterologist to get her initial medication and dosages, since they can run more tests and my daughter was only 4 weeks old at problem onset. Increasing the dosage is not the worst thing ever if it helps.

As far as the food allergies causing digestive upset, it can happen. My daughter was alternating between painful constipation and diarrhea, and I could never figure out why. Turns out, it was a rice (RICE!) allergy. I always assumed her super sensitive tummy was contributing to the bowel issues, but a change of diet has worked wonders. I think I would increase the med and explore a possible odd allergy. Whatever you decide, best of luck.