Prevacid and reflux

One of my boys has reflux and was recently switched from Zantac to Prevacid because the Zantac didn't seem to be working anymore. We've noticed some improvement but he still has reflux symptoms and pain, especially at night. The reflux seems to bother him most during and after his evening feedings and sometimes he won't finish breastfeeding or a bottle because it seems like it is hurting him to swallow. You can tell he is still hungry because he tries to eat, but then stops to cry when he swallows. He is typically not a fussy baby. When he has reflux pain, he will scream for a moment or two, arching his back or kicking his legs, often spitting up, and then when it passes (within a few minutes) he usually calms quickly. Lately he has these painful episodes maybe 4 or 5 times an evening, each one lasting only a few minutes.

He's been taking the Prevacid for about 12 days now, and the doctor wants us to give it a few more days to see if we see more improvement as it starts to work. She also tells us often that this is a typical thing that will pass when he gets older. Although that is reassuring, my baby is still in pain every day and I want to help him to sleep better and eat better now with as little pain as possible. Since he's still gaining weight the doctor doesn't think his problem is serious, and she seems to be encouraging us to just wait it out until he gets older. Are my expectations too high - thinking that the medicines should clear this up? If your baby took Prevacid, how long before you saw an improvement in symptoms? Would you say it was 100% better? Do you remember the dosage? What time of day did you give them the medicine? Was your baby taking Zantac and Prevacid at the same time? Our doctor mentioned this as a possibility if things haven't improved by next week.

Thanks for any help you can provide. It is heartbreaking to see my baby in pain, and so easy to see the difference since our other baby has no reflux. I just want him to feel better and not sure if I should be suggesting other options to my doctor or asking different questions.

 

Our boys had very bad reflux. Michael's was mostly spitting up, but Gabriel's was a lot like what you are describing - trouble eating, etc., but still gaining weight. We did Zantac first and it didn't do much. We then switched to Prevacid. They each got half of the 15mg pill, 1 hour before their evening feeding (around 5pm). It did not take care of all their symptoms, but it definitely helped after about 2 weeks. We tried giving each of them a full pill, and it gave them awful stomach cramps, so we just stuck with half a pill, which at least helped some. They did eventually outgrow it. By about 6-7 months, the Prevacid seemed to be controlling all the symptoms. We tried cutting back a few times and saw symptoms come back - we finally were able to cut it out completely with no symptoms when they were about 11 months. At one point we tried doing both Prevacid and Zantac with Gabriel, but it didn't seem to help much, so we just settled for having the 1/2 tablet of Prevacid help them some, knowing that in time they would outgrow it.

Hang in there - reflux is so tough, but thankfully it's not forever!

 

My DS was prescribed prevacid (never did use zantac) and the doctor prescribed one full 15mg prevacid a day. I double checked with him that a 15mg dosage was ok and not too much (after seeing that several moms here gave 1/2 of a 15mg solutab) and he assured me it was fine. And our DS never had stomach cramps from it. I would say the prevacid started helping my DS feel better within 4 or 5 days, but it was all a blur then. It definitely started helping before 12 days though. We gave it to him around mid-morning (even though prior to getting on prevacid his worst times also seemed to be early evening). You may also want to try thickened formula if you haven't tried that already. I think prevacid in addition to the thickened formula really helped my DS.

 

Thanks guys.
The original prescription and instructions from the nurse for the Prevacid said one full tab per day. When I spoke to the doctor today she said they had made a mistake and we should only be giving him a half a tab. She said the full dosage is too much for his age and size, so we will try cutting it back to half. Maybe he was having some discomfort from too much medicine, but we've been giving it to him in the morning and he seems fine most of the day with symptoms starting in the evening. We are going to try giving it to him at night instead.

The Prevacid actually seemed to help after 4 or 5 days, then it seems like we took a step back over the weekend. I just don't know what kind of expectations to have, whether it's normal for him to still have reflux pain every night and whether the medicine is working or not.

 

Did you just thicken the formula with rice cereal? He is getting rice cereal once a day now, in the early evening. He doesn't swallow much of it, mostly spits and plays with it. I think he would tolerate it in his bottle just fine.

 

I tried thickening with rice cereal, then oatmeal, and those were exercises in frustration for me (and my boys!). I started making a gel thickener that I added to their formula and it worked great, making it the consistency of the Enfamil AR without the constipation side effects.

 

Helpful info. Thanks!

 

Shera - have you thought about doing an elimination diet and/or switching to a hypoallergenic formula like Nutramigen or Alimentum? For some reflux babies, that's the only thing that will work. My daughter Piper had severe reflux, and still suffers from it at age 3.5. She ended up on Prilosec when the Prevacid didn't work. It's not better, just a different medicine that reacts better for some kids. I also had to cut out all milk products from my diet and could only supplement with Nutramigen. Anytime I had milk, cheese, ice cream, etc. she would have a reflux flare up and regular formula would cause problems too.

Also, is your son sleeping on a wedge? That was a big help for us too. We bought the Tucker Sling/Wedge combo but there are other brands out there.

Hang in there - reflux is HARD!! Oh - I totally don't agree with your doctor. Sure, your son will outgrow this, but there's more the doctor can do and more you can do if you want to prevent the reflux pain. Start with your diet and a formula change (your insurance might pay for it), and a wedge...

 

Actually he was sleeping on a wedge in the co-sleeper, but we moved him to the crib about a month ago and haven't used it since. I'd kind of forgotten about it, but I'll give it a try again. Thanks for reminding me.

I haven't tried an elimination diet yet but certainly open to it. There were a few times when he had reflux symptoms during breastfeeding when I had eaten a lot of tomato-based things - pasta sauce, chili, and sliced tomatoes, so I cut tomatoes out for a while, but then I started eating them again on occasion and it didn't seem to bother him so I thought maybe it had been coincidence. I can certainly try cutting the tomatoes again. If you have any books or resources to suggest that explain a good method for food elimination, I'd be happy to hear them.

Right now he is eating both breast milk and Enfacare. The only other formula we've tried was Neosure and he didn't do well with it. It gave him both reflux and gas. I am supposed to have a check-in call with the doc on Monday and I will ask about other formula. I'm totally willing to switch if it will help. I like our doctor but get the impression she thinks I want more/different medication for him, when in reality I just want him better. I actually DON'T want him on the medication if it isn't helping.

 

My DS was also a refluxer in the same way yours is, the pulling away but still seeming hungry. WE also transitionned from zantac to prevacid. IN canada they don't give the solutabs at that age bc they say that does is too high, they give it based on weight in a solution that you adminster to the baby. We started at 2.5 mg then adjusted until we got to about 4.5 mg. IN any case, we saw results in less than a week. I, like you, wanted to help my baby FEEL better. The doc was slow on the uptake with this b/c I think they also thought we were after meds or something but that's not the case. I agree with the pp, I think you need to try a different formula. If you breast feed exclusively eliminate dairy from your diet first b/c that seems to be the main culprit a lot and then if not that, try the elimination diet with other foods. If you also use formula, we tried the nutramigen but my babes didn't like it. We then went to the gentlease from Enfamil and finally the good start from Nestle and it seemed to help in combo with the prevacid. Honestly, trial and error.

I hope you sort this out soon and your little one feels better. I know how difficult it can be to watch them in pain. OUr DS slept in his swing for the first 4 months of his life and it was a lifesaver being elevated like that.

 

I never had any books on food elimination - just followed the plan suggested by our pediatric gastroenterologist (I'm sure I spelled that wrong). At first she wanted me to eat just brown rice, turkey and a few other things for two weeks. When I seemed a little nervous, she had me cut out all dairy -- even the hidden dairy that's listed in other foods under names like whey and casein, and all tomato based and spicy foods. And she told me it was critical that I didn't give Piper any milk or soy based formula, that would cancel out all of my diet elimination. So we had to get Nutramigen, which is technically milk based, but it's broken down more or something so that it doesn't bother sensitive babies. That worked for us, so I never had to do more. And FYI - once I cut the two major trigger foods and regular formula out, we were able to wean Piper off of Prilosec. I still had to avoid the foods, but she didn't need medicine.