Reflux mommies - come on in

adrielegorburu

So DD's reflux has been more or less managed with Prevacid over the past few months. Before she had the whole nine yards, massive amounts of spit up that would really upset and hurt her, arching back, screaming while eating etc.  After we started the prevacid she was a different baby, sleeping better, way happier during the day, not spitting up nearly as much (and it was "happy" spitting up) and so on.  Well in the last week or so she has started to really spit up way more.  Shes like a hose sometimes and her daytime naps have gone from 1 hour to 20 minutes (dont know if thats related to her reflux).  And she will spit up for hours, not just after bottles. I had DH take her into the pedi today to ask about increasing her dosage.  Shes gained almost 5 pounds since it was prescribed. Pedi said since she was gaining well and is mostly "happy spit up" - they werent going to up her dosage. Now I wouldnt call it "happy spit up" because she will cry for the big ones, but I have to agree that even though shes spitting up crazy amounts of milk, shes gaining lots of weight and is officially CHUNKY! (She was 14 1/2 pounds at her pedi today!) - I dont know if I'm happy with the Pedi's decision.  Maybe because I wasnt there and I dont know if DH told the doc everything I would tell them - WWYD? keep the status quo and let the spit up flow - or get a second opinion from a GI? Have you guys had your dosages adjusted for similar reasons?

lwmooney87

Our GI recently increased Reagan's dosage because she went from not vomiting at all (thank God!) to vomiting again and eating less and being more fussy with bottles. It has made a difference. Now she is sick but that's a different story. Reagan is just now 12 pounds though, so she can't afford to eat less. So, we didn't have any problems with them increasing the dosage. I think it's definitely beneficial to see a GI. We don't have to go back to any follow up visits but they are still managing her Prevacids. Peds Doctors just don't get it sometimes. I would see a GI if I were you (or maybe call there yourself and explain it to the nurse why you want her dosage increased and see what they do). Hope this helps!

JeepersWife

DS is on prevacid and our doc said that there are only 2 doses and the dose he is on will follow him till he is one or so (should we stay on this med).  We split the dose and give half in the AM and half in the PM because he was metabolizing it so fast.  Also, have you tried adding rice/oatmeal to the bottles to thicken them?  Our GI stated we can do that and DS is still young!  We also add one ml of mylanta to every bottle to coat the tummy which helps with the reflux as well.  Because DS will spit up long after a bottle and it is mostly clear, and after doing an upper GI, we found that his tummy empties slowly.  Maybe you do need to see a GI!  Good luck!

adrielegorburu

JeepersWife:

DS is on prevacid and our doc said that there are only 2 doses and the dose he is on will follow him till he is one or so (should we stay on this med).  We split the dose and give half in the AM and half in the PM because he was metabolizing it so fast.  Also, have you tried adding rice/oatmeal to the bottles to thicken them?  Our GI stated we can do that and DS is still young!  We also add one ml of mylanta to every bottle to coat the tummy which helps with the reflux as well.  Because DS will spit up long after a bottle and it is mostly clear, and after doing an upper GI, we found that his tummy empties slowly.  Maybe you do need to see a GI!  Good luck!

 

Weve been adding Rice cereal to her bottles since she was in the NICU - we call her milk her milkshake because its so thick already! lol - It took forever to find a nipple that works! I'm considering a GI consult - I just feel like a baby should spit up - but not spew milk everywhere all day long.

ClickMama

I would get a second opinion.  I've ranted over and over here and on other boards about my experience with my Pediatrician.  I like my pedi, but she was ultra conservative with treating my LO's reflux it was very frustrating.  So, I would get a second opinion with a GI.  My pedi told me that she was not comfortable prescribing anything other than Zantac (which she plateau-ed on), so the GI got more aggressive and put us on Prilosec.  I don't believe in happy spit up baby when its that much, as you describe it.  You know your baby best and know that it may lead to a worsening stretch. 

Do some research online about the dosage and weight with Prevacid (check out infantreflux.org - good info there).  With Prilosec its 1-2ml/kg so you can see its weight sensitive.  I would imagine Prevacid is as well.  

 

kck329

Is she throwing up all day, not just after feeds? If so you should ask for a GI consult and then ask them about delayed gastric emptying. It goes along with reflux for a lot of preemies and basically means their stomachs don't empty fast enough so the milk sits there and causes them to spit up even after it should have been digested. DD is so much better since she was medicated for delayed emptying.

lemen99

I would base this decision on how she is acting, not how much she is spitting up.  If she has gained 5 lbs the Prevacid is basically doing nothing.  If she is HAPPY, I would not go back on meds.  We cannot get off them at 3 years, LOL, you don't want meds if you don't need them.

Her naps could be shorter from reflux - but it could be from a lot of other reasons too - so you need to look beyond that for more clues.  If she's mostly happy when and after she eats, gaining well, don't worry.

If she's very fussy after she eats, arching her back, screaming, pulling away from bottle, that sort of thing, definitely talk to your doctor and/or see GI.