Omeprazole, Reflux, CMPA

[DaxsMum]

Hi! Looking for advice regarding my 4 month old son and the omeprazole suspension that he is on for silent reflux (linked with non IgE CMPA).

First off, he HATES it! He will greedily lap up any other medication he’s had to have but this daily dose has become a heavy burden in our house.

Someone has told me, they believe there’s two types of omeprazole suspension. One tastes awful but is cheaper and the other doesn’t taste so bad but costs a lot. Any one have any info they could add to this? As I’d like to hound my GP about it. It ruins every evening and has taken up to two and a half hours before now to get the dose in him. With him screaming, fighting and bringing it up again. We try all sorts to distract him. Most recently I bounce him (he’s very heavy) around the house while reciting Bear Hunt while Daddy squirts 0.5ml in when we pass. It’s working okay for now, but nothing last long before we have to come up with something else. It’s stressful, we all hate it and it makes bedtime really late so he’s overtired too. We do it in the evening as it’s a two man job and his symptoms were always worse at night. He gains weight rapidly so his dose is always being increased which makes it that much harder.

Also, I think the omeprazole is causing him constipation. Since being on it his stools have become thick, dark, sticky and smell terrible. He can’t seem to poo for several days and the longer it goes on the more uncomfortable and unsettled he becomes. He is almost always trying to poo and shows signs of tummy ache too. We do massage, baths etc. He’s entirely breastfed on demand and has plenty of wet nappies. We have been dairy, soya and egg free since the beginning of November so it isn’t any of that. I’m sure it’s the omeprazole that’s causing it. Has anyone else had this?

Thanks so much for bearing with me for this long post. Suggestions will be gratefully received.

The cheap version is the one where you open up a capsule yourself, semi dissolve the microgranules inside in water/milk, then squirt that in. The expensive version (and it is a lot more expensive) is any that comes to you already as a liquid.

Have you tried mixing it in his milk? I wouldn't mix it in a full bottle incase he doesnt finish it, but mix it in an ounce at the start of the feed.

Agree with pp that the liquid stuff is the expensive stuff. You could always asking about getting the tablets and seeing if he'll take it better?

I have asked about the dissolvable tablets but doctor refuses and keeps saying it’s absurd I want to give him tablets. If liquid makes him gag he won’t be able to swallow the tablets. Despite that I’ve tried to explain on multiple occasions that it’s a dissolvable tablet that you mix in liquid. She just refuses and says he’s too young. It’s infuriating.

It says on the literature not to mix it with milk. I’ve no idea why though.

My son was on Omeprazole MUPs from 7 months. They are pills. He ended up on a tube (other problems) but before the tube, I used to mush it in pureed apple. From 5 months your son could have that?

You can buy omeprazole in pill version over the counter if you want to give it a go, millions of people take it. We have the pills prescribed for LO (who also has CMPA). He likes his omeprazole, whereas giving him the ranatadine, or indeed calpol or calpolfren, we have to do the kind of thing you do, walking and distracting and tiny bits at a time to stop him spitting it out or making himself sick.

Mixing it with milk makes it less effective.

My daughter was on Omeprazole MUPS. It’s a tablet but it’s designed to be put into water - it breaks up into granules so you make your own suspension each time. The little granules are ‘gastro resistant’ which means they don’t dissolve in the stomach acid. When they are in your child’s mouth they don’t give off taste (they only dissolve once they get to the intestines). Other formulations dissolve a bit in the mouth so you get the yuck taste. I don’t think they are massively more expensive. Our Dr gave general prescription and asked us to discuss with pharmacist which was best for kids - MUPS was what he advised. BTW the not mix with milk bit is because milk dissolves the tiny granules so you get the bad taste.

I totally feel your pain and have come searching for same answers. My lo will literally take anything but not this. We tried milk full bottle took so long to drink cuz she didn't like it and wasted half. Half bottle tasted too strong and spits it out. Vanilla did not help at all. The gp offered me an adult tablet to crush up but said would discuss with pharmacy how much of a tablet per day which I am going to ask for this week. Did you have any luck with getting tablet? I even asked manufactures to add a flavour like Calpol but they said no cuz it would dilute it but heavens diluted is better than not taking it at all! Be interested to know if you've found a solution this is such a nightmare she loved ranitadine and would open her mouth for more! Pharmacist told me worse thing could happen with mixing with milk is it wouldn't work properly but I think it has been working in milk when she doesn't spit it out (the rare dream feed) Maybe you could try that see if you get better results than us. My husband tasted it and he gagged so how they expect babies to swallow it is beyond me. Be interested to know how you get on? X

No luck so far. Bear Hunt is still going pretty well. My little man is entirely breastfed so putting it in a bottle wouldn’t really work for us. But I can imagine since the flavour is so strong that it would just make the ordeal go on for longer.

I was told he has the reflux because of his allergies and as the allergies are now under control that we may like to try weaning him of and seeing if he needs it anymore. Of course I would love to have it out of our lives and don’t want to unnecessarily medicate him, but I’m nervous all the same about taking him off of it. I’ve heard some horrendous things about withdrawal from adult users. I don’t know if the same applies to babies.

Glad to hear he is getting control of it. Oh I don't know about withdrawal. My lo was on ranit and omeprazole together at one point and refused omep previously and she didn't have any issues when she stopped but she had the ranitadine as a back up so don't know what she would have been like. The consultant told us to just eventually let her outgrow the dose so if she ok on a dose stay at it until it wouldn't be enough for her weight anyway so maybe that would be an option rather than just stopping but her SR isnt from allergies. It's poo isn't it. xx

That’s a good idea. He’s been due to go up a dose. But that makes a lot of sense as we haven’t put it up yet and he’s showing no signs of discomfort. Thank you. Hope you find some answers x

Ask about esomeprazole. LO got moved to that at about 4-5 months old as I couldn’t get LO to take the tablet one the grainy bits made him gag it all back up!

Esomeprazole comes as sachet and you mix with water and it turns to a yellow paste type thing. Was so much easier that the tablet one

Hi my baby has to take the liquid foo and we have been doing it first thing in the morning. We go to the kitchen and start with Omeprazole which i squirt into the side of his mouth in about 5 goes (small amounts at a time), then follow with 1.5ml of lactalose which helps with constipation and can be purchased from the chemist but i also got it prescribed. My baby doesn't seem to mind the taste. Could you try it of a morning before a feed? Or even mid-feed to try and get a new routine.