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Help please - baby refusing omeprazole(43 Posts)
DS (12wks) is now on omeprazole and gaviscon. I make it up with 10ml apple juice and then give him 5ml. He took it fine from dh on Saturday but has now got wise to it and is simply spitting it out. I put it into a syringe and have tried front of mouth, back of mouth, it makes no difference.
Any ideas? I'm at my wits end. We came off ranitidine as it wasn't working well, and the omeprazole seemed to work well on Sat but if he won't take it anymore then obv it's not going to work, is it?!
Disclaimer - this is posted in virtually every topic I can think of!
Is it for reflux? The only thing we used was Sma staydown formula which was fab and I got it on prescription, does it taste horrible? Wouldn't have thought apple juice would be too nice with medicine in, maybe try it in milk?
Paed said juice or yoghurt but I was unsure about yoghurt as he's so little. Apparently you can't put it in milk
Staydown is good as it's like gaviscon but it doesn't help the acidic element of reflux which is what the omeprazole is for.
I wouldn't give a 3 month old apple juice either though wonder how they expect you to give them it then? have you asked your hv for tips? Might be worth a try, but will depend on how helpf your hv is mine is fab. ds2's reflux was fine on the staydown til we started weaning then orange foods seemed to trigger it, they gave him ranitidine at the gp's but the paediatrician said not to bother with it and just see how he got on as it generally gets better round 12 months (ds didn't really show any drastic improvement til around 18 months though).
Yes - I've just spoken to hv. She said to persevere with the apple or to try OJ.
In an ideal world he'd be having nothing but milk/water but after a morning of constant screaming in pain I'm beginning to get a bit desperate. He's finally gone to sleep but is sobbing quietly now and then
The other thing the paed said to try was some stewed apple.
I don't want to wean him early (not that it would be, simply a means to getting the meds down him) but I'm not quite sure what else to try.
I would try and hold on for weaning if you can. My ds was not good on solids so he was around 7 months before I started properly weaning but every baby is different, is it in liquid or is it a soluble tablet?
It's in tablet form which you have to grind and dissolve into a specified amount of liquid/similar and then his dosage is 1/2 that.
It's not licensed for babies - ranitidine is, but R doesn't suit or work for some babies so omeprazole is treated as a last ditch attempt to control the pain.
I just don't know what else to do though. He's spending hours and hours crying in pain, even when held upright. It's all through the night too which si rubbish as dh works away in the week and I have 3 other dcs to be on form for in the day.
I'm rapidly losing my perspective on this one
Sound like very extreme reflux? Are you sure it's reflux and not some sort of milk intolerance? My friends baby screamed constantly and she was put on lactose free milk and she changed instantly.
It was discussed with the paed but we decided it was unlikely. The fact that his initial response to both ranitidine and omeprazole was good seems to be an indication that reflux is the problem I would've thought?
Mind you, whilst I've had a fair amount of dealings with reflux, I've had none with dairy intolerance! What other symptoms are usually associated with dairy intolerance?
It is pretty extreme to be fair. DD1 was much more 'ill' - severe weight loss, dehydration etc but she was never bothered by it as such. DS2 however, is still gaining weight like a good 'un because he seems to comfort eat a bit. So it was a lot harder to get anyone to take him seriously!
My ds was only 4lb 14 at birth but always gained weight but was just constantly sick so they said they couldn't afford to let him lose any so put him on Sma staydown, he's much better now at 21 months.
Not sure what the symptoms are all I remember was that my friends baby was just always screaming and sick I think, the health visitor recommended the Sma (I think) lactose free milk you can buy it over the counter from boots etc but I think they keep it hidden, it was an instant improvement but can take a while, when she knew it worked she got it on prescription, may be worth a try if all else fails with no improvement? Will go google lactose intolerance.
Me too. Later anyway!
DS was 9lb6 at birth and at 12wks is now 14lb (well, he was 13 days ago - so goodness knows what he is now!).
Maybe it's worth buying a tin to see. I wonder how long it might take to see an improvement.
To be honest, I'd try anything at this point. He's so healthy looking and (when not screaming) such a happy little man but then he has these shrieking episodes always linked to the very acidic sick. I could cope with the constant vomiting after feeds - it's the sicking up much later when you can smell its all acid. And the fact that it so obviously causes him pain.
I think I'm going to call the paed again tomorrow to see if we can get another appointment soon to discuss the
non progress. Our other option is to put him on domperidone which speeds up the process of digestion so milk is not in his stomach for as long.
I really don't like putting him on all these drugs, I didn't like it 14 years ago with dd1 and if it wasn't for the pain I don't think I'd bother.
I used to put mine in those shop bought apple puree for weaning babies, e.g. cow & gate fruitapura. I presume he is on the LOSEC Mups type that dissolves fairly badly? I used to laugh when they said 'first dissolve it then give him exactly 7.5 ml', because it just used to stick in lumps in the syringe. So I used to wait until the tablet went mushy in the puree, draw it up in the nurofen syringe which is bigger, then give it to DS on a spoon. Worked quite well, I did used to give it to him like this at that age because I figured it was no thicker than yoghurt. Also you are not supposed to crush the tablet, you have to let it dissolve.
It is possible to prescribe an omeprazole suspension - i.e. the chemist can make up a liquid for you, but it has a short shelf life (2 weeks?), has to be and opinions are divided as to whether it is as effective as the tablets, we used it for a little while as DS was only about 7/8 weeks. Worth a try if nothing else works?
What dosage is your DS on btw, is it 5mg? Omeprazole might take couple weeks to see improvement, as the damage already done to throat will need to heal first iyswim. Also are you giving it first thing in the morning before the first feed? If after 2 weeks it doesn't work I'd see if they will increase dose. Domperidone never had that much effect on my children, it also has some nasty side effects and not prescribed in some countries for children.
HTH. Babies with reflux are bloody awful - it is literally just trying to mentally survive each day.
Would you try making a really weak chamomile tea and mixing the drug in that. The Chamomile in itself shoud be really soothing for the whole digestive tract.
OJ is the last thing you would give anyone with reflux due to the acidity.
I would try not to use food to hide it and hence wean him early. You want his GI tract nice and healthy before you start introducing food.
Try the chamomile...
I'd not thought of that. How would I give it him though? ANything in a syringe is now automatically sus and he won't take liquid from a spoon. But won't the bits of tablet block a bottle teat? And he's def not ready for a beaker.
FWIW, the tablet leaflet specifically says anything acidic!
Combine thank you for all that. Yes, he's currently on 5mg. He was on ranitidine before that which worked up to a point. I didn't realise that I wasn't meant to crush them
After complete refusal this morning, I ended up giving him a spoonful of Ella's kitchen pure apple with it in tonight. He's obv not ready for weaning yet as I kept having to spoon it back in again but I couldn't think of any other way of getting it into him.
I might ask the paed about the chamomile tea though. I'm not sure about its acidity - might not be high enough.
I would second or third getting him tested for lactose and other food intolerances as well.
They do a poo test irrc.
(It was a long time ago DD1 is almost 13)
Hi, DS 17m has been on losec since about 7 weeks old. He has combined this with nutramigen prescription milk plus 2 sachets of gaviscon per feed plus Carobel to thicken his milk. We see a paed at the Portland called Eltumi who is very good. We have also had advice from Allison Scott Wright who gets slated on here re sleep but is very knowledgeable re reflux.
Getting the losec dosage right makes a huge difference so I would check that. In terms of getting losec in, we used to dissolve in boiled water, let cool and then syringe in, combined with spot of singing or whatever distraction worked! We've had to redo it many many times and I have often felt like crying with frustration but it does get better. Since DS was weaned, we moved to dissolving the losec then mixing with pureed apple.
DD has had omeprazole suspension since she was 8-9w old. Used to be 2w shelf life, but new lab does 4w one. Our chemist orders it for us. Ask your did to change prescription.
Does it come flavoured as a suspension? As in, will he like it?!
IIRC you can get them to flavour it, it just tastes foully sweet, but DS2 used to take the suspension okay. Boots used to make it up for me with flavouring in but independent chemist said it would shorten shelf life even more, don't know if its true. Great news five about 4w shelf life, I was forever down the doctors and chemist getting the bloody stuff.
According to my paediatrician the starting point (i.e. lowest dose) for omeprazole is 1mg per kg, so your DS may well need more omeprazole now, you will need to get him weighed and increase the dose regularly.
Thanks guys. Ended up trying everything but apple puree (1tsp) was the only thing which he would tolerate. However, it has had no effect.
I've had another (long) conversation with our paed today who has spoken to another gastroenterologist. So, now we're going to try nutramigen and go back to ranitidine.
Just as I've stocked up on aptamil
buttonmoon, looks like you have come up with a new plan but just thought I would comment on the advice given about the omeprazole suspension. My DD (4.6yo) is prescribed it in a blackcurrant flavour. The unflavoured one has probably one of the most disgusting tastes I've ever encountered - acidic seawater is the only way to describe it!
the BIG downside to the suspension is the cost. By mistake the chemist left the paperwork in the bag when I picked up DDs prescription last week and the invoice showed that the cost (inc VAT and delivery charge) was £196!!
the suspension only lasts for 4 weeks but that's not such a problem for us as DD takes 5ml daily and so we at least use the whole bottle.
DD also has to take artificial enzymes with everything she eats and as a baby we used to sprinkle them onto a small teaspoon of apple puree so the advice you were given about using stewed apple or puree seems to be sound.
Really hope you get the problem resolved soon as it cant be much fun for you all right now
oh ps, nutramigen tastes absolutely foul so don't be surprised if your DS turns his nose up at it
DD has a severe daily allergy and was originally prescribed nutramigen. She just wouldn't take to it at all (I was breastfeeding up til then so the change in taste was probably quite severe). We were then pescribed Aptimil Pepti which is a bit more palatable and she stayed on that til earlier this year.
If you are going down the route of exploring a milk intolerance, pop over to the allergy board as you will get a lot of advice about the different types of formula milk you can try
My dd was also an omeprazole refused. I told the pead and he said not to worry as it doesn't work well in babies anyway. What he said - which is very true - is that there isn't much you can do to improve reflux, it does just become better around weaning time. I was advised to wean early due to severe reflux, and glad I did as it made a world of difference!
Agree re nutrimagen - I used to add vanilla essence to make it taste nicer (disclaimer - he was 4/5 months +). I also did half & half breast milk the first week to try and him to take it. Not sure DS1 was dairy intolerant anyway, nutrimagen & pepti made no difference.
Everyone raves about neocate being the best dairy free formula but I think it costs the NHS a trillion pounds a box to prescribe.
Hope new regime works for you, maybe ranitidine will work on an increased dose anyway.
Mintyneb - totally agree about taste of unflavoured suspension - it tastes like bicarbonate of soda. I actually think that's what it is. Hopefully my next baby won't have reflux or if it does it won't be as bad, but if it is I'll ask for blackcurrant!
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