silent reflux worsens with weaning: advice on administering Gaviscon

[mandasand]

My 6m boy twin had silent reflux diagnosed at about 2m old. Gaviscon works a treat for him but, since weaning over the past month or so, the old symptoms have returned.

Our doctors' practice has two docs: the one who knows his history is my long-term regular doc and is away for a while; the other I barely know. I recently asked the latter if we could try Ranitidine, but he won't prescribe as it's unlicensed. (Don't get me started on this and related points such as his advice to stop weaning and/or feed two hourly ... which feels impossible with twins, one of whom isn't suffering from silent reflux!)

Am working with nice health visitor on this until my regular doc returns to work (and no guarantee she will prescribe Ranitidine). Neither I nor HV can get our heads around Gaviscon dosage (quantities and timings) with bottles and solids.

He has 6 x 180ml bottles of formula a day (doesn't finish all the milk though) and each bottle has 1.5 sachets of Gaviscon in it. I understand this to be the correct ratio of medication to milk. Since he is 17 lbs, and could therefore be given up to 6 x 2 sachets per day in 240mls of milk, could we use up to 3 sachets per day with solids?

And how best to administer it? And at what point in a feed which involves solids and then a bottle? (But often he won't take the bottle a while after the solids because he's uncomfortable.) Would giving the bottle first help? But then too full up from the milk?! Doc couldn't advise, HV baffled, etc! Help!

You can ask a pharmacist for help with the dosage/administration of Gaviscon.
When we weaned DS (who had moderate reflux and was on ranitidine), we spaced out the solids and milk. We tended to give the solids first, and then the milk, as the milk usually came up, and it would bring the solids with it if we'd given them afterwards.
However, it is normally recommended to give milk before solids (as milk contains more calories/nutrients), so we tried to avoid giving too much solid food so that he'd save his hunger for the milk.
Some solids seemed to stay down better than others: apple worked well for us, but rice did not. if your DS seems uncomfortable with one of the foods, it may be worth trying something else. Also, gaviscon is known for causing constipation in some babies, so make sure he's getting plenty of liquid.

Why don't you review the solids if they're resulting in symptoms returning? That's what I did. Certain foods (acidic, citrus, soya and dairy) set mine off so I cut those back until they were older.
Also have you tried hydrolysed formula as silent reflux can be triggered by cows milk.

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