Andersen Baby's Tummy Troubles

Wednesday, October 30, 2013

Trying to chronicle my third baby's digestive issues so I know better how to treat them and those of subsequent children (the first two had tgis as well, it was never fully understood or controlled). If it helps someone else, all the better.

Acid reflux symptoms manifested at approximately 3 weeks of age. Went to doctor shortlly thereafter, was prescribed Prevacid solutabs, 7.5 once a day. Knew it wouldn't be enough. Did it twice a day. Began to see results after a week. Doctor refused to up dosage to that amount. Was forced to switch to omeprazole/Zegerid/MCS homemade compound. Started to work after 4-5 days, then rapid decrease in sleep and comfort level. Acid production started to decrease again by day 12 but with it came an increase in stomach pain.

Some reflux symptoms such as gasping, head turning from side to side (possible Sandifer Syndrome), inability to sleep for prolonged periods, still present, especially noticeable during the day. At night stomach pain becomes apparent. Legs drawn into chest, screaming, screaming accompanied by some grunting when stomach is massaged. Very little gas is passed. Sleep is sporadic and short lived at best right now.

Bowel movement is pasty and grayish colored (from the compounded medication) but otherwise normal. BM occurs same time every day at approximately 7AM. Baby has no trouble passing BM. No mucus or blood present.

No noticeable stomach pain before day 12 on compounded PPI.

Currently on...
Gerber Soothe formula (probiotic in powder)
Mylicon drops in every bottle (doesn't seem to be helping)
Omep/Zeg/MCS compound at 2mg/ml, 3.5ml (7mg) 3xs a day as per MARCI kids dosing guidelines/suggestion

Day 14 started adding in extra probiotic (brand name to come soon, need to check)

Researching digestive enzymes, may add those into regimen a few times a day
Reading that low acid can cause lack of enzymes, which would make sense with the schedule of symptoms (stomach pain not apparent until acid reflux starts to diminish).
Klaire Labs has hypoallergenic enzymes but out of stock
May try GNC brand although contains dairy and soy

My kids seem to have these problems regardless of what formula they're on. Need to look beyond the formula if we can.

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What's working for Nora

We figured it out so much quicker with this baby than we ever did with our first two. She is now an incredibly pleasant, and dare I say easy, baby. Here's what's working for Baby Nora:

Gerber Goodstart Soothe formula

KlaireLabs Ther-Biotic infant probiotic, 1/4 tsp in morning bottle (work up to this much - start with 1/8 tsp.

OTC lansoprazole capsules, 10mg 3x's a day, changed to 15mg 2x's a day for convenience (this is trial and error; some babies need the three doses so I'd start with that first)

Rolaids liquid antacid (1-2ml) for flare-ups (which are almost 100% GONE!)

Bassinet placed on an incline (front wheels locked and placed inside my husband's work boots, which were then placed on top of a few large books)

Medication information

H2 blockers (ranitidine, Zantac, Pepcid, Axid) are often used for mild acid reflux. They can be given with food. They are VERY weight sensitive and will need to be increased as your child gets bigger. They have a tendency to stop working altogether after a few weeks. A way to prevent this might be not to use it all the time. If your baby needs constant treatment, I suggest looking into a PPI.

PPIs (omeprazole - Prilosec or Zegerid, lansoprazole - Prevacid, Nexium) are proton pump inhibitors. They are, in my opinion, very safe and effective. In babies they are often prescribed twice a day, because younger children metabolize the medication faster than adults. They are available in capsule, suspension, powder (that you make into a suspension) or solutab (which is meant to dissolve quickly on the tongue). Except in the case of Zegerid, these medications are delayed-release, which means they need to be given on an empty stomach (more than 2 hours after the last bottle, usually, in babies) and then 30-90 minutes need to go by before baby is fed. This allows the drug to be absorbed before the acid pumps are activated by food. The drug essentially temporarily paralyzes some of the pumps and limits acid production. H2 BLOCKERS AND PPI'S NEED TO BE GIVEN 4 HOURS OR MORE APART FROM ONE ANOTHER, IF GIVING BOTH.

Liquid antacids (Mylanta Cherry Supreme - discontinued/recalled since 2010), CVS brand cherry antacid, Rolaids) are effective for occasional flare-ups. Aluminum free is the only kind I will give my children. Rolaids came out with one in the fall of 2013 (right in time for Nora) that is easily procured in the United States at most supermarkets. Liquid antacids can cause loose stools because of the magnesium. They are not meant to be used long-term, only until the H2 blocker and/or PPI start working. They are wonderful for the middle of the night when baby can't settle back down and isn't yet due for another dose of her other medication. LIQUID ANTACIDS SHOULD NOT BE GIVEN WITHIN AN HOUR OF A PPI DOSE. THEY CAN BE GIVEN WITH AN H2 BLOCKER WITHOUT ANY PROBLEMS.

IF YOUR BABY IS STILL HAVING ACID FLARE-UPS, THEIR MEDICATION MOST LIKELY NEEDS TO BE ADJUSTED.

Disclaimer: I am not a medical professional. I make no absolute claims on the veracity of my information, nor do I guarantee that you will see the same results we did. Your mileage may vary.