Is this a reflux medication wean fail?

[GrumbelinaPicklebottom]

Hi all,

Frequent lurker, occasional poster.

My DS is 21 months old. He has reflux and MSPI, diagnosed at about 5 weeks old. He's been on omeprazole since about 10 weeks of age (when ranitidine stopped working for him), and still drinks Nutramigen - up to 25 oz per day (a lot, I know). He struggles with solids, particularly textured ones, and nothing seems to be helping in that respect. I am hoping it will improve with time.

I thought it was a good time to try weaning him off omeprazole - that and getting a bit of pressure from everyone that "he should have grown out of it by now". I did half a dose for a week, then half a dose on alternate days (effectively a quarter of his original dose) for a week. since yesterday, we are medication free.

He doesn't seem to have been in any pain, other than teething discomfort. However, he complains of feeling full (even first thing in the morning), and has been vomiting a lot (he had silent reflux so never really vomited much before). It's often psychological - he vomits in anticipation of food or his bottle, for example. He also has a very sensitive gag reflex eg a piece of bread the size of my thumbnail triggered a massive vomit today. The vomiting has been increasing in frequency since medication weaning started.

He's only been med free for a few days. Should i persevere and see how things go? Or is this a fail? I don't know if the teething is contributing but he's waiting on all 4 canines to come through at the moment.

I'm worried if it is a fail, and I don't get symptoms under control again soon, we'll take massive steps backwards in terms of his eating, as it seems there is a large psychological component to that.

Please advise - having a really tough time with this. There have been a lot of tears here today - his and mine, after a massive vomit. It just doesn't seem like things are getting any better, and I'm so desperate for him to just eat like a normal child and get him off formula.

I should add that he has been seen by a paed at the local children's hospital, but he has been particularly unhelpful (he insisted it was all psychological and DS' sleeping problems were behavioural). I think the period of uncontrolled reflux from 10 months onwards really caused a significant deterioration in solid intake, which explains his problems eating today. So not hopeful for any meaningful contribution from them (and not bitter at all either )

Anyone?

It's so tough isn't it? Many ((hugs))

I think you need to see another paediatrician, someone who at least is sympathetic and can relate to what you are going through. The one you've described sounds rubbish and very much like a paediatrician I saw. I then asked GP to refer us elsewhere. Whereabouts are you?

I remember when we weaned off my DD off lansoparazole she did start puking for a week. But her reflux was much milder. Go with your gut instinct, if it is upsetting him, then I would leave him on medication, because then he obviously needs it.

I'd put him back on the Losec and ask for a referral to another paediatrician or a paediatric gastroenterologist.

I can understand where you're coming from because my DS had (has) a psychological component to his eating problems - would be sick if he saw his baby brother dribble, or mouth anything, as babies do.

My DS is still on Losec at 7. Although we are down from 30mg per day to just 10 now, and probably ought to try getting him off that soon.

DS's gastro said Losec (omeprazole) has a really safe record for long term use in children, so I'd be tempted to keep on with it if there is any doubt at all, whilst you get some help from a different specialist.

Good luck with it. I know it is very very stressful.

My DS is 2 and still on ranitidine. If they need it, they need it. Don't be pressured into weaning off the omeprazole if you don't feel it's the right thing.