WWYD? (Do I listen to the Dr or not?)

Avery has had issues with reflux since the day he came home from the hospital. He had a scan done when he was just a few weeks old that showed reflux with aspiration so the pedi put him on Zantac and Reglan. I have never seen that the Reglan has helped at all with the spitting up. When he saw the pediatric GI dr a couple of weeks ago, he told me to stop the Reglan and start giving him Erithromycin. He said that in small doses, it acts as a motility agent instead of an anitbiotic. A friend of mine who is a pharmacist told me the same thing. So he's been on that and, again, I'm seeing NO improvement! The only thing I can see help him is the Zantac. It helps the acid not hurt him but doesn't help with the spitting up.

Last Monday, he had a gastric emptying scan. It showed a moderate delay, two episodes of reflux, but no aspiration. When I told the GI dr that the Erythromycin doesn't seem to be helping, he told me to stop eating dairy products, which I'm fine with, but he also said to continue the meds. I just don't know how comfortable I am with that. Why do I need to keep giving him a medicine that doesn't seem to be helping? He's gaining steadily so he's not throwing up enough to affect his growth. He doesn't seem to be aspirating anymore.

So what would you do? He has an appt with his regular pedi tomorrow and I'm going to talk to him about it, but I wanted some opinions from fellow mommies too.

TIA!

 

Cutting dairy totally helped my DD. However, we did continue meds for a short while and then stopped all together. She did fine off the meds. I'm sure your ped will have some good input.

 

I think you should try to avoid the diary as suggested and then wait if you see a change. If you stop diary and the medication at the same time you don't know what is doing what. My ds was on Zantac, later Prevacid, and we also tried hypoallergenic, but never try (or stop) 2 things at the same time ... you won't find the answer (if there is any). So I understand your point, but don't try to do too much at the same time, and give it a shot. If no change, stop the medication and see what happens (that's what we actually did with the Zantac on doc's orders and there was no change ... so no reason to give it; Prevacid was a big help though).

 

personally, I would not stop a med on my own say so since i don't have a medical degree. I would also be weary of asking non-medical professionals their opinion on a medication issue.

I'd tell the doctor why you are hesitant and ask exactly what you said:
QUOTE
Why do I need to keep giving him a medicine that doesn't seem to be helping? He's gaining steadily so he's not throwing up enough to affect his growth. He doesn't seem to be aspirating anymore.

I'm sure the doctor's answer will help you better understand his decision.

 

In my opinion, stick with the Zantac because that can help with the pain, but stop the Erythromycin because it's not doing what it's "supposed" to. I say this because I don't think any doctor really has the magic answer. Instead, you're getting some really good advice from trained professionals, but you'll notice that the advice varies. If every doctor you talked to said the same exact thing, I'd be more apt to follow that advice. At least for us, the hospital staff said one thing, the pediatrician another, and the pediatric GI a third. I figured that as the mom, I should make a decision taking into account all of the professional advice I was given. My daughter Eleanor had (has) severe reflux; we never used Reglan or Erythromycin because the studies out there show some fairly serious side effects from the Reglan and not a lot of success from Erythromycin. I guess it works if there's significant delay in emptying but for most babies, it doesn't do much.

I do think that the Zantac or Prilosec or Prevacid is worth it so that Avery isn't in any pain. As he grows a bit you can keep his doseage steady and he will self-wean from it or you can up the doseage if it's obvious that he still needs the Zantac.

My two cents...

 

I say if your baby is no longer aspirating, then the erythro probably is helping. Zantac only affects stomach acidity and does not promote motility. So I'd stick with the GI docs recommendations.

 

Zantac didnt seem to help my ds with his reflux and throwing up but what did help is I add rice cereal to his ebm-no fussing, no spitting up. Simple as that...not sure if that is something you want to try???
I add one tbs per ounce of bm. Worked like a charm...the reason I know it works is if I try and nurse him or give him ebm with out the rice we go back to the crying and spitting up, once I add the rice he is fine. Just a suggestion, you may have already explored that option. FWIW this was recommended by my pedi.

 

Was he on the Erythromycin at the time of the scan? If so, and they still saw DGE and reflux, I would probably keep him on it.

My babies were both on Reglan/Axid, and Jake was eventually put on Prevacid for the reflux. They were still spitting up on the Reglan as well, but, it definitely helped increase their intake.

:hug99:

 

QUOTE(becky5 @ May 19 2008, 08:30 PM) [snapback]782167[/snapback]
Was he on the Erythromycin at the time of the scan? If so, and they still saw DGE and reflux, I would probably keep him on it.

My babies were both on Reglan/Axid, and Jake was eventually put on Prevacid for the reflux. They were still spitting up on the Reglan as well, but, it definitely helped increase their intake.

:hug99:


No, he had not had any erythromycin for two days prior to the scan b/c I had read that it could give a falsely normal result.

 

i wouldn't just stop the meds. ask your doctor first and tell him your feelings on the meds. ask him everything you just asked us and whatever else comes to mind from there. i am not a doctor so i cannot tell you what to do about medication. hope you find something that would help.