Zantac not working ...

[reAllytee]

Hi,

Im just curious as to what my next move should be. I know you cant offer medical advice but just advice in general would be great.

Squeak has been on Zantac for a number of weeks now with a decline in the amount of vomitting which is great but he is still incredibly fussy, still not feeding well etc. We found he settled a little when he first started on it especially in regards to the vomitting but in the last few days ive noticed him spitting up more. Nothing like he was a few weeks ago but its now more saliva he is bringing back up rather than his feed.

He is on 1ml per day & im wondering whether i should be asking the doctor to up this or try a different medication. Mylanta & Gaviscon do nothing for him either so im wondering whether the Zantac is the same or whether its because its still a low dosage.

We also still have many days of breast refusal so have looked at my diet but besides milo i cant find anything else that affects him. He also has formula from time to time due to refusal to feed. We have him on Karicare HA-AR because of being told of the cows milk issues but this still hasnt made a difference.

I guess what im asking is should i be pushing for the doctor to try something different or the likes when this doesnt seem to be working ?

Thanks.

[RISA]

Hi,

Well, it sounds like your instincts are pretty good, and although it can be tough, I think it is really important that we do listen to our instincts, and do what we feel comfortable with.

Have you talked to your doctor about what is going on, and what you think you should do about it? If not, I think that's a great idea. It is possible that the dose of Zantac needs to be increased as that often is necessary as bub puts on weight. (and the drs often do start on quite low doses as you suspected).

There are other medications available which may also be an option- that is something to discuss with your doctor. Sometimes I think it comes down to their personal preferences and experience with dealing with refluxers and medication.

The breast refusal is unfortunately a common sign of reflux. You may find if the medications are increased, the feeding difficulties will resolve, but that may not necessarily be the case. It is often difficult, and can involve trial and error to find out exactly what is best for our own children- though it would be so much easier if someone could tell us exactly what we should or shouldnt be doing (well, people do, as I'm sure you know, but it would be easier if they knew for sure if it would help!)

Interesting that you have noticed milo affects him. So what could be in milo that causes problems??? My first thought to that was cows milk, especially as it is so common in refluxers. If it is cows milk allergy or intolerance that is part of the issue, then it would help to completely remove dairy from his diet. This means (if you're interested in this option), that you need to completely avoid dairy- even in trace amounts, which involves reading food labels and recognising which components are dairy (eg casein, whey, lactose, etc). If you do find this makes a difference (may take a week or more), it is really important to seek expert dietary advice e.g. from a dietitian experienced in this area, as it is essential your diet is nutritionally balanced.

The formula you are using may not have made any difference for several reasons- while you are breastfeeding, and if cows milk sensitivity is an issue, if you eat anything with dairy, it can affect him for several days. It may not make any difference if it is just the occasional bottle, when he is getting dairy through your milk. Also, thickened feeds aren't always effective for refluxers, though sometimes it can be the only treatment they require (once again, it can be really confusing and tough to figure out).

The bottom line is... trust your instincts and please talk to your doctor about it. It sounds like reflux could still be a big issue, and that he is still quite uncomfortable, and it can take a while to figure out the best options for him.

I hope that helps

Glenda