Home › Forums › Infant Reflux Support › HELP!!! › Is there a Pattern? Please help! May be long.
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December 6, 2008 at 7:21 am #59291
Anonymous
InactiveSo im going to post here Conners daily and Nightly routine. Im trying to figure out if there is a pattern, and maybe there is something that Hubby and I are doing that is aggrivating Conners Reflux and we don’t know we’re doing it.
Daily Routine-6am Feeding of 4 ounces6:30am- Falls back to sleep.9:30am- Wakes up fussy to eat, Zantac 1.5ML Given10am- Prevacid 7.510:30am- Feeding 4 ounces and 1 Tsp Karo Syrup10:45- Falls back to sleep11am- Awake to play12pm-Back to sleep2pm-Prevacid 7.52:30pm-Feeding 4 ounces2:45pm-Back asleep5pm-Zantac 1.5ML6pm-Feeding 4 ounces with 2 TSP Oatmeal cereal7pm-7:30pm- Bath8pm-8:30pm- Back to sleep9:30pm-10pm- Awake and very fussy, 1 TSP Mylanta Supreme Cherry given. Prevacid 7.5 given10:30pm-11pm- Feeding 4 ounces(still awake and fussy)12am-1am- Back to sleep3am-Feeding, extremely fussy colic like symptoms3am-6am- Extremely fussy until 6am feeding*This schedule was before I knew to wait 4 hrs between the dosage of Zantac and Prevacid*Symptoms when fussy- Colic like behavior, Crying unconsoleable for hours, nothing comforts him. Flails arms and legs. Spitting up usually more at night. Wants to over eat at night even with cereal in bottle. Regurgitates and reswallows at night, gags only at night, coughs only at night. Most symptoms appear only at night.I give 1 TSP Mylanta Supreme as needed, doesn’t work. I use Mylecon drops, Doesn’t work. I try 0.4ML infant tylenol, doesn’t work.We keep him swaddled since it helps him sleep, and we tried to unswaddle him and it makes the discomfort worse.He seems to be spitting up 2-3 ounces of his feedings ONLY AT NIGHT. We feed in an upright position, Keep him upright for 30min after a feeding, His crib has an incline mattress so he isn’t ever flat on his back. We burp in between bottles, and burp several times during a feeding.His spit up is mainly very slimy, it isn’t milk or formula colored, it is usually a cloudy substance.Diaper Details- He has very normal pee diapers, suffers from constipation but with the Karo syrup once a day, he can have 1 BM a day. Never more than 1 BM daily. his BM’s are mustard seed yellow(TMI sorry)and a good texture, not to watery, not to hard. It smells as all heck, sometimes of rotted milk.Things our GI said to try- 1 TSP Mylanta supreme as needed, He told me to discontinue PPI due to tummy discomfort(went against that one). Upped Zantac to 1.5ML 2 times daily. 1 TSP Dark Karo Syrup once a day. 2 TSP baby oatmeal per ounce of formula(I only do about 2 TSP)at bedtime bottle.We use Dr.Browns bottles.Conner did well last week. He wasn’t very fussy at all, slept pretty much through the night, atleast 6-7 hours. We didn’t change anything in the schedule. He is on Enfamil Prosobee. Rash is mysteriously gone. Indoor temp is a constant 75 degrees. We use a humidifier with distilled water. Keep a fan running at all times.Thursday night he started to go back to square one. He wasn’t getting Prevacid on a regular basis as I was trying to see if it was even working. I started the Prevacid back up with Marci-Kids dosing 22.5MG daily on Thursday night because of the fussiness. All last week he DID NOT spit up. But Thursday he started spitting up again, and is spitting up again like before we started meds.I think thats pretty much about it. If I think of anything else I will post it. Can anyone think of anything that could be possibly going on? I feel so lost and I have no Idea what to do anymore.Could the PPI be infact causing him abdominal discomfort? Should I discontinue anything to see if it helps? I know having someone other than me and hubby see whats going on can help. Any advice or information is extremely appreciated.Thanks in advance, and sorry this is so long.TamiDecember 6, 2008 at 7:26 am #59292InactiveOne more thing
He HAS NOT gained weight in almost 2-3 weeks. He is holding steady at 11 pounds 12 ounces.Im calling the oncall GI later today, and calling my GI Monday, Is there anything I need to ask them? Is there anything I need to suggest changing?Thank you.December 6, 2008 at 7:37 am #59293InactiveYou poor thing! I am going to guess that his discomfort is due to the fact that the medications were not being given properly. If they aren’t given correctly, they might as well not be given at all! I read your other post and I also like Erin’s suggested schedule (prevacid AM, zantac, prevacid before bed, and zantac for middle of the night so you can have the 4 hours spacing).
