Help...

Jenelle - posted on 11/21/2008

I also agree that it sounds like reflux. My daughter has it. We use Nutramigen formula with oatmeal in a Dr. Brown's bottle. She is also on Zantac and Reglan.



Every baby is different on what will work for them. The Similac Isomil and rice caused serious constipation for Kailynn, to the point where she would scream in pain when she finally did go.



Unfortunately, the upright after eating thing is neccessary. I know for those middle of the night feedings it can be a pain, but think of the pain your baby is in. If it is reflux, the acid coming up repeatedly can "eat away" at the lining of the esophogus.



You may want to try elevating the head of the matress. Babies R' US sells some wedges that lift at the proper angle and go under the fitted sheet.



Good Luck!

Megan - posted on 11/17/2008

We were having some issues with gas/ fussiness etc.. We were on Similac Advance and changed to Similac Sensitive. The gas got better but then he was terribly constipated. So we switched again to the Alimentum which acutally made him 1000x worse!! He was then spitting up and just acting funny. We finally switched to Neslte Good Start and he is like a new baby! The ped said sometimes you need to switch brands. We use the Dr. Brown's bottle which I think made a difference in the gas for my DS (versus the playtex drop-ins).

Sami - posted on 11/17/2008

it sounds like acid-reflux to me..but idk.

Mary - posted on 11/17/2008

Thank you so much!

KIRSTIN - posted on 11/17/2008

Also I would get away from the Dr. Browns bottles. They didnt work with my son, they just made his acid reflux worse then what it was. Even through I know they cost more in the long run, I know use the drop-ins. That elimates all air from getting into the stomach and helps stop spit ups

KIRSTIN - posted on 11/17/2008

Ok I couldnt get it to post on here so Im just going to type it out.



Lakeside Pediatrics

Narayan Veligati M.D.; F.A.A.D

902 North Riverside Rd

Saint Joseph Mo 64507



Tel: 816 271 4965

Fax: 816 271 4948



Vomiting and Reflux



What is vomiting and what is regurgitation (spitting)?

Vomiting is forceful expulsion of stomach contents associated with nausea and retching where as regurgitation is passive spitting. The most common cause of spitting in infants is Gastroesophageal Reflux.

What are the causes of vomiting in children?

Common medical causes are :

Infection: Otitis media, Gastritis or Gastro-enteritis, Esophagitis, Urinary tract infection and meninitis.

Allergy Cow's Milk Protein or Soy Milk intolerance

Metabolic: Urea cycle, amino acid & organic acid disorders, uremia, fatty acid oxidation disorders, adreno-leukodystrophy, etc.

Neurologicl: Hydrocephalus, cerebral tumors or Intracranial hematoma and Degenerative disorders.

Surgical: Pyloric stenosis, Duodenal or Intesinal atresia, Meconium ileus, Necrotizing entercolitis, Vascular ring, Annular pancreas, Malrotation, Intussusception, Volvulus and Choledochal cyst.

When do you suspect surgical cause for vomiting?

Bilious vomiting, persistent nonbilious vomiting, abdominal distension and pain, blood and mucus in the stools or jaundice are red flags for surgical causes.

What is Gastro-esophageal Reflux?

It is the reflux of gastric contents in to the esophagus and oropharynx due to lax Gastroesophageal sphincter. it is the most common cause of spitting in infants and usually resolves by one year of age.

What are the complications of Gastro-esophageal Reflux?

Persistent reflux can cause esophagitis (heartburn), excessive crying, cough, wheezing, asthma, aspiration pneumonia, fodd refusal and failure to thrive.

How do you diagnose Gastro-esophageal Reflux?

It is a clinical diagnosis. PH probe study is helpful but not necessary. Studies such as ultrasound scan and upper GI study is done to rule out other conditions.

When do you suspect Pyloric stenosis?

These infantshave persisten vomiting after every feeding, present usually around 3 to 4 weeks of age, and fail to gain weight. It is more common in boys (especially first born) than girls (4:1). US scan and or UGI study is helpful in the diagnosis. Treatment of this condition is surgery (Pyloromyotomy).



