Constipation

[Anonymous]

Evan (5wks) started on Prevacid (but only 5mg) 9 days ago… but started a much higher dose (22.5mg) 2 days ago. He’s also doing 1-3 mL of Zantac/day + Mylanta as needed (usually 1.5mL 2-4x/day).

Yesterday & last night were miserable – but NOT b/c of his reflux (Yay!). He’s been straining, grunting, constipated, hard tummy, etc.

Could this be due to the Prevacid? If so, does it just take a few days for his system to adjust?

Also, we have 3 hemoccults in w/ Ped GI (samples from last week) & 3 w/ the general ped (samples from last night & this morning). Should be getting results from both today. After yesterday (& the constant crying from tummy troubles) I’m more than willing to eliminate milk + soy… considering TED. This might be a better ? for another topic but should I consider TED even if occults are negative?

[Anonymous]

UPDATE:

The results are back from the 3 samples to general ped’s office (samples from yesterday)… 1 of them had blood in it. Ped said he’s not worried & to continue Prevacid (this conversation was b/w dh & ped – I would have brought up Evan’s misery). I’m worried b/c he’s so uncomfortable & miserable right now.

Also just heard from Ped GI & from the samples from last week – 1 out of 3 had blood in them. Waiting to hear from the dr. for “suggestions”.

What to do now? Call & talk w/ ped’s nurses &/or the office’s lactation consultant & explain Evan’s discomfort? Or just start TED?

Ugh – this is almost worst than his reflux (almost).

erinntx2008-06-27 12:41:51

[Anonymous]

Hmmmm…your post reminded me of what happened with my son after increasing his Prevacid up to 22.5 mg (and then later 30 mg). If memory serves, there were about 2 or 3 days after the increase where he seemed uncomfortable, but we couldn’t really tell why. He just wanted to be held a lot, but he didn’t really seem to be in REFLUX pain for a change. I read later on this site that it may have been some tummy cramps brought on by the med increase, but for us it DID pass quickly — and then his reflux was much better controlled on the high dose. I think this is typical, although it doesn’t happen with all babies.

About the TED, I’m not sure what I’d do if I were you. I was on the strict TED forever, but it was absolutely what my son needed (in addition to marci-kids dose of Prevacid). The TED is NO fun, but so worth it if it works. I’m curious as to what suggestions the doc will have for you. I would think that if there is blood in the stool, and it’s not from an anal fissure, there would have to be some protein intolerances going on (milk, soy, other).

This might be silly question, but are you sure your son’s constipated? Did he actually have a hard stool when it passed? I’m just wondering because both my sons did the awful grunting, straining hard tummy, etc. and I would’ve thought it was constipation, but their stools were not hard. Turns out for us it was protein intolerances, which the TED took care of completely.

I guess my advice would be to stick it out with the high dose of Prevacid, and go ahead and eliminate all dairy/soy from your diet (even hidden ingredients). With those changes, if you don’t see big improvement within a couple of weeks (sorry, I know that’s a long time!) then I’d try the TED next and/or try 30 mg of Prevacid. That’s what it took for my son to finally have relief.

Good luck! Hope this helps.

[Anonymous]

Paula pretty much said it all.

I can tell you that many of us had to our LO’s on a laxative (we had to use Miralax) when they were on a PPI drug like prevacid. PPI’s are notorious for causing constipation. When we weaned Landen from prevacid his poops returned to normal and we took him off Miralax so we knew it was indeed the PPI that made him constipated.

[Anonymous]

Paula,

The Ped GI was pretty much useless (par for the course w/ us but that’s another story). His nurse said that he wants 3 more hemoccults in 2 wks & wants to see him again in 3-4wks.

General Ped said continue the Prevacid (he’s the one who actually finally increased dose to 22.5mg) & we’ll talk again @ his 2mth appt (in 3 wks).

I’m a bit frustrated that no one’s listening to me… his reflux IS better but he’s still straining & crying a lot.

