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Acid Reflux
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Dr. Mike,
My 6 month old son (as of 2/24/02)
has been diagnosed with a pylorus spasm and reflux. The ped.
gastroenterologist also added that his esophagus and stomach do not
empty as quickly as they should thus causing additional discomfort.
He is on 0.8 ml of Reglan 4 x's/day,
Prevacid 2.5ml 2 x's/day and now Carafate at bedtime 1 tsp.
The last few days he hasn't been
eating well and has sounded a little raspy so I thought maybe he
was getting a cold. So far he hasn't "caught" a cold,
but today he wouldn't eat more than 3 oz. of formula at a time and
didn't even increase the number of feedings to compensate. I
don't think we even consumed 20 oz. today and he's supposed to be
consuming at least 24 preferably more.
I looked at your "warning
signs" and today he was extremely irritable, drowsy, and
flat out refused to eat. I am so worried, but at what point does
this "refusal to eat" become dangerous? As long as
we're not eating, he's happy and laughing. But I will say at
times he'd be laughing and then launch right into crying. I am
at a loss.
Any suggestions?
Thanks,
K. P. (Weatherford, Texas)
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Hi
Ms. P,
As
you already know, "reflux" (gastroesophageal reflux) means
that some acid contents of the stomach can go up the esophagus (food
pipe) instead of down. When it happens to us adults, it's called
"heartburn", and it can really hurt. When babies get it, they
don't understand the feeling, and cry.
Your
GI doc has your baby on Prevacid (which inhibits stomach acid from
forming), Reglan (which helps prevent the actual process of reflux from
occurring), and now Carafate (which acts as a barrier to protect the
stomach and esophagus from acid irritation).
Even
with all of the those medicines, a "breakthrough" reflux can
always occur and irritate your little one...which could be the cause of
his intermittent crying. The raspy cry could be from the refluxed acid
that can irritate the vocal cords, and cause a raspy or hoarse cry.
Other
possibilities for his crying bouts are
that he is getting a "cold" or that he just wants to cry
(which is normal in babies).
Anyway,
babies, whether
they have GER or not, will go through ups and downs when eating, for
other reasons, e.g. colds, mood changes, growth spurts, etc. In any case
where a baby is decreasing his appetite, things to keep on eye on are
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Making
sure that your little one pees at least every 8 hours
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Making
sure that his tongue and mouth still have the usual amount of spit
or saliva
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Checking
that his stools stay the same consistency and color
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Comforting
him as best you can when he cries
The
fact that he still can be happy and laughing means that he is in general
good health. But, take him in to see your doc, or at least call him/her.
Gastroesophageal
reflux will start to get better as he approaches 1 year of age, and
takes more "solid food" and less "liquid food". You
are almost there.
Also, there is an association called PAGER
(Pediatric/Adolescent Gastroesophageal Reflux Association), which
discusses the latest and most pertinent topics about reflux.
I
hope that helps you. Dr. Mike
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Dr. Mike,
My baby boy is 7 mo. old and has acid reflux.
(He had an upper GI(barium study) at 2 mo. and a
similar but more advanced study done at 6 mos.
confirming that he still has reflux at 54%.)
My son hardly ever spits up or vomits and hasn't
much since he was born. Since he was about 2 weeks
old he's cried almost all day long and had very
conjested breathing. He's been on 1ml. of Zantac
twice a day for the past five months and we've seen no
change in his fussiness or his breathing. My son's
pediatrician doesn't seem alarmed since my baby is a
very healthy weight (20 lbs.) and doesn't vomit. My
son has been sitting up by himself for a month and
he's still as fussy and conjested as ever. I don't
think my baby should still be crying all the time and
I'm extremely frustrated because I don't know how to
treat him at this point. Should I take him to a
specialist? If so, what kind of specialist should we
see?
Thank you for taking time to answer my questions.
Paige B
Alexander, AR
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Hi
Paige,
Fussiness
may still be related to reflux, but I don't think the congestion is.
The
general rule for reflux is that if your baby is growing and gaining
weight well, then the side effects of reflux drugs are probably not
worth it. I'll bet that's the way your doc is thinking, because that's
how I would think.
But,
if you and your doc feel that the reflux is still making your little one
miserable, then there is room to go up on the dose of Zantac. Also,
another medicine (Reglan) could be added (if needed).
If
you have a desire to see a specialist, it would be a pediatric
gastroenterologist.
I
hope that helps you. Dr. Mike |
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I have a baby that has acid reflux and
currently taking prilosec. How long will this last, he is now 9 months
old. I tried to take him off it at 6 months and did not work, now I
tried it at 9 months and still not working. I do thicken his formula,
tablespoon for every ounce as directed. please help me. Thank you.
Acid reflux, otherwise
known as gastroesophageal reflux is frustrating, especially for the
parents.
As you know,
gastroesophageal reflux or GER is similar to heartburn in adults. The
acid in the stomach backs up into the feeding tube (esophagus), and
gives a burning feeling in the chest. Sometimes, the stomach acid can go
all the way up to the back of the throat, and then the babies will spit
up frequently.
GER can be a little bit
more bothersome in babies than adults, though. With severe GER, some
babies will hold their breath, and stop breathing. Others may breathe
what they spit up into their lungs, and get frequent lung infections.
So, it's important to treat GER, especially in babies and infants.
The treatment is not
really aimed at curing the illness, but making your baby feel better,
until he/she outgrows it. The basic approach is to thicken the feedings
(as you are already doing). Prilosec helps to inhibit the acid content
of the stomach, and make it less irritating when your baby does reflux.
Reflux doesn't just go
away. Your baby has to get bigger and his/her gastrointestinal tract has
to mature a little bit more. By stopping and then starting medicines off
and on, you'll frustrate yourself. In the next few months, you will
probably be advancing the diet to more and more baby foods. This will
help, since the baby foods are "heavier" and don't reflux as
much as formula. Discuss it with your doctor (you are in good hands),
but I don't think you should try stopping the Prilosec for at least
another 3-6 months.
The GOOD NEWS is that
almost all babies with GER will outgrow it! As long as your baby is
feeding well, and gaining weight then it's best for you and your baby to
try and be patient.
Enjoy being with your
baby! The GER will pass.
I hope I have helped.
Dr. Mike
This article was reviewed 04/23/2010 07:24 AM
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