Management of Gastroesophageal Reflux:

Supportive measures

Frequent small feedings

Burping in between and after feeding

Kepp head elevated after feeding

Thicken the formula with rice cereal approximately 1 tsp. for an ounce of formula and use a cereal nipple

Try a different formula

Without Cows milk protein: Soy formula

Without soy or Cow's Milk Protien:Alimentum, Nutramigen, Neonate, or Pregestemil



H2 Blockers:

Ranitidine (Zantac) 15mg/ml (3mg/kg/12hr)

Famotidine (Pepcid) 8mg/ml (1mg/kg/12hr)



Omeprazole (Prilosec) 0.3-3.3 mg/kg/d

Lansoprazole (Prevacid) 0.45-5mg/kg/d

Nizatidine (Axid) 15mg/ml; 2.5-5mg/kg/d



Metoclopramide (Reglan) 0.1 mg/kg/6hr P.O, half hour before feedings



Antacids (1/2 - 1 tsp. QID)

Mylanta

Maalox

Gaviscon

Riopan



I really hope this helps you. Of course dont get scared of the information that is the first thing I didnt when he gave it to me. Just talk to your daughter's doctor and if you still dont get anywhere with him, there go to a different doctor.

Mary - posted on 11/16/2008

I've been using the Dr. Brown bottles and her doctor said Nutramiagen and Alimentum are the same they are just made by two different companies. And her doctor insists she's "normal"... I'm seriously thinking about taking her somewhere else.

Angelique - posted on 11/16/2008

Oh BTW My son is on Enfamil Nutramigen and Dr. Brown bottles as well. Some do well with the Alimentum and some do better with Nutramiagen.

Angelique - posted on 11/16/2008

Sounds like my son! Your daughter needs to see a GI, my son is on liquid Zantac for acid reflux. He couldn't sleep laying down. I would suggest you let her sleep in a swing or car seat until you can get her to a GI.

Mary - posted on 11/16/2008

She only spits up a little. but she gets really fussy when she spits up, like it hurts her. I tried the rice cereal thing but it just made her sleep longer, she still fusses and screams when she burps. yea i'd really like to see that print out.

KIRSTIN - posted on 11/16/2008

Also I just got out the print out my son's doctor gave me. The formula you have your daughter on has no cows milk or soy milk in it.. that could also be the problem. Also look at how much she is spitting up. Is it the entire bottle, most of it, or just some? If it is the entire bottle or most of it you need to go to a different doctor. Also try thicken her formulawith rice cereal that helps alot but you have to use a different nipple then what you normally use. If you would like the print out my son's doctor gave me just let me know and I will scan it and post it on here for you.

KIRSTIN - posted on 11/16/2008

My son also had the same problem. The doctor said that it is acid reflex plus lactose intolerant on top of it.. I agree with Monica, use Similac Isomal Advance Soy (thats the pink can). Try this and if that dont work then talk to the doctor again. My son takes the soy formula with rice cereal plus Zantac that the doctor dx. Everything is better no fussiness, spit up, and etc.

Monica - posted on 11/15/2008

Oh yeah...My doctor also said that sitting up helps them feel better to there stomach. Laying down causing the stomach acid to come up. That may be why she screams when laying and not when her bouncer.

Monica - posted on 11/15/2008

I had a simpler problem and that doctor found out that my little guy was having lactose intolerant. So, he switch him to Similac Soy (pink can). He is doing great on this formula. I went from a very unhappy baby who scream, spit up all the time to a very happy baby. They also have Similac Sensitive which was the next thing my doctor was going to try if the soy didn't work.

Jessica - posted on 11/15/2008

Doesn't sound normal to me. You might want to try a different formula. I know Enfamil makes one especially for babies that spit up. Will is on the one for gas and fussiness. My cousin went through about 6 formulas before she settled on one of the Similacs for sensitive stomachs. They thought she had reflux until they fixed that, AND how much they were feeding her. Right now you shoudn't be feeding more than 4 ounces every 31/2 to 4 hours. Hope this helps!