It’s VERY common to see a pattern of good days mixed in with bad days. That’s what makes reflux SOOOO confusing and why we call it the ‘reflux roller coaster!’. Just when you think you’ve got it all figured out…all hell breaks loose! I knew we finally had my daughter’s reflux under control when the good days FINALLY outweighed the bad!Something else I read, that I may have misunderstood, but I’ve heard you mentioning he still spits up on the meds (or something along those lines). I’m sad to say…reflux medications do NOT stop a baby from spitting up…they only eliminate the acid from the spit up so it doesn’t burn so bad when it comes up. We had Sarah completely happy by 4 months and she didn’t stop spitting up until 10 months! I just didn’t want you to think the fact that he STILL spit up meant medicines weren’t working!Just remember to be consistent for at least two weeks with your plan of action before giving up. It’s easy to be tricked into thinking everything is great and then slacking on medications, or skipping doses, or changing something else completely. Try to find a good routine (stick with soy…if that’s what you’re still on, and follow correct procedures for meds). See where you’re at after several days on the same routine.GOOD LUCK TO YOU! HUGS!
December 6, 2008 at 7:58 am #59295InactiveAmy- Thank you. I feel so bad that I wasn’t giving the meds properly, but I had no clue about the 4 hr spacing because my GI doesn’t want Conner on Prevacid at all, and he didnt mention that. I am going to make sure they are given properly for now on.
I know the spitting up isn’t going to stop on the meds, Im just worried with the amount of spitting up he has because he has not gained weight in so long. I never knew about the *reflux roller coaster* lol I always figured once they started acting or getting better, they would stay that way, instead of bouncing from good to bad. I know gerdlings have their good days and bad days, but I didnt know that the symptoms could go all the way back to square one.I feel absolutely horrible for the way I was messing up Conners Meds. I really don’t want to take him of his PPI or the Zantac as both seem to still work….when given properly lol.I made sure to write down the exact directions to the new dosing with the meds so hubby is on the right track as well.Now I always thought that with the meds, smaller more frequent meals, constant burping and oatmeal added to bottle and so forth would cut Conner back on the spitting up. He was doing so well with not spitting up, and now it seems that the poor baby can’t hold anything down(only at night).Also, should Conner be having more than 1 BM daily? Or is 1 MB normal for his age (8 weeks). I can’t remember the pooping routine with my other 2 kids, so im not to sure.December 6, 2008 at 8:56 am #59296InactiveHi There! I agree w/Amy. Sometimes it takes a good 2 weeks to see real improvement and to know whether or not the meds are working. One other thing that I wanted to mention…
You’re concerned about the amount he spits up…Does he ever seem NOT hungry? Just something to take into consideration…Some babies have DGE(delayed gastric emptying)…which basicly means that their stomachs don’t empty as fast as “normal” babies…they are left w/food in their tummies to reflux more often and spit up more…A lot of times GIs prescribe a motility drug(erythromycin/reglan) in combo w/a PPI. The motility drug helps speed up their emptying and helps them consume more(sometimes) BUT helps there not be “leftover” food sitting in their stomach to reflux after long periods of time. It’s something you may want to discuss w/ur LOs GI. My DD has been on prevacid solutabs in combo w/erythromycin for 3.5-4mths and has been doing so much better. Good Luck!eta: Yes, 1 BM a day should be fine. I get concerned when they go a few days in b/t (even that is supposedly normal).valentine4mommy2008-12-06 08:57:51
December 6, 2008 at 9:03 am #59297InactiveAmber- Thank you for that information! I never heard of DGE before. He is always hungry when his normal feeding times come around. When he is having what I call a *Reflux attack* he will want to over eat as it soothes his tummy temporarily(sp). Sometimes he will only eat 2 ounces. He doesn’t ever eat anymore than 4 ounces, unless like I said he isn’t feeling good.
