Andersen Baby's Tummy Troubles

Thursday, October 31, 2013

Wednesday afternoon: Slept from 2 to 3, squirmed and sucked on the hand she was able to get out of the swaddle until 330. Sat with me at the computer until 4, crying and then screaming. Intermittent screaming since. Fell asleep at 730, put her in bed at 8. Woke right up. Screamed with Dave until 10, slept w/pcifier until 11, ate at midnight, fell asleep on me at 115, slept in raised bassinet until 330. Had a BM at 330. Looked normal.
Then 430AM-10AM. Very quiet. I don't think she was pain free; I think she was too tired to fight sleep anymore. No more meds as of this afternoon to see if stomach pain diminishes off simethicone and PPI.

Thursday: no real naps. Slept a bit in car, in my arms, and in her carseat in the cart at the store. Lots of screaming, especially in the evening. Straightens legs when she does. Hiccups, gasping, etc. Ate at 715pm. Diarrhea diaper at around 730PM. No real issues taking bottles. After an hour-plus of screaming (7-815 with a quiet time during her diaper change) we gave Rolaids liquid which provided relief (hyoscyamine at 745 did nothing), so acid seems to be the big problem. Fell asleep at 830pm, finally spit out pacifier at 920.

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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.