Zoton

[mum2bee]

Hi,

I have a baby girl who is 8 weeks old. We have been having some really difficulty in settling her over the last 3 weeks. She won't sleep during the day for any longer than about 40 minutes after I have gone in to resettle numerous times. This along with excessive dribbling, vomiting, arching the back and screaming during feeds, the doctor has diagnosed her with reflux and has put us on 1/2 sachet of Zoton once a day.

We have put her mattress and her cot on an angle and I try not to lay her on her back very often.

However, I have been trying this for a week with no improvement so the doctor has increased the dosage to 1 full sachet twice a day.

I have been mixing the sachet with milk (formula) is that okay?

How long will it take for the Zoton to work?

Thanks
Carmel

[RISA]

Hi Carmel,
It sounds like your little girl is really uncomfortable with her reflux, so good on you for not only getting a diagnosis so quickly, but also for trialling some treatments that may help. Sometimes it can take a while to find exactly the right treatment, and it can often take a bit of trial and error to get it right.

According to the information we have, if you use milk/formula with Zoton, it will reduce its effectiveness. It might be worthwhile trying to experiment with just using water. Some doctors are okay if you use only a small amount of water, so the suspension is more like a gel than a liquid. It may also be worth talking to your doctor about that, to see if that is something you could try (it may be easier to administer like that).

It can sometimes take quite a few weeks before you notice any difference, though the waiting is really hard. It can seem to take a while to show improvement, though some bubs seem to respond very quickly.

If, after a few weeks of using the higher dose, there is no real difference in her reflux, the doctor may consider trialling elemental formulas (e.g. Neocate or Elecare), as it is common for refluxers to have food sensitivities - with cows milk protein being particularly common. I presume you are bottle feeding as you mention using formula with the Zoton, but if not, then an elimination (under medical guidance), might be worthwhile.

Using the elemental formulas can be a quick way of determining if food allergies/intolerances are an issue for your child. Reflux can be so confusing and difficult to assess, so if you can try something that will give you answers, it might be worth doing it.

I hope I've been able to help,

Glenda

[mum2bee]

Thanks Glenda for your prompt response.

I was wondering, she I be giving her Zoton and then waiting 10 min before giving her a feed as opposed to feeding her immediately after?

Is it common for reflux babies to not settle well during the day and settle well at night?

We are seeking help from a child health nurse early next week I hope in regards to the settling problems we are experiencing. However, any tips on settling reflux babies would be much appreciated.

Thanks for your time.
Carmel

[RISA]

Hi,
with the Zoton, you should check with your pharmacist to make sure, as I don't have any qualifications, but from the information we have, it is more effective if you wait at least 10 minutes before feeding. Sometimes it can be hard to wait that long, and it becomes a balancing act too- I don't think it helps if they get distressed, wanting a feed, while you try to hold off, so you may also need to do what works. If they are crying/screaming for the feed, it also defeats the purpose, as that will only make them reflux, and stand the chance of them not feeding well. As with all the advice anyone gives you, just remember it has to work for you, and you need to do what you feel comfortable with!!!

Reflux babies are all individuals, and while some struggle both day and night, others will be okay either during the day or during the night. That can be really confusing, as you think that they should be uncomfortable all the time, but it doesn't always work like that. It may be that they are just so exhausted, they sleep well at night, or perhaps they reflux more during the day. It's hard to say, but yes, it is quite normal for that to happen.

I hope you get some help with the child health nurse re settling- though often, if the reflux is still not well controlled, there isn't a lot you can do.

Things that might help during the day with your daughter, are try to keep her upright as much as possible throughout the day, but especially during a feed and for 1/2 hr after.
Try to avoid any tight nappies/elastic waistbands, as that can cause reflux.
Try burping frequently during a feed (unless she objects).
Change her nappy (and offer play time) before a feed, rather than after.
Offer her a dummy if you are happy to do that, as a lot of reflux bubs are settled by sucking.
Try to reduce the amount of pressure on her tummy-e.g. no slumping.
Try to get into a routine as reflux bubs often prefer that (though at the same time, it can be extremely tough to do that).

Other things you may be able to do are
- carry her around as much as you can- esp skin on skin contact, though it is way too cold probably at the moment to do that! Keep her with you in a pouch/sling as that is often quite soothing to refluxers
- often comforting them earlier, rather than later, works best, so they don't get more worked up (and reflux more)
- sometimes massage works well for some, others seem to like baths (there seems to be something about refluxers and water, though of course not for all)
- try using soothing music
- give her something with your smell on it- a teddy bear you have worn in your clothes for a while

You may have already tried a lot of those things already, but you never know when someone will come up with something new.

I hope that helps, and I hope you see some positive changes soon,

Glenda
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[mum2bee]

thanks for all you advice. this may sound like a silly question, but if the zoton works and seeing she has silent reflux what differences should i expect to see?

[RISA]

Hi,
It's not a silly question. The only difference between 'general' reflux and silent reflux is the vomiting. All the other signs and symptoms can be the same.

Zoton is a Proton Pump Inhibitor and reduces the amount of acid that is produced in the stomach; it doesn't actually stop them refluxing (or vomiting). It should, however, if successful, reduce the amount of pain she has, and potential damage/inflammation she gets. This means that you would hopefully notice an improvement in her sleeping and settling, along with her excessive dribbling, back arching, irritability and screaming- and any other signs she has.

I hope that helps

Glenda

[mum2bee]

Glenda,

Do you know of any bubs that are on 2 X 30mg sahets of zoton per day? The dose seems really high.

[RISA]

Hi,

There is an enormous range of dosages that are used on bubs/children with reflux these days. Some doctors prefer to use small doses, while others feel more comfortable prescribing larger doses. It may help to talk to a pharmacist (maybe call one on Medicines Line?) and discuss your concerns, or talk to your doctor about it. I think that bubs don't metabolise all the medication, so they don't actually absorb as much of it as you imagine (though that may not be correct either, so please check with the pharmacist or doctor about that).

Have you noticed any improvement with the dose that high? If not, it might be time to talk to your doctor again. Are they aware you are still having problems??

It may also be worth discussing whether changing medication might help, or whether food sensitivities are a factor (cows milk protein and soy protein are quite common in refluxers, as well as things like wheat, and egg).

Hope that helps
Glenda