I wonder with DGE if they can be so routine, that he eats even though he isn’t really hubgry causing him to spit up more? I will def. mention this to my GI.December 6, 2008 at 11:29 am #59304InactiveI’m not sure if it’s common for babes w/DGE to overeat or not. I’ve only got experience w/my DD refusing to eat more than 15oz/day for quite some time possibly due to DGE. She has never been tested for it, the GI preferred adding in the med and if we saw improvement then that was good. So, I’m hoping we’ll be able to back off the emycin here shortly though. I’m not sure if Averi has DGE or not, but I do know that when she teethes she REFUSES to eat and that may have been her problem this whole time. Reflux is really hard to figure out. Teething and colds throw a MAJOR wrench into things and you don’t know what’s causing what. So, I figured I’d mention it just in case b/c another thing w/DGE is that when the stomach doesn’t empty after the normal 2-3hrs it may be causing the prevacid to be ineffective. You know, since prevacid has to given on an EMPTY stomach. Let me know how the GI appt goes. I’d be curious as to what they said.
Also, if the GI does consider adding in a motility drug…do your research…erythromycin is much safer then reglan. The only problem is that emycin in certain forms is being discontinued. Good Luck!December 6, 2008 at 12:54 pm #59308InactiveThere are a number of things that can cause reflux to flare up. One is constipation another is yeast imbalance.
Stinky stools at your DS’s age are a bit suspect, has he ever shown signs of thrush?
Oatmeal and rice solids can be horrid on immature digestive systems, or at least they were for Janna. Have you heard of simply thick? Its more expensive but it’s been a great thickening solution for us.
I’m also suspicious of the Zantac – depending on how long your DS has been on it – he may have generated a resistance to it. If an H2 is working the relief it gives should appear within 20-30 min of dose.
Conversely a PPI takes longer but it’s relief lasts longer.
Another mention, Janna used to “comfort feed” when her reflux was acting up. I believe it initially gives them some comfort from the heartburn-like pain – like drinking a glass of water would help an adult.
I’ve also noticed you’re feeding 4 ounces each feeding – wow he’s eating like a trooper, I could only get Janna to take between 2-3 oz per feeding and we were at 8 feedings per day instead of 6.
Jsquared2008-12-06 13:00:28
December 6, 2008 at 1:22 pm #59310InactiveOne thing I noticed was that you are giving the Prevacid and Mylanta at the same time?? Is this right? If so, you need to actually space them apart too. The Mylanta works the same way that the Zantac does, so you can’t give it too closely to a delayed release PPI.
December 6, 2008 at 3:23 pm #59315hellbennt
Keymastersummary, lol:
1) prevacid and zantac need to be spaced anywhere from 2-5 hrs apart. I give that range, bcse that is the range I’ve ‘seen’ on this board the past 5 yrs- our ped GI said 2 hrs and that worked for us. others say 3 or 4 or 5. I usually ‘just’ post 4 hrs bcse it’s the most ‘common.’2) prevacid and mylanta cherry supreme (this is the one kind w/ no alumimum- check the ingredients) also need to be spaced 4hrs apart.3) zantac and mylanta CAN be given together!December 6, 2008 at 3:53 pm #59317InactiveThe things that I notice besides the spacing of the meds are:
1) giving oatmeal in general (can be very rough on such an itty bitty tummy)…
–>sidenote: why are you thickening? i don’t remember… have you had a swallow study done?
2) the brand of the oatmeal (most/many have dairy &/or soy)
3) the soy formula – are you positive he’s okay w/ soy…
There are so many factors so it can be extremely overwhelming & we all get that… so I would only try to do 1 thing @ once.
If I were you I would:
1) Continue the Prevacid for 2 wks
2) Continue giving Zantac (w/ Mylanta) 4 hours apart for those 2 wks.
3) Stop the oatmeal (if you need to thicken use simply thick or the other brand – drawing a blank right now)
4) continue w/ your current formula but note any patterns
5) stop the karo syrup
6) start a probiotic
Again, that’s just my opinion…
erinntx 2008-12-06 15:53:58 December 6, 2008 at 4:13 pm #59319KeymasterDecember 7, 2008 at 12:15 pm #59347InactiveSorry I haven’t replied to the recent posts on this subject. I had a wedding reception to do for my father and new step mom. Anyways I followed the 4 hr spacing for Conners meds yesturday, and he did a lot better. He stayed awake in the reception nursery the whole time (4 hrs) and wasn’t fussy at all until it was time for him to eat. He cried all the way home, but I think I bundled him up a bit to much and he was over hot.
