Reflux - any ideas?

[Madissun]

My 2 month old (today!) son has been on Zantac for 2 weeks today. Haven't seen much improvement and today he started squealing before vomiting. I called his paed and we've upped the dosage from 0.8 ml 3 times a day to 1.1ml 3 times a day. He also has gaviscon added to his formula (nan ha gold) 3 times a day and we're increasing that to 4 times a day now. Just want to know if anyone has any ideas on what else i can do to help him? We changed his formula a few weeks ago to S26-AR but this constipated him so the paed put him back onto nan. He was first put on zantac for 4 days at about 6 weeks of age by the doctor. When we went back, it hadnt worked so he put him onto losec. He was on that for a week before we went to the paed who said he should've stayed on zantac for longer in the first place. So we went back to zantac and today it has been 2 weeks. His bassinette is raised and i feed him in an upright position. Does anyone have anymore ideas? I really expected to see improvement by now!

[scarlet121]

Hi Kasi, I have quite a few things I can suggest. First I think that the choice of formula is a good one, the S26 is not generally a good one for refluxers as it stays in their tummy longer and takes longer to digest. The HA one is more broken down so it digests quicker and then there is less to reflux on.

With the zantac it is extremely weight sensitive, so even if he puts on 100g you may need to adjust it. What does he weigh and I can work out if the dose is OK. A lot of people do well on zantac but some do need more. The gaviscon I beleive is pretty messy and quite ineffective if the zantac doesn't work. Some kids don't like the thickness plus you have to space it an hour either side of the zantac otherwise it can render it ineffective.

So the first thing I would do is check the dose of zantac (if you post his weight I can do that)
If the dose is OK, then I would probably ask about going back on the losec, if you go back on the losec,t hen stay on the zantac for at least 2 weeks, spacing both meds an hour. The zantac doesn't take long to get out of the system, and although it seems it isn't working it does do something, but you may need to wait two weeks to see some effect with the losec, so it is best to keep them on both.

Keeping your bub as upright as possible, use a baby sling, give him a dummy all of these help.

For us thoguh getting on the right dose of the right medicine is the key. If your doctor won't listen make them listen as sometimes they tend not to.

Good luck, post again if you have any other questions.

[Madissun]

Thank you for replying- i was hoping to hear from you cos your name comes up quite a bit on the reflux topics! He weighs 5530grams, he was weighed just this morning.

[scarlet121]

For that weight I get .6ml to 1.2ml three times a day, so if you aren't seeing any improvement, then ask your dr if you can go higher. They have a book that they use to work out the doseage, there is a minimum and maximum, even if he is on the maximum it won't hurt him, zantac is a really safe drug that has been around for a long time.

I would find when Parker was on zantac that it would work great for a week and then things would go bad. The doctor showed me how to work out the dose so I could adjust it with weight gain and it worked better if we increased it with his weight.

If after trying the increase for say a couple of days to a week, then go back to the losec, if you are on a good dose and it isn't working I would just move on. PPI's like losec are safe too but work differently. Just remember that they can take up to two weeks to see a difference sometimes longer to see the true effect since it depends on how much healing has to be done

[Madissun]

Thanks Scarlet, he seems to be having a good day today. Maybe the increased dosage did the trick? Fingers crossed!

[Madissun]

Thanks Shannon. I think i'll stick with the increased dosage of Zantac for another two weeks max and if theres no improvment, i'll ask to change back to Losec.