Infant reflux...how long for meds to work? (Domperidone and Omeprazole)

[jellybeans]

Hi 6 week old DS has silent reflux and the last few weeks have been horrendous. He has constant fluid coming up after feeds, violent hiccups, sick, and worst is gagging and choking, sometimes a couple hours after, have been to A and E twice he choked so bad, diagnosed with GORD. Tried gaviscon which didn't work, just made his poo bad. He started on the above meds 4 days ago but no sign of better days yet, could it take time? DS does not sleep AT ALL at night and we are exhaussted and desperate for DS to be happy, he is so miserable all the time poor thing. I am breastfeeding and often dread feeds as i feel guilty as i know whats coming and feel responsible

Well doc said to use domperidone should be given 30 mins before feed an omeprazole had to be given more than an hour apart so we couldn't think of any other way around it.

Thanks. Dairy free diet not happened strictly yet as haven't been shopping yet. Am having to study what can eat and then will send DH to shops!

Hi jellybeans I was away for the weekend but have typed up a list of milk-free soya free meals my ds used to eat (when old enough to eat lots of solid foods). This is to help a nanny of another cowsmilk and soya protein intolerant child but I can e-mail these to you if you are interested? Just send me a message using the 'contact another mumsnetter' link.

Docs often forget to tell you about the optimal time to give meds. I think it's because they think the extra info might stop you from giving them at all. Of course it's better to give some meds at the wrong time than not at all. But I found this site very interesting: It's based on research on omeprazole and other ppi drugs and how they are taken up and used by kids' bodies as opposed to adults': marcikids.

Although it's a long time ago now, I think I used to give ds2 his omeprazole half an hour before a feed (hard to predict for a breastfed babe though) and the domperidone just before a different feed. I also think I used to split the omeprazole dose so it was given three times a day, despite the doctors prescribing it for just twice a day. This was based on the info from the Marci kids site and of course it depends how confident you are to change what the doctor has prescribed. I agree with bigbaubles though that trial and error is often required to work out what is suitable for your child.

If you are weighing your baby weekly I would let the doctor at the hospital know if his weight increases by more than about 10%. Also do you know what weight your baby was when the medicine was first prescribed? If so, you can work out what dose the doctor has prescribed in mg/kg/day (which is what they start out with). Then it's fairly easy to see for yourself if the weight increase would lead to a different dosage. I haven't explained that very well but if you send me the figures I would be happy to do the calculations (ex OU tutor now sahm in need of a bit of academic diversion ).

just to clarify, the dairy free meal ideas are for you not for your ds

and the 10% increase is from whenever the docs weighed him, e.g. if weighed at 4kg then let them know when he reaches 4.4kg as they should up the doses by then.

Done

Thanks so much for all help, will try contact you

Hi there :)

My ds has been diagnosed with reflux, poor mite, and prescribed ranitidine and domperidone. We gave him the ranitidine on it's own at first and it seemed to be working but then stopped, so we started the donperidone as well today despite my being very concerned about side effects- he's just so miserable :(

What I wondered was how do I go dairy-free if I have to top up (milk production pretty meagre) what formula would any of you guys suggest? (I am already dairy-free myself as have allergy to milk protein.)

I know this thread is from december but I could really do with the advice.

Hi pleasant. Sorry to hear about your DS. If you have been advised to top up the only really dairy free formula is neocate and GPs are sometimes reluctant to prescribe this as its v expensive to the NHS. Soya formula was not really recommended by our doc as apparently most CMP intolerant babies are intolerant to soya; they don't like them having it sub 6 months anyway.

Other than that there's nutrimagen and pepti-junior, both of which have apparently really broken down the cows milk protein in them. Nutrimagen is really really foul. Both of these are prescription though I think you might be able to get pepti over the counter. Is there any way you could talk to a BF counsellor about increasing your supply? What are you topping up with at the moment?

pleasantly,
my DS also suffered from reflux and cow milk protein intolerance. the first 5 months of his life were hell.
Anyway, we originally got Nutramigen over the counter, our pharmacist ordered it for us and we paid. Shortly after this we had an appointment with the paed who prescribed it and we no longer had to pay for it.
It does taste and smell horrible but it took DS about 24 hours to get used to it (at the age of 4 months or so). It took us far longer to wean him off it as he didn't like the taste of the normal/ sweet stuff.

Medicine wise, the only thing that helped DS was omeprazole. We saw a dramatic improvement within just 24 hours.
Domperidone made absolutely no difference whatsoever.