Losec not working. Correct dose?

[ozloz]

I'm so confused.

My son was diagnosed with Silent Reflux at 7 weeks he is now 4mths old.

Some symptoms... fussiness when feeding, distress during and after feeds, back arching, squirming, coughing, gagging, swallowing when there's nothing there, catnapping during day, happy when elevated...

He was put on Zantac which had an initial effect but then stopped working after 2 weeks so we upped the dose, still no results unfortunately.

At 9 weeks we started him on Losec 5mg a day. This took 7 days to kick in and it coincided with me taking him to sleep school, when he was 11 weeks old. We had 3 days of absolute bliss at sleep school. He would feed, then play (flat on his back on the floor!), then sleep up until his next feed. We also cut out his 3am feed and had a night where he slept through, Bliss! On the fourth day though he woke from a day nap screaming, we gave him Mylanta to settle him. The following day we returned home. I was expecting him to revert back to his old habits a bit, I was told to expect this. So over the next few weeks we would have 3days out of the week where he would be unsettled with reflux or wind and this was ok to deal with as it wasn't every day.

Then over the past three weeks it has been every day. His dose of Losec isn't working anymore and I am really confused because the pead has told me that we can't change the dose of 5mg for quite a while. He told me to introduce rice cereal to see if that would help and I also replaced 2 breastfeeds with thickened formula to see if that would make a difference. But it hasn't. So I have gone back to solely breastfeeding him.

I've made an appointment to see another pead for a second opinion and have an appointment with a gastro in january.

I've tried everything that the pead has recommended and we are still not getting anywhere. He has been on 5mg of Losec for 10 weeks, from what I've read his dose of Losec seems quite low so I would think that this would be the reason its not working, but the pead doesn't want to put it up. My son now weighs 6kgs.

It's been going on for so long and I'm just so confused.

Any assistance would be greatly appreciated. :)

[RISA]

Hi,
It sounds like things are still quite difficult for you, and it's no wonder you feel confused. Like other mums you are probably asking yourself hundreds of questions a day trying to figure it all out, and trying to work out what to do. I wish I could give you the answers, but unfortunately it is trial and error as every child is different.

Well done for following your instincts and getting so far. It sounds like you have made some progress too (plus you know you are on the right track). That in itself can be really difficult, so good on you.

Although the dose of Losec seems low to you, a lot of doctors are being much more cautious when bub is less than 6 months old these days. Have you talked to your doctor about his reasons for not wanting to increase it? I have heard that some babies have (temporary) abnormal liver function at that age if the dose is too high, so that may be why he is being so cautious. It may help if you talked to him though, as he may have other reasons too.

Is he aware that you are still struggling? that the thickener didn't help? He may be able to recommend other options too, like adding in Zantac to use as well, or considering whether cows milk protein sensitivity is a factor.

Has anyone ever suggested food sensitivities to you? A medical article I read said that approx 40% of reflux babies had an intolerance or allergy to cows milk protein. Since you are breastfeeding (and IF you wish to pursue this option) it may help if you avoided ALL traces of dairy temporarily,to see if it helped. Since a good proportion of cows milk sensitive bubs are also sensitive to soy, it may also be worth avoiding that as well. It does sound like a difficult option, but if that is part of the problem, you may see enormous benefits for changing your diet. It isn't the answer for everyone though, and you do need support if you want to consider it. If you do try it, and you do find it helps, then it's important to seek help from a dietitian who can ensure your diet is balanced and that it replaces all the nutrients you are missing.
If you'd like more information about diet for reflux bubs, I can point you in the direction of several websites. Just let me know.

I hope that information helps, and please keep in touch with your doctors. I hope you are able to get the answers you need too,

Glenda

[ozloz]

Hi Glenda,

Thanks so much for your reply. A bit of knowledge and support make you feel so much better.
I do think there's a possibility that my bub may have a milk protein intolerance. If you could let me know the details for those websites and any info you might have on diet while breastfeeding or contact details for dietitians that would be greatly appreciated.

Warmest Regards
Lauren

[RISA]

Hi Lauren,
I am glad I was able to help!That little bit of info can go a long way, can't it! :)

If you wanted to trial a dairy/soy free diet for a week or so, to see if you notice any changes, it's a matter of avoiding all the obvious sources like milk, cheese, ice cream, yoghurt etc, but also all traces, which involves reading food labels. If you do it for a short period of time it may give you an idea, but please seek medical advice if you are continuing with it, as your diet is so important! (and it is also important to figure out if there are any other sensitivities too- it can be a very confusing area)

http://www.medeserv.com.au/ascia/aer/infobulletins/hp_allergy_milk.htm has some good basic information on this topic, and so does http://members.ozemail.com.au/~breakey/babypage.htm#Is%20your%20baby%20food%20sensitive

The Dietitians Association of Aust would be able to give you info on dietitians who specialise in that area. http://www.daa.asn.au/

This site gives you some idea of what to avoid initially which may also help too. http://www.foodallergy.org/allergens/milk.html

Good luck with your 'investigation' and I hope you get some answers. Keep looking for them, and I'm sure you will find them- life does get better!!!

Glenda