I didn’t really mean constipated… I meant all those things you mentioned (grunting, straining, hard tummy, etc). His poops are still loose. They are also mucousy, stinky (NOT like a normal breastmilk poop) & often green. I mentioned all this to both docs @ his 4wk appts.

Anyway…since there WAS blood in his stool that usually means intolerance(s) right?! Is that usually dairy/soy? or can anything be causing the blood?! I’m so clueless here :). My 1st son has sensitivities to dairy & if we don’t limit it (carefully) he gets VERY constipated… that’s the only experience we have though.

We will stick w/ the high dose of Prevacid for sure. I’m ready to eliminate something though. I did dairy for 5 days a few weeks ago but Ped GI told me to stop. I was doing hidden dairy but I wasn’t doing soy as well so it wasn’t probably a true test.

My debate/dilemma is: do I just do dairy/soy for now? & then if I don’t see results/improvement in 2-3wks THEN do TED? or do I just do TED now…

[Anonymous]

This is just what I would do. I would do TED to go ahead and clear everything out and in 2-3 weeks start adding non dairy/soy things back in to see how he does. I am looking at it from if just taking dairy and soy don’t work you have another 2-3 wks after that to see what might be causing the problem and by starting with a clean slate (ie ted) then it might not take as long to figure out what might be bothering him. But hey I didn’t last with bfing my lo so I may have it all backwards.

[Anonymous]

Without hard stools then I wouldn’t worry about a laxative, it’s probably all intolerance! (and I was not trying to dismiss the idea of intolerance before at all, rather just giving more info on PPI’s and their ability to constipate BTW )

I agree with the others- def try TED. Landen had all of the same symptoms- grunting, straining, crying, increased reflux, red face, mucousy bloody stools, etc etc. until we did Neocate for 4 weeks+. Good luck & keep us posted!

[Anonymous]

Hey there! I also breastfed on the TED for a LONG time.. same as Paula.. and your post makes me think of two things…

1. the green stringy, mucousy poop with the straining, etc. sounds very much like my son.. and his was due to intolerances.

2. It’s possible he is reacting to the lactose and/or aspartame in the solutab. Paula could tell you more about this too. They ended up on a different form of Prevacid because of it.

So, all that to say, I would start TED. It’s no fun, but worth it if it helps you little guy. If you don’t see improvement after 2 or 3 weeks, then I think I would STAY ON TED, but then maybe try switching his Prevacid form to the capsules or packets. Then, if no change, you can add the food back in, etc.

Let us know how it goes.

[hellbennt]

I did TED, so I’d say to do it. Also there are enzymes you can take to help resolve the blood in the stools (along w/ the diet). I have an article here in my hand- I can give you more info later- have to head out the door-

this was discussed recently;

https://www.infantreflux.org/forum/forum_posts.asp?TID=11039&KW=pancrease

&

google:

breastfeeding clinic U of CA, Davis Medical Center

Pancrease

Pancrease MT4

hellbennt2008-06-28 09:53:05

[Anonymous]

Ok, so we went today & bought all (ha ha) the stuff for me to start TED tomorrow. We have a Whole Foods very close so it was fairly easy to buy. I just need to make sure I plan out my meals for @ least 2-3 days at a time – otherwise I will get hungry & frustrated (esp since my time is so limited right now with trying to make my little guy – & toddler – happy).

There are so many things I’m thinking about though… so I’m just going to ‘think outloud’ here:

-maybe the stomach cramping (or whatever) IS from the increased dose of Prevacid (b/c they seemed to have lessened today-4 days after starting high dose) – BUT that doesn’t take away from the fact that there was blood in the stool

-I’m worried about the solutabs causing a reaction – BUT he’s always had mucousy poops basically since birth (& has only been on solutabs for 4 days – was on suspension before)

-I didn’t eat dairy or soy yesterday or today & today was definitely a better day… not any better w/ sleep (& wanted to nurse every 2hrs) but not as much inconsolable crying, less straining/grunting, etc. Also the diapers smelled much more like breastmilk diapers. I know I wouldn’t see results this quickly but still makes me wonder.

