Surprise-Another Reflux Question

[jd11365]

So if all the Zantac/Pepcid does is take away the acid, what takes away the reflux? She still vomits, gags, wheezes, etc. Apparantly all the Zantac/Pepcid does is take away the acid thus any additional pain. Though spitting, gagging and wheezing can't be any fun either... Plus, I hate the idea of giving her medication if I don't have to...she's only 6 weeks old! I'm starting to think it's just because she has a very difficult time burping, even with the Mylicon and it's not so much the reflux...I don't know... The one ped said she's just colicy, the other said to try the Pepcid to see if it was the acid...I just want to do what is right. I feel so impulsive jumping from one thing to the other, one ped to the other...I'm on overload.

[Marisa6826]

Time takes it away usually. Babies are born with a very relaxed esophageal sphincter (a ring-like muscle between the esophagus and stomach).

As they get older, the muscle strengthens and they are able to keep their food down. Of course this is aided by the fact that the baby will be able to sit up on her own and she starts eating solids, which are heavier. If you continue to have problems, your doctor may recommend giving her a different formula, or putting cereal in her bottle. Mine recommended the cereal in the bottle, but my gut said not to do it. I haven't and she's already been getting better on her own.

Zantac is very safe. It's been used for over twenty years. All it really does is lessen the acidity of the stomach contents. It is not like some of the stronger medications that actually prevent the production of stomach acid, such as Prevacid.

Many pediatricians are starting to recognize that most of the so-called colicky babies really have reflux.

As far as giving her medicine she doesn't need, if she DOES have reflux and is not treated for it, she can do permanent damage to her esophagus due to the stomach acid actually burning the tissue.

I don't know about you, but I had (and continue to have) horrible reflux during my pregnancy. It is a nasty, nasty feeling. I would do anything to prevent Sophie from experiencing that pain!

Try sitting Kayla up during her feeds as much as you can. Keep her upright for at least 20 minutes, raise the head of her crib and changing table (books or a few bricks work well). The idea is to rarely let her lay completely flat. If you can't hold her after she eats, but her in her bouncer seat. If you don't have a bouncer, I strongly recommend one! Another trick is to change her dipe BEFORE feeding her, so you don't have to lay her down again.

Sophie's been on Zantac for two months now (she's just past her 6m mark) and I've seen a significant difference in her. Yes, she still spits up all the time (she ALWAYS has a bib on!) - but she doesn't cry the way she used to.

Give Kayla some time. She's still so very, very young. I know it's difficult and the crying is enough to drive you crazy. I promise it DOES get better!

PM me if you would like to talk further. I would be happy to give you my number!

Chin up!

-m

[4S Ranch]

I really feel for you! Both of my girls have had reflux. I get a lot of the projectile vomiting, and I practically live in spit up soaked clothes. My little one is only 3 mos. now, and the reflux is so much better already! I've found the most helpful thing is to wear her in a sling (see the Places to Go: Strollers, carriers, etc. for tips on which one to get if you don't have one) after she nurses for at least a half hour. I carry her (and have from birth) in an upright tummy to tummy position with her legs dangling through the bottom of the sling. For this reason, I like a padded rail so she doesn't get red marks on her legs from the fabric cutting into her.

There's also something called a Tucker sling - www.tuckersling.com
that props up your baby at a 30 degree angle.

Here's an excerpt from Dr. Sears' "The Baby Book" that I found helpful...

Treatment of GER

- Place baby propped up at a thirty degree angle in the prone position for thirty minutes after feeding and while sleeping. The stomach-down position is most effective; simply placing a baby upright in an infant seat is of little help. A special sling is available that holds baby while lying prone on a propped-up crib mattress (The Tucker sling mentioned above).

- Wear your baby as much as possible to decrease crying. Babies reflux more while crying.

One of the most experienced babywearing mothers in my practice feels that wearing her baby after a feeding promotes "digestive organization"; that gentle motion and closeness to mother enhance intestinal function. I share this belief. Perhaps this is similar to the system in which mother cats lick their kittens' abdomens after feeding.

In most babies, GER lessens somewhat by 6 months and subsides by the first birthday. Some children continue to need treatment, or are not even diagnosed until later.

HTH Good Luck!

Shelly

[jd11365]

I swear, it's so nice to have someone else who knows what you are going through...though I wish you didn' t have to. I only have one other friend with a baby, so this board is my sanity when it comes to needing questions answered in that immediate moment when you just don't know what to do or need reassurance. As long as the Pepcid is safe, I will continue to use it...I'm sure the dr wouldn't prescribe something unsafe (which is what I keep telling myself.) It just made me pause when the other ped said she doesn't prescribe such meds unless the baby has "severe" reflux. I just want her happy and comfortable... Thank you so much for your support and great suggestions!

[Marisa6826]

Shelly-

Interesting about the sling. I have a Bjorn that Sophie LOVES.