I got him home, gave him his 2nd dose of Zantac, waited the 30 min, and hubby fed him while I ran to get more formula, and he went right to bed. He slept from 11:30pm till 6am and wasn’t fussy after he ate his 4 ounces at 6am which was a relief. He then slept from 6am until 11am, which allowed hubby and I to catch up on some well needed sleep.Now one more question lol, I wanted to put his meds on a schedule, where he would get them the same time everyday, but im worried if I do that then the Zantac will have a better chance of not working.This is how I was dosing10am-Prevacid10:30am-Bottle2:30pm-Prevacid3:00pm-Bottle7:00pm-Prevacid7:30pm-Bottle11:00pm-Zantac11:30pm-BottleAnd since he slept so long he didnt get his first dose of Prevacid this morning until 11:30am.I was wondering if I should keep the timing on a schedule of when he got his meds, but switch his meds around. Instead of him getting Prevacid first, do Zantac first then Prevacid, then 2 days later go back to Prevacid first? I hope that makes sense.Also to answer some questions, I didn’t give the Mylanta right with the meds I always waited atleast 45 to an hour. I was scared it would cause a negative reaction if I gave it so close.I also don’t think personally that he has DGE, He eats very well when it’s time for him to eat. He also eats 4 ounces unless he falls asleep while eating, but wakes up shortly to finish whats left over. Im going to gradually up his formula to the 6 onces he should be getting, im just worried that if I start feeding him 6 ounces off the bat he will start spitting up more.My doc says I will be over feeding him, but I dont think thats the case. Also I noticed that Conner gets congested at night, and actually snores lol. Im not sure if it’s dust, as my house gets extremely dusty, and I try to dust every 3 days. I have hubby take all the boys out to a friends or to a grocery store so they aren’t around the dust(it gets bad). It doesnt sounds like a stuffy nose, or runny nose, it sounds like he has a boogie flapping around in there lol. Anything I can try to help the congestion? I already have a humidifier. And I have a cieling fan on constantly, hubby is always hiking the heater up to 80 degrees, and I get to hot so I keep the fan on.Anyways, thats my update. Im hoping now that I know about the 4 hour spacing, he will start to get better. I just feel so horrible that I was causing him more grief than goos by giving him his meds 30 min apart.Im soooooooo happy I found this forum and all you lovely women, because without you all id still be struggling, because for some reason my doctors don’t seem to want to give me correct advice.December 7, 2008 at 3:02 pm #59349InactiveI think you could switch the meds around…TBH…I don’t have enough experience w/both to know whether or not it would help by changing it up or not. I do know that in time the zantac may prove to be ineffective(babies seem to reach a plateau w/it). BUT once that happens the prevacid will be well into his system.
About the DGE, he probably doesn’t have it if he has no problems consuming his bottles. Especially if you think he’ll eat more than what you give him each feeding. I’d increase and if he eats it, then he was hungry. If you notice him spitting up more then you can always back off. KWIM?!So, he only gets congested at night? I have heard/read that it can be a sign of intolerance/allergy…BUT…I’m not sure if it has to be an all day type thing. Hopefully someone else can chime in who has more experience in that dept. Although the temp up to 80 degrees isn’t good for a baby…It should be b/t 68-72. If my DD gets overheated I notice she sounds congested also….Glad to hear he’s doing better! Hopefully he’ll cont. to improve!!!valentine4mommy2008-12-07 15:03:14
December 7, 2008 at 5:25 pm #59354InactiveErin
1) Continue the Prevacid for 2 wks- I wont come off Prevacid lol2) Continue giving Zantac (w/ Mylanta) 4 hours apart for those 2 wks.-I will continue the Zantac aslong as it still works3) Stop the oatmeal (if you need to thicken use simply thick or the other brand – drawing a blank right now)-Simply thick didnt work, it irritated him pretty bad. I use Gerber oatmeal which does contain soy.4) continue w/ your current formula but note any patterns-Most of the issues I have had were not caused by his Formula, IE Rash which was from the baby wash.5) stop the karo syrup- I use Karo to help him poop as he gets very constipated on say formula, and that causes his reflux to flare up.6) start a probiotic- I refuse to use a probiotic, My sister who had crohns disease came off her prescribed medication and used a probiotic which worked really well, but once she decided she didnt need it anymore, her crohns flared up and was 20 times worse than before the probiotics. I also heard that probiotics help the body by placing good bacteria in it, and once the probiotic is stopped the body has a tendancy to allow the bad bacteria develope 100 times more than before taking it.Amber- I know for sure that Conner isn’t allergic to Soy. His congestion is just during the night after hubby cranks up the heater. Im thinking the air is just really dry in the house and dry air can cause nasal congestion, nasal irritation, and sinus irritation. -
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