That’s all 🙂 Thanks for “listening” & we’ll see how the next 2 wks go.

[Anonymous]

Hi Erin,

I’m sorry I’m just now getting a chance to check back in on this thread. After reading your reply to my reply, where you describe your son’s bm’s, I would also definitely say to go ahead with the TED, as you are — so it’s unanimous 🙂 At first I just cut out dairy, then dairy and soy, then all dairy/soy including hidden ingredients. Things were a little better but not that much. Then I found on this wonderful site the info about TED, and I thought, why not? I’m not eating what I want to anyway! So within just 2 DAYS of starting the TED, all of the grunting, straining, arching during feeds, screaming during feeds, mucousy poops were gone, and they never came back UNLESS I ate something with too much protein. I think you CAN see results quickly if protein intolerances are a major part of your baby’s problems.

To answer one of your questions about what your son could possibly be intolerant to — it varies, but proteins are generally the hardest things for a baby’s immature digestive system to handle. The most likely suspects are milk and soy proteins (hence MSPI), but then there are some babies (like my unlucky little Nate) who can’t handle much protein of any kind (hence MFPI – multiple food protein intolerance). He was so sensitive that even a handful of almonds or sunflower seeds would guarantee a horrible feeding a few hours later. But good news — he outgrew the “multiple” part of his intolerances by around 7-8 months, and then I “just” had to avoid dairy/soy til he was weaned a couple of months ago.

Oh, and Naomi hit on something potentially very important — some babies cannot handle the Prevacid solutabs. My older son has a milk allergy, and I’m 99% sure that Nathan does too because while on the solutabs for a few weeks, he had horrible stinky gas (I kept trying to figure out what I was eating to cause this, but I was on TED so there was nothing!) and insomnia — waking up from short naps not in reflux pain but just WIDE awake suddenly. But another mom on this site mentioned that the solutabs contain milk ingredients, so we switched Nathan to Prevacid packets (these unfortunately are being/have been discontinued, though). When that happened, we switched to the Prevacid capsules, which you just open up and sprinkle on something acidic like applesauce. By the time we got to the capsules, Nathan was spoonfed so this was no problem. But for a newborn, I believe you can open up the capsules and pour the medicine beads in a little apple juice, and give by a dropper. They still need to be given 30 minutes before a feeding.

Good luck!! I hope the TED helps Evan a lot, but then again I hope you quickly find that you can add back in a lot of things to your diet. Just feel encouraged that you’ve got a plan of action now and different options to explore — TED, then maybe increase Prevacid up to 30 mg, then possible med change (to another form of Prevacid or another PPI). My son was not happy til I went on the TED, we got him on 30 mg Prevacid (22.5 mg gave almost NO relief), and we got him milk-free Prevacid. Those were the 3 critical things for us.

Sorry this is so long — hope it helps some.

[Anonymous]

Paula,

Thank you SO much for your response (& no problem about getting back to the thread).

I guess the “plan of action” for now (as you suggested) will be to 1) do 2 wks of TED & then if no changes, then 2) change to milk-free prevacid. Thanks for the info on the capsules.

Do the solutabs bother all babies w/ MSPI? or just some…

Like I said: Evan’s always had horrible stinky gas & poops – since birth. So although the solutabs might be making things worse, I obviously think there’s something else going on. BUT, the extreme fussiness + no more napping (& worsened night sleep) coincides exactly w/ starting solutabs… so who knows. I guess we’ll just wait the 2wks & see.

I don’t think the marci-kids website recommends a 30mg dose until 13-14lbs &/or 3mths old. Evan is still around 11lbs & 6wks so we’ll be on 22.5mg for a bit longer. I’m just grateful that my general ped looked @ the marci-kids info (Ped GI wouldn’t).

Thanks again for your post – it was very helpful.

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