Ranitidine dose?

[Mummy081212]

My little boy was weighed today as was approx 7.10kg. He currently has 1ml ranitidine 3 tones a day. Can this be increased do you think? His silent reflux symptoms are getting worse! He’s 14 weeks old tomorrow! Thanks!

I would go back to the GP, preferably one who specialises in paediatrics. Might be appropriate to increase the dose or if it’s not helping there are alternatives like omeprazole. Hope things improve soon, I remember how tough it is!

I went to see my GP today who advised that she wouldn’t prescribe that unless it was through a paediatrician! You can imagine how long the paediatric appointment is going to take to come through! I definitely think there is room for more ranitidine though it’s just getting it confirmed by somebody!

According to this - the MAXIMUM dose for his age/weight is 1.5ml 3 x a day! He’s currently only taking 1ml.

I used the nice guidelines for my ds when he was bad with it - I had a great relationship with the paediatrician and could ring up and say weight is x, need to increase to this dose is that ok. So, I was using those as my guide - also meant when he was good I could reduce the dosages too.

I'd say push the referral as No one will be happy saying you should do this because we aren't medically trained and your child may have other things going on. Consider if private referral will be an option

Sorry pressed post too early!

There is a dosage gps can prescribe and then a higher dosage paediatricians can do so don't expect a gp to be prepared to agree to nice guidelines as they may be out of their remit.

For reflux, are you using gaviscon as well as ranitidine? If it's not working, may need to look at omeprazole through the paediatrician
Sitting upright, cot propped up at head end? There is a good fb group - living with reflux which i would recommend as well.

There is a range of safe doses for Ranitidine. GPs usually start of with the minimum safe dose. You can go back and ask for the dose to be increased within the safe range. My DD was on the maximum for her weight after she showed some improvement on a lower dose, but was still in pain.

You then need to go back regularly as he grows to get the dose increased in line with his weight.

spinn thanks so much for your reply. I am phoning the Paediatric team tomorrow re: referral and 100% looking into going private if we need to. GP has phoned tonight to say she won’t allow us to go higher with the ranitidine - it has to come from a Paediatrician. GP also wouldn’t prescribe omeprazole but was keen for us to try cows milk free formula. She spotted some exzema on my son’s face and now seems to think he’s CMPA which I’m devastated about as I did not want to go down that route. I want to wait to see a paediatrician before I make anymore changes.
We are on Cow and Gate anti reflux milk but I hate it so was considering going to normal milk and starting with gaviscon again?!

A large proportion of babies with reflux do have CMPA/CMPI, especially if he also has eczema so I would give the cow's milk-free formula a try. It was very beneficial to my DD. She was intolerant rather than allergic and grew out of it by age 2.

DippyAvocado thank you. Just in the process of sorting a referral to a private Peadiatrician. I fear we may may have to go down that route 😓

I've had 3 with cmpa, reflux is a sign of cmpa so don't rule it out. 2 of mine had cmpa plus reflux (ie we removed the milk issue and still reflux refused to leave the party)

Read up on milk allergies in the nhs - there is a good process they follow for babies as to which milks to try.

From my experience, if he's on anti reflux milk and ranitidine and it's not working then you need the stronger paediatrician stuff / change the milk.

Most kids outgrow the milk allergy in the toddler years - at the moment he's only getting milk but once weaning he will have a range of foods so the body can start to tolerate some dairy where as now it is being overloaded.