Silent Reflux, Omeprazole and Carobel

[mcl1995]

Hello,
My daughter is 9 weeks now. After being back and forth with doctors, trying Apitmal Petit and Gaviscon, she was prescribed Omeprazole at 3 weeks old after having a trip in the ambulance to the childrens hospital due to a choking episode from acid coming up from her stomach.
Since starting her omeprazole, we really have noticed a massive difference. Shes gone from continuous crying for sometimes up to 3 to 4 hrs straight to really only upset when shes tired or hungry. The only symptom we really still have is that she is sick after almost every bottle. Its not massive amounts but enough to soak her clothes around her neck/shoulders. We have tried everything, we keep her upright for 30 mins (sometimes more- even at night) and sleeps elevated in a SnuzPod (with the foot provided). However she will always be sick, as soon as she is lay flat whether its to sleep/nap or have her nappy changed, she will just be spew up milk. This can still happen 2+ hours after her bottle. For example last night she had a bottle at 4am, I didnt lay her flat until 5:30am, she was sick over herself so I picked her up, got her back to sleep and put her down again around 6:30am and was sick immediately again. Can anyone help/make any recommendations on what to do?
I’m considering bringing in Carobel to her bottles, but not sure if this will have any adverse effects because she is mostly content now and read that Carobel can sometimes cause constipation. She is currently on Kendamil and my health visitor said this is quite a watery formula - which I haven’t seen anyone else mention, does anyone else know whether this is true?

You should bring it up with your doctor.

When ds1 was put on reflux medication they also had us give him a little bit of baby rice before every meal (he was bf so couldn't mix it with the bottle). They told us this was to provide some ballast for the milk in his tummy and make it less likely he would spew it up.

I can't say it worked perfectly but I think it did help (or maybe it was just that over time with the medication he got better, who knows!).

Anyway, probably worth asking your paed.

Thank you! We are currently waiting to speak with our GP just now and hopefully get referred to a paediatrician to discuss it.

Hope you get some good help! Having a refluxy baby is hell, they suffer so much and you just can't help!

Kendamil made my babies reflux worse but I think he also had a milk intolerance, they’re all different but Hipp organic worked wonders for us plus probiotic drops, after this we managed to drop the omeprazole eventually

Have you tried not lying her flat? You can get reflux wedges.

Dd2 (11) had reflux as a baby and she had to have Cow and Gate Staydown formula milk (don't know if that's still around now) and Carobel too. We found the carobel excellent iirc.

@Gamechanger2019 How did you work out this was the Kendamil? We have tried Aptimal and she was also put on Petit 1 for a short period because they thought it could be an intolerance but since omeprazole everything has been fine other than constant sickness. She was put on gaviscon again and that didn’t do anything for the sickness, only made her constipated. She has been on both Kendamil and Kendamil organic since and I have had no issues, she has a dirty nappy every day and seems to enjoy the milk, I didn’t consider this could be causing her sickness.

@Crimsonripple We have a SnuzPod which comes with a wedge for under the foot which we have been using (The manual actually says not to use this whilst sleeping but we have spoken to 2 doctors who have babies who use this and they gave us the ok to use). We try keep her up as much as we can, but sometimes its just not practical, like changing her nappy, she is just instantly sick every time. I should add too, its not only when shes flat, she is also sick the same volumes when shes elevated too, such as in car seat or in her mamaroo or even just sitting on my knee. Its really frustrating because she doesn’t get a lot of tummy time or time on her back for her own development so I feel really guilty.

@Meredusoleil Thanks! I mentioned Carobel to the doctor and he didn’t even acknowledge I had said it, he just straight away told me to give her gaviscon on top of the omeprazole, which we have tried and done absolutely nothing but made her constipated. Our doctor is now suggesting to up the dosage of omeprazole however when she first started on omeprazole she was on maximum dosage for her weight at the time, yet was still being sick. He has suggested its because her dosage hasn’t changed but shes got bigger - but that just doesnt make sense to me if she has been sick the whole time on omeprazole, obviously the maximum dosage doesn’t help.
I have heard good things about Carobel, I’m nervous to start her on it because she has dirty nappys so regularly, and I saw the affects of Gaviscon and seen her struggle so don’t want to put her in any pain because currently it doesnt seem like the sick bothers her, it just comes up and out and she lays there smiling.

We also tried Gaviscon first and it didn't work. Definitely try the carobel. It really helped my dd2.

He was just continuing to be sick even when on omeprazole so I changed again, I tried loads including prescription milk.

My son has been on the max dose of omeprazole for a while. Whilst it greatly reduces the amount he is sick, he is still sick to some degree after a feed, and like you say can be for up to hours after. I don't know if it is possible to eradicate it entirely. We tried carobel first on the advice of the health visitor and it cleared his reflux up almost entirely, but unfortunately it made him incredibly constipated which upset him much more than the reflux. So we had to stop it, which was a shame as it was fantastic for his reflux. We went onto gaviscon which did nothing for his reflux and he was still constipated. Omeprazole is the best thing we've found for his reflux, even if he is still sick it isn't as much as it used to be, and he's not as uncomfortable as he used to be. He's also on kendamil.

How are you giving the Omeprazole? Are you doing one dose or splitting the dose. I found splitting the dose more effective. Also you must do regular weigh ins and reevaluate the dose. I found Gaviscon pretty useless. We changed the milk from Aptimal to Aldi and also added Colief Infant Drops (they are for colic but seemed to help her hold the milk down. We also held her up 30 minutes after feeding, elevated the cot ect. We also only fed in an upright position.

@Meredusoleil Did you find carobel constipated your baby at all?

Yes this is exactly what is happening with my baby, to the point ive considered weaning off omeprazole to see if her pain us gone and finding alternative for sickness

Yes this is my worry with Carobel, as gaviscon constipated her I’m worried the Carobel will do the same and its a toss up between having her in pain with reflux or pain with constipation. Its a real shame. It might just be a case of trying it to see how she gets on with it. She doesnt seem in pain at all just now, even when shes sick it doesnt seem to bother her

We give it in 1 doze. We tried splitting it but didnt see much effect so went bk to giving as 1. She has always been on same dose, she was issued max doseage at 3 weeks and has remained on that, but even when she was on max dosage for her weight it didnt help the sickness which is why I’m reluctant to increase the omeprazole because its not ideal for a baby and from the previous experience at max, it didn’t kerb her sick. We can hold her up for 1hr+ and she will still bring it up, she sleeps at a slight elevation and again still sick, which is scary at night because I hate putting her down after her night feeds but thats a vicious circle as it means I’m up all night with her sleeping in my arms upright.

My husband also made a good point yesterday about sitting her upright, we spend maybe 30mins to 1hr sitting with her after her bottles (which is sometimes not practical if we are out and about) but he said yesterday we are spending this time with her sitting up and then we put her in her carseat/pram/crib for her to be sick anyways

I basically spent the first 6 months of my daughters life like that. It's exhausting and I feel for you. Do go and check the dose even if you choose not to increase it. Also know it does get better. If it continues to be bad it might be worth discussing early weaning with your HV. Weaning really made the biggest difference for us (I know it's a while away for you).

I forgot to say wearing my daughter in a baby carrier really saved my mental health. It let me get on rather than being trapped to the sofa. She was comfortable and I was mobile. If you haven't got a carrier it's really worth inventing in a good one (second hand is fine) because they are better for your back.

We’ve just been through this with my 7week old son.
He is lactose in tolerant so we changed the milk but we have also been using Carobel. It’s worked wonders.
He is no longer sick, sometime the odd little bit comes up but nothing like before. And he seems a lot more settled when drinking from the bottle now. Before he used to gag and choke while eating. Which made the reflux 10x worse due to all the air going down.
Hasnt made him constipated, he has actually been going more, but I think this might be because the milk is staying down!

Not that I remember.

I have had two with bad reflux and unfortunately in my experience them bringing up milk is something you have to get used to.
The omeprazole doesn't keep anything down, it neutralises the stomach acid so it doesn't hurt them when it comes up. Anything you can give them manages the reflux, it doesn't fix it. We ended up using a combination of omeprazole and reflux milk (which basically just has the carobel mixed in). Even with this DC could bring up milk hours after his feeds.

Try thickening their milk on top of giving the omeprazole but also invest in some decently thick bibs and a ton of muslins. Layering bedding with waterproof sheets in between means you can change the bed quickly at night if they're very sick. It's grueling and relentless at times, but it does get better. My youngest is 8 months and we've stopped the omeprazole and should be able to stop the thick milk soon.

Its so exhausting, and I keep trying to explain to my doctor, nothing with regards to my daughter is too much for me, i would sit up all night if it meant she was better but I would rather for her sake she wasn’t sick constantly all over herself, its a shame for her! I spoke with my doctor about increasing the dose yesterday but I’m reluctant to do this just because I don’t think the omeprazole is helping the sickness at all and therefore would rather not give her more if its not going to help but suppose worth a try!
Re the carrier- currently got her on me just now haha! I had the BabyBjorn one which is for 0-3yrs and felt it was just too big for her, I bought a second BabyBjorn one, the carrier one for 0-1yrs and its SO much better and easier to work with, she can see a little more too so doesnt hate this as much. I’m trying to wear her as much as possible but she screams when I put her in it so not ideal when we are out and about, been trying to put her in it around the house to get her use to it and trialling like 10 mins when we are out shopping etc to get her out her pram!

Oh wow, glad its making a difference! I think Carobel is going to be my choice rather than increasing omeprazole. I’ll try it for a period and if shes in any discomfort or pain just stop and reassess my other options! Thanks