finally, some reflux relief

this may be "duh" information for many people here, but it was news to me so i thought i'd share in case it proved helpful to anyone else.

we're dealing with some pretty bad reflux and having the usual sort of difficulties trying to improve our boys' quality of life. we started out on zantac and then switched to prevacid when it seemed like the zantac wasn't as immediately effective as we hoped. unfortunately they ended up with constipation and gas as a side effect of the prevacid (5 days without a poop, then both went about 6 hours after we stopped giving it to them) so we went back to the zantac. we also switched from similac enfamil to similac sensitive during all of this (mixed about half and half with EBM). which sort of complicated things because it meant we made a number of changes all around the same time so it was difficult to know what was improving things and what was worsening things.

we usually mix up a big batch of the formula and add it to EBM bottles as needed per feeding, but mid-morning i ran out and the boys kept me hopping so i wasn't able to mix up more before their next feeding. we had a bottle of the neosure ready to feed so i cracked it open and used it. i didn't think much of it since they'd been on neosure since they were in the NICU. we actually switched to the sensitive formula due to bowel problems rather than reflux so i didn't think for an instant it would have an effect.

immediately they started having terrible reflux flare-ups. arching their backs and screaming during bottles, spitting up and crying in pain after every feeding, getting no more than 30 minutes of rest between each episode. i was so busy dealing with the reflux episodes that it didn't occur to me that switching back to the neosure had made it worse again, so i did 3 feedings with the neosure/EBM bottles before i realized what had changed. i felt terrible and immediately mixed up more sensitive formula and switched back.

unfortunately it seemed like the damage was done and the flare-ups continued. they were in pain like i'd not seen in them before. finally around midnight after a lot of searching i happened on a reference to mylanta being safe for babies to knock down immediate acid flare-ups. because its method of treatment is different from acid blockers you can use it in conjunction with medications like zantac and prevacid. i found this information after hours and hours of wailing and spitting up (and some tears of my own because i felt so terrible about not being able to stop the pain).

our ped was unavailable and the 24 hour nurse line wouldn't give me any specific advice because they said they're not affiliated with our doctor. wish i'd known that sooner! so i jumped in my car and drove to a 24 hour pharmacy and had a long conversation with a very nice and very experienced pharmacist. he advised me on usage and dosage and sent me home with two syringes. DH and i dosed the boys before their next feeding and the change was dramatic. all day they'd been screaming at their bottles and eating only an ounce to an ounce and a half each time. but after the mylanta they had calm feedings and they each easily finished off 3 oz without hesitation. then they both slept soundly for the next 3 hours. it was such a relief because we could see right away that the pain had been soothed.

i'm not advising anyone to try anything without talking to their doctor first, but i wanted to share because i know so many parents here are dealing with reflux episodes. this isn't a long-term solution, but it seems to really hit the spot for bad flare-ups. here are the details if anyone wants to discuss options with their doctors:

we've got a 7 pounder and a 6 pounder. for these weights the pharmacist recommended 1 mL by syringe at every other feeding. it works out to a maximum dosage of 4 times per day (we were advised not to dose any more frequently than that). we're using the regular strength mylanta, not the concentrated extra strength version. maalox is another option, but the difference between maalox and mylanta is that mylanta has simethicone in it so there's an added benefit for gassy babies there. we chose the cherry flavor and the boys seem to love it. it's the easiest medicine we've ever administered. after the first taste they lap it up eagerly.

one last thought: the prescription acid blockers like zantac and prevacid, etc, require an empty stomach because they need the presence of stomach acid to activate. because of this we did not dose them with the mylanta on a feeding where we were giving them the zantac.

 

Thank you for your advice...my baby girl reflux is getting worse :-(..went from spitting up once a day (too much to be calling spitting) to now 2 or 3 times
with pain while eating.

Where do your boys sleep? Dr. recommended a bouncy seat but it just looks uncomfortable to be there all the time... I have one
that has a vibrator and that seems to calm her down...when I turn the vibrator off she wakes up...
Does anyone know if having the vibrator on for a while harms them?

 

we have bouncy seats and swings but we've ended up using our car seats. the swings have such a deep cradle that they're really more ideal for bigger babies. at our boys' size they're just too little and they sink so deep into the seat that they end up scrunched up and it seems to force more spit-ups. the bouncy chairs are better but they just hate the bouncy chairs at this point. we have the crib mattress propped up but i don't think it's enough of an incline (i keep reading 30 degrees is ideal) so we've had mixed success in there. when we're awake and watching them we also let them sleep on their tummies in the PNP. but mostly we end up using the car seats.

my only concern about vibrators was about the one in the PNP. they sleep on their tummies in there which means one ear is down against the floor of the PNP. the vibrator is directly under the floor so i had concerns about it affecting their hearing after a while.

 

We too got the okay for Mylanta when we were dealing with the reflux. Too bad it didnt really work for us. But I am glad that you kiddos are getting some relief.

 

I am glad that your babies are finding some relief and thank you for posting your experiences on here for the other mom's who are dealing with reflux!

 

I am glad you posted this! My boys are still on Neosure (also mixed 50% with EBM) I was never advised as to when to take them off. I have an apt with the ped this Friday but have noticed the boys are both showing different signs of reflux - I was going to ask then if we could go off it. I will try and call the ped on Monday to see if I can take them off Neosure - I am sure it is okay for my bigger guy - but for my little one - not sure yet.

I dont know about the vibrations - good question though.

Thank you again!

 

our GI doc told us to give ds mylanta too. the mint flavor is supposed to aggrevate reflux, so we got the cherry. he was 13lbs and they told us 1.5ml

 

We also used Mylanta Cherry in combination with their reflux meds and rice cereal in their bottles. Glad you found something that works, reflux is so tough. :hug:

 

QUOTE(Shelly @ Oct 26 2008, 01:16 AM) [snapback]1042274[/snapback]
I am glad you posted this! My boys are still on Neosure (also mixed 50% with EBM) I was never advised as to when to take them off.


our ped told us that the general rule of thumb for preemies is to keep them on it for 20 weeks.

he basically left it up to us if we wanted to keep them on it because we were clearly having all kinds of gastrointestinal problems (mostly poop related but clearly reflux related, too). he said since they're growing so fast and they're clearly thriving he thought it would be okay if we switched to give their guts a break. he did warn us that the dramatic growth would likely taper off as a result but he felt they would continue to grow and thrive. he also said we could bump up the concentration of the sensitive formula the same way we bumped up the neosure in order to give them more calories. we haven't done that yet, though.