Commencing Losec

[m'smum]

Hi,

I am a mum of a beautiful 3.5 month old baby. She has been unsettled since about 2 weeks after birth.

I started out breastfeeding however she seemed to never be content after a feed so I presumed that I did not have enough milk (despite her having regular weight gains) so I started complementing feeds with bottles. This definately improved things (and I subsequently swapped over to all bottles at 3 months).

Despite her improvement with the comp bottles I felt that she was colliky or had reflux. She did have a lot of wind and also she would hiccup and had lots of wet burps, choking sounds and horendous other loud cough sounds. She would scream whenever we layed her down and would only like to sleep upright on our chests.I did not seem to have a problem once she went to sleep however if she did not go to sleep about 2 hours after a feed she would scream and just wanted to suck all of the time. Whenever I stay at home and she has her sleeping routine and familiar surrounds she seemed better but any outing or change in the day seemed to upset her. Putting her in the pram to take her anywhere did not really work she would cry - like she was in pain and would be ok if held upright.

She has however always been a very good sleeper at night. She also is on the 90th percentile for weight so certainly was never failing to thrive.

When I went to the paediatriation I advised that I had been using infacol and infants friend etc but nothing seemed to settle the crying. He told me to use Marina infant mixture and try that but if she was still unsettled to try Losec 1/2 tablet twice daily.

The Marina was great and she seemed to be a new girl for a few weeks. However still I sensed that at some times she was in pain she would arch her back and roll and scream in her cot. Compared to other babies around me it just seemed that I could never put her down - she would not sit in a rocker or swing chair just always wanted to be cuddled and would go to town sucking her thumb or try and get her whole hand down her throat.

So here I am one week into Losec. I guess I am just writing because I am just so unsure about everything. Unsure whether it is definately reflux, unsure whether giving her the medicine is good because she is so young, unsure because it seems so difficult to administer, unsure about the differences between all of the medications I hear about - gaviscon, zantac, mylanta, losec and unsure for how long she needs to be on this.

The first few days of the tablets were not great she cried in pain so I also gave her marina and that worked - the last couple of days though have been great and she has been sleeping like a dream.....a little to well I seem like I have to wake her before each feed (would the medicine have any kind of sedation in it?).

I am due to go back to the Paed next week and would be great to know if there is anything else I should be asking.

Thank you for your help.

[RISA]

Hi M’smum
My heart goes out to you, because I can remember feeling so unsure of myself as well, and it’s horrid. Dealing with reflux can be so difficult because there are often no easy answers and it can be a matter of trial and error to find the best solution- what works for one may not work for another which adds to it. What’s worse is that you probably have a lot of people telling you what you should do, and it ends up being even more confusing. All any mum wants to do is her best for her child, and I am sure you are giving your all to do that.

Is there something in particular that makes you worry it isn’t reflux? If it helps, what you describe is quite common amongst reflux babies. As you do feel unsure about the diagnosis though, it is best to talk to your paediatrician about it. At the very least he may be able to give you peace of mind, but all the same, it’s important to follow your instincts and check.

I understand your concern about giving medication, but it’s also important to remember that there may be concerns about NOT giving it as well. It sounds like she was quite uncomfortable prior to you introducing medication, so you may not have had a lot of choice; also a good topic for conversation with your paediatrician.

I totally agree about it being difficult to administer. Are you using the suspension, or the tablet and trying to dissolve it? Since you mention the tablet, I presume you are doing that, but it is available (for a price) in suspension form from compounding pharmacies if you would find that easier. If you are using the tablet, how are you giving it? Definitely not easy to give to a baby!!!

You need to talk to a pharmacist about the different medications, but basically, there are several categories of medication commonly used to treat reflux. Infant Gaviscon is used to thicken the stomach contents in the hopes of reducing reflux. Mylanta is an antacid so may offer temporary relief. Both are short acting medications, and if needed to be used constantly, it is often preferable to use a longer acting one. Zantac reduces the production of acid, and has been used for many years. Losec suppresses acid reduction even further, and is generally much more effective. Both types need to be taken regularly and it may take up to several weeks to notice any real changes, especially if there is any irritation in their gut from the reflux.

There is no sedative in Losec, so perhaps the reason she is sleeping is because she feels more comfortable? Often they are so sleep deprived and overtired because of their discomfort, so if the Losec has helped her already, it may just be she is catching up on the sleep she missed. My son did that when he had to have a procedure in hospital. He was so overtired that he slept and slept afterwards. Naturally, I was very concerned, but the doctor said he was just so tired. Hard not to worry all the same!! Of course, if your instincts still tell you something is wrong, then please don’t hesitate to take her to the doctors to be reviewed. Our littlies can get sick so quickly, can’t they, so please let your instincts guide you.

And one last thing- while many babies will outgrow reflux well before they are 6 months old, there are some who will continue to suffer from reflux up to 12 months, or even beyond that. It is not possible to predict when your daughter will grow out of reflux, and so therefore may be able to come off medication. Sometimes they are able to come off medication well before their reflux is outgrown – once again, they are all different. Reflux in children is often a very difficult condition, and can be a matter of trial and error to find the best options.

I hope that has answered all your questions and concerns, but please feel free to contact us again if you like. Please don’t be too hard on yourself and please try to take some time out to look after yourself through all this.

Glenda