However, if I put her on her belly after she eats, it almost certainly ensures she will throw up!

I guess whatever works for each of us!

-m

[Marisa6826]

Jamie-

Glad to be of assistance. And my offer still stands - if you're having a bad day, PM and we can talk!

-m

[4S Ranch]

Marisa,

Does Sophie (love that name!) throw up when you put her in the Baby Bjorn? Or do you mean flat on her tummy laying down? The way I hold my DD in the sling is exactly the facing in position that you use in the Baby Bjorn. The bottom part of the sling goes right under her bum and her legs dangle down. Seems like she burps better, on her own, when I hold her this way.

When she's sleeping, I always lay her on her side. What about you? I also have a moses basket that I use downstairs for naps, and I elevate one end. Laying her flat (back, side, or tummy) makes her spit up every time.

Even when it's just a little bit of spit up, my mom always says, "oh, she spit up, you should change her clothes." I already change her clothes (and mine) at LEAST 3 times a day! And I don't know what it is, maybe the angle, but many times when I put her in the carseat, she projectile vomits.

I'm lucky, my DD doesn't seem to be in any pain with her reflux. In the early days she cried from pain a couple of times, and it sounds like it REALLY hurts! It breaks my heart. If that happened a lot, I would definitely give her the meds!

Shelly

[daisymommy]

Josh used to get his Zantac dosage upped anytime he gained a significant amount of weight (every time we visit the Ped!) Zantac is one of those drugs that unfortunately babies become desensitized to after awhile, so the dosage has to be constantly increased along with their weight. Josh wasn’t on anything else (even though there are some stronger, possibly more effective medications out there), because we were told by the Pediatric GI specialist that Zantac is the safest, most researched drug out there for reflux, with the least amount of side effects. He said if the Zantac really didn't help much, we could try something else. I'd say it helped (along with some other changes) to reduce the reflux by about 75%.

Also, don't let your doctor tell you to let her cry it out because she’s just colicky--that actually causes babies to reflux! Dr. Sears says that unless he finds otherwise, he starts out assuming that colicky babies are either/or both protein intolerant, or have reflux. When my Ped. first said Josh was just colicky I quoted Dr. Sears and said “COLIC is just a 5 letter word that means your baby is hurting and no one knows why.” That got me a referral to an allergist and GI specialist.

The GI specialist we saw for Joshua gave us "4 step" advice for treating his reflux. He said if after trying #1 things didn't improve, move on to step #2, and then #3, etc. if it still didn't help.
1)Lifestyle changes- For example: Burp baby after every 2 oz. Hold baby upright for 20-30 minutes after feeding. Don't ever actually lay baby down flat (even to sleep). Elevate everything including crib mattress. Don't let baby cry it out (actually causes them to reflux). There are many others you can find in baby books.
2) Hypoallergenic formula (if you are bottle feeding) such as Similac Alimentum or Enfamil Nutramigen. If you are breastfeeding you may need to cut out allergy causing foods such as dairy (talk to Rachel about this). He said a protein intolerance can make reflux worse. Alimentum worked miracles for us!
3) Zantac which only decreases stomach acid and therefore lessens pain of baby spitting up. Was not meant for decreasing amount of spit up. However, we found that as there was less irritating acid in his stomach, the amount of spit up did somewhat decrease (as a side benefit)--this doesn't always happen though. Josh was on 1ml. 3 times a day.
4) Cereal in the bottle
Josh was on cereal in his bottles at about 2 months old. Yes, it was very early, but it was a last resort when everything else was not working. It took all 4 steps to get things under control. He would spit up 2oz. of every bottle! After a few months, things got a lot better and we cut out the cereal in the bottle. Then we still followed the other 3 steps until he was 8 months old. Now he is on regular formula, and off the Zanatc. We still have to hold him upright for 20 minutes, and if he has been rolling around on the floor he still spits up. But we've come so far!

Try holding her upright when you feed her, and for 30 minutes afterwards. We would always put Josh in his bouncy seat if we couldn't hold him in our arms for the full 30 minutes. I don't know if anyone has told you this, but only use the car seat for car trips only, not to keep her upright in the house. The slant of car seats bends their stomach and causes them to reflux sometimes, versus the more relaxed incline of a bouncy seat. It took us awhile to figure out why Josh as screamed when he was in his car seat. Then the GI specialist gave us this info.

Here are some great reflux info. websites. GER stands for Gastro esophageal Reflux
GER in infants
http://www.people.virginia.edu/~smb4v/tutorials/reflux/ger.htm
Pediatric GER
http://www.geocities.com/HotSprings/Villa/2193/educate.htm
Dr. Sears: coping with GER
http://www.askdrsears.com/html/10/t106004.asp
Reflux support board
http://pages.ivillage.com/momlwt73/PSFP.htm

Good Luck and Take Care. Email me if you’d like more info and support.