Reflux and ranitidine- needing help

[LadyRenoir]

• Disclaimer- I will ring the GP later on in the day, just wanted some opinions

Short version: Have your babies on ranitidine drank less milk than usual? Has it worked straight away, or after few days?

Long story if you bother to read:

I posted before, so maybe some people remember, but our baby was diagnosed with silent reflux at 6 weeks- he is now 12 weeks (bottle fed). Signs were mainly bringing bits of milk up and horrendous crying after feeds. GP initially not keen on prescribing anything, then gave infant gaviscon which only resulted in massive constipation.

He is not a very settled baby (premature as well, so a bit behind with development), but otherwise has no skin symptoms (a bit of cradle cap) and poos normally and he is not throwing up. Weight gain has been good so far.

We were referred to paediatrician who initially asked us to try gaviscon again. She did mention he was most likely overeating by a lot for his weight, although there was no excessive weight gain and still on the same percentile since birth. The advice was to also cut down some of the milk not to overfeed him.
In the meantime the reflux got worse, the crying has become even more horrendous and even worse than before after feeds and went on forever, we can no longer cuddle him, as he is only comfortable carried around on a shoulder. Luckily he is fine sleeping on his back at night, although he is not a great sleeper. We started hearing him swallow loudly the milk that kept on coming up his oesophagus. We got a prescribtion of ranitidine (he is 4.8 kg and got 3x0.75 ml).
So far, I think he is crying less and is more alert in the morning. But, he is now having a lot less milk than before. As in, around a 100 ml daily less than he should, so going from way over he ends up being a lot under. He usually comfortably has 100-120 ml and 2 of the 7 feeds a day were closer to 150, and now he mainly does 80 mls.
It's only been the third day of the trial, so will need to give it a few more days, was just wondering if it was normal.

Congratulations on getting the ranitidine prescription, OP!

For my DD, ranitidine took about 10 days to fully kick in. It worked well in conjunction with anti-reflux milk (and not so well with regular formula).

DD feeds didn't really go down after raniditine but she has always been a hungry baby and has had more than the standard recommended amount. Her "going off milk" usually meant reducing milk feeds down to the quantities on the formula tin and it only happened when she started teething.

The dosage (0.75mls) is not the maximum that can be prescribed for a 4.8kg baby so if the medicine does not work as well as you have hoped, you may want to discuss quantities with the doctor (the maximum would be 3mg per 1kg of weight converted into mls, i.e. 3x4.8kgx10mls/150mg = 0.96mls). The dosage will also need to be upped as the baby keeps gaining weight.

If ranitidine does not work, the other alternative would be omeprazole but I didn't need to go there with DD.

Good luck!

I’ll be following this with interest! My DS, 11 weeks has reflux and vomits a lot! I’ve tried everything except medication, but this is probably the route we’ll end up going down. I’ve just started a thread about him squirming. Does your DS do this?

Did your doctor discuss trying omeprazole? We found it to be so much more effective at managing silent reflux. However that aside, what formula are you feeding your baby? Do you think there could be a dairy intolerance? Our paediatrician told us that there is a strong correlation between reflux babies and dairy allergies. Our daughter is prescribed neocate formula (which we thicken with carobel), ranitidine and omeprazole. My understanding is that Omeprazole is designed to stop the production of excessive stomach acid, whilst ranitidine manages any acid that does sneak through to cause discomfort. For the ranitidine element, make sure you are leaving at least 15 mins from giving it to your baby and then feeding. Then ensure baby is kept upright for at least half an hour after the feed. What dose is your baby on? And which bottles are you using? I was recommended mam bottles and they are so much better than others. Try not to panic, it takes about a fortnight before everything starts to work properly.

Sorry I missed the but absolutely it the dose... my daughter is on 3mls a day, so as recommended above, don't be afraid to ask your paediatrician for advice on whether to increase your prescription.

@tootiredforeverything we are using regular cow&gate milk. He has been gaining weight fine, so paediatrician not keen on changing milk, and to be honest we were not keen on reflux milk ourselves.
They have not excluded cow milk allergy, but in their opinion it was not likely, as he has no other symptoms.
He has actually started eating fine today, and sleeping a lot more. I was a bit worried at first, but then i remembered he used to nap before the reflux kicked in, and since then almost completely stopped napping during the day. He can be up from 5 am until 7 pm, so it's nice to see he is actually resting during the day now.
We are using Dr Browns and Mum bottles (Mum for out and about, as I find the pipes and stuff of Dr browns bottles a pain to use when not at home).