Nothing seems to work

[Anonymous]

Hi everyone. I’m waiting for my son’s GI to call back, and and am hoping between her feedback and some ideas here, I may be able to bette help ,y son. A little background. My son is 3 months old and of course has reflux. He never had any major testing done, but was diagnosed based on spitting up, sour smell of his breathe and apparent pain he was in .

He was put on Prevacid, the compound version, 2.5 ml 2x daily. It worked beautifully for his reflux. He never spit up or seemed to be in pain because of the reflux. However after about a month, we started connecting another problem to the Prevacid. Twice daily, not long after giving it to him, he would scream and scream and pump his legs. he also had painful BM’s. A couple of times, to experiment I stopped the Prevacid for a day-what do you know?! No screaming. I told the Pedi about this who said that infants can have abdominal pain from Prevacid-Thanks for letting me know sooner Doc!!! And why did I have to find that out for myself? (But that is besides the point)

Anyway, she put him on Zantac 1.7 ml 3x daily (He is 11.6 pounds). At first, no tummy pain, it seemed to be going well. But now after a couple of weeks, his reflux is back with a vengeance. He spits up all the time, cries, and shoves his fists into his mouth constantly to the point of gagging (we have no indication that he is teething). He also wakes in the middle of the night crying and when I pick him up, there is spit up on his face.

I feel so bad. He is generally a very content baby, and now is always uncomfortable. The Prevacid hurts his tummy but the Zantac doesn’t seem to be working. Is there anyone who has a similar issue with an effective medication protocol? I’ve heard that Prevacid has traces of lactose and he does have a milk allergy-so if this was the cause of his pain, is there another medication that does not have lactose? Or another form of the prevacid that does not?

I’d appreciate any feedback and am hoping to give the GI some ideas, since I’m not sure how seriously they take a baby’s pain as long as he is gaining weight 🙁

[hellbennt]

answered your other post:

well the dose sounds low- so I’m not sure?

have you read through Prevacid 101 and looked at the dosing chart?

Prevacid 101:

scroll to the last page of this post, (it’s actually also about other PPIs like prilosec, too)
https://www.infantreflux.org/forum/forum_posts.asp?TID=1936&PN=0&TPN=1

I’d start there.

next: I wouldn’t give a compound (read through prevacid 101 to learn why).

also: the solutabs have their own ‘things’ that might and I say MIGHT affect your baby- aspertame (is there aspertame or some other ingredient in the compound? again, it’s in Prevacid 101)

you can always try prilosec or nexium- the dose for these are also in Prevacid 101…

[Anonymous]

I feel kind of dense but after reading…ok so the Prevacid Solutabs that have the lactose are not what the compound is made from or is it? And is it the compound that upsets baby’s stomachs or all forms of Prevacid (bc it seems alot of moms describe the same problem my son has).

And I am also wondering if any other PPI’s do not have lactose. Of course this is assuming that it is the lactose thats bothering him-which is quite possible since he does have a milk/soy allergy or intolerance (those two definitions confuse me, but anyway…)

[Anonymous]

I am at my wits end. The GI had nothing to offer except to suggest that we try Prilosec. She didn’t even know which PPI’s or which forms of the Prevacid have lactose. She said the lactose would not be the cause of his abdominal pain anyway. Aren’t they supposed to know these details inside and out? So now I don’t know what to do. Try the Prilosec, go bak to Prevacid, stay on Zantac…

[hellbennt]

ok here goes: the solutabs have lactose, which is milk SUGAR, not milk protein, so it’s usually not that ingredient, per se, that bothers sensitive babies (mspi). it can be ASPERTAME.

a compound is what it’s called when they take a medicine and make it into a liquid. your compound could have something in it that is hurting your baby’s belly. maybe it’s aspertame, maybe it’s stevia, maybe it’s the coloring, etc. you can TELL your dr to please TELL the pharmacist to make it a particular way:

https://www.infantreflux.org/forum/forum_posts.asp?TID=4505

so: it may OR may not be the actual lansoprazole – that’s the medicine/drug of prevacid

what does your prevacid bottle say? how many MGS/ML?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Calculating Proper Prevacid Dose for you:

prevacid dosing is 1.25 to 1.5 mg/kg three times per day

Range of prevacid dosing:

Low end:

5.2 x 1.25 = 6.5 mgs a dose

6.5 x 3 = 19.5 mgs a day, total for the day

high end:

5.2 x 1.5 = 7.8 mgs a dose

7.8 x 3 = 23.4 mgs a day, total for the day

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

you can give OTC prevacid capsules. then you’ll know if it’s the actual prevacid. Well, it’ll give you an other point of reference…open up the capsule and give the beads in there. if there’s a tablet inside the capsule, throw it away. the medicine is in the beads. make sure to give on an empty stomach and then give a ‘meal’ 30 minutes later. when you give the beads, you need to give w/ some applesauce or pedialyte.

OTC w/ applesauce, pedialyte, etc:

https://www.infantreflux.org/forum/forum_posts.asp?TID=14642&PID=113339#113339

and:

best EXPLANATION OF FOOD ALLERGIES/INTOERANCES and their RELATION TO REFLUX that I have found, to date: 2nd post: https://www.infantreflux.org/forum/forum_posts.asp?TID=2697&PN=2

hellbennt2012-03-05 18:16:12

[hellbennt]

oh! forgot to tell you about the zantac. you should be giving it 4 hrs seperate from the prevacid.

currently taking 1.7 ml of Zantac 3x daily.

ok highest zantac dose by weight is 10mgs per kilo. don’t just take my word on this! read https://www.infantreflux.org/forum/forum_posts.asp?TID=8288&PN=1

11.6 pounds = 5.2 kilos

5.2 x 10 = 52mgs total of zantac per day, total

your bottle of liquid zantac says 15mgs/ml

this means that for every 1ml of liquid you give, there’s 15mgs of the medicine zantac in that 1ml of liquid

so 52 divided by 15 = 3.5mls total a day of zantac

1.7 x 3 = 5.1 mls a day he’s currently taking

so your zantac dose is higher than I would have thought? not a big deal, I don’t think?

[Anonymous]

It sounds like your son is having a reaction to the Prevacid itself. That’s a side effect that some babies have to the medication although it’s not common. I also believe that the solutabs have a trace of lactose, but not sure about the compound. I don’t think it does although I’m not sure.

However, I don’t think that’s why your son is having the side effects. Our GI doc at CHOP said that if your daughter is having a side effect to the prevacid you would know because it would happen shortly after and she would be really uncomfortable which is what it sounds like for your son.

There’s other PPI’s out there that may work better for your son. Our daughter hasn’t done so great on Prilosec, but has done pretty well on Prevacid. Some babies do better on one or the other. There’s also the PPI Nexium. I don’t know much about it, but it was mentioned to us at our last appointment. Hope this helps and sorry for your little one. Hope you find the right match soon!

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