Worried about 15 month old eating very little - can Ranitidine and Gaviscon affect appetite?

[BlueBumedFly]

Hello

My DD continues to worry me silly. Some would say I have a bad case of PFB (my 2 other girls are step-children) and they could be right.

She has a whole history of Silent Reflux and is on Ranitidine and Gaviscon. She eats very little but is a good size (99th percentile for height and 24lbs). She does love milk!

Today's meal was one small chicken ball (mixed with veggies and apple), 4 baked beans and a mouthful of mash. Chicken ball about the size of a large grape.

She always seems keen but then has a few mouthfuls and no more. She also has terrible constipation.

Am seeing the consultant on the 1st September to see if they will change her meds. I have tried reducing meds but she starts to vomit again.

Do I just have a non-eater or could the meds be having bad long-term effects?

Help! Worried all of the time. She really does live on fresh air.

Many thanks

Um - can understand your worries, given history, but lots of children this age do seem to live on air. Will she eat fruit - might help with the constipation?

Gaviscon is well known for causing constipation ... and doing bugger all for reflux IME

ranitadine is good for helping with the silent reflux pain

perhaps your DD doesn't eat much because it hurts - her tummy/oesophagus ???

ranitadine is very weight dependent so reducing it is IMVHO not the best thing to do as you have found as the vomiting comes back

i do also think that some toddlers are very picky/don't eat a lot but as she is drinking milk that is a plus point

any other outward signs or symptoms? how long has the constipation etc been going on for? what ethnicity are you/your daughter? anything else that you can mention?

It may be the constipation that is giving her a poor appetite. Unfortunately the gaviscon is a bugger for causing it.

My ds is nearly 8m and we managed to get him off his gaviscon and ranitidine entirely in the past 3 weeks. His vomiting came back for the first week, but has since stopped. And he's pooing normally for the first time in months and discovered an appetite he never had before.

How much milk does she have in a day, is it breast / formula / cows milk?

If she is always constipated / bunged up then she may not have room, could you try adding olive oil to her food, she may be too young for Linseed Oil/Flax seeds as they work well to 'keep things moving' and maybe speaking to the doctor to get her some Lactulose?

Habbibu - she will eat fruit from a tetra pack like Heinz 100% apple or Ella's kitchen but not put anything like a grape or orange in her mouth.

RubySlippers - I have always worried that the pain starts once she starts to eat as she does get stressed and cries to get out of the highchair. I don't reduce the dosage of Ranitidine, just have tried to drop it for a few days. I am at a loss really.

misi - outward signs are that sometimes she does cry for no known reason whilst eating, does get panicy to get out of the chair and will battle to exit quickly. The constipation has been going on since we went onto Cow's Milk at 13 months but she has been on Gavi since 10 months. We are both English born/white.

Otherwise she is happy and keeping up with her peers at Nursery, crawled late at 11 months but walked within 6 weeks of crawling. She talks and smiles and is very cheeky!

I am just exhausted of every meal being a battle ground. I try to smile and take the plate away without a fuss but don't want to be ignoring a problem or if she is in pain.

If she has not pooed for 3 days would you avoid giving Gaviscon tonight and pray she does not vomit? I am worried that if she has a intestinal block or build up then gavison is just making her worse. Stools on Friday were gray, like little blocks of clay. Sorry to be so descriptive!!

I used to describe my son's poo as plasticine, it was so firm!

How much gaviscon does she have and how often?

She has it once a day, 2 sachets, before the bedtime feed. I give it in a syringe in 10ml of milk then give the main bottle immediately. It just gets too thick if you put it in the main bottle, like a latte! Also has 1.33ml of Ranitide twice a day.

Plasticine is a good description! She does really struggle and has even passed a small amount of blood as a result of straining (

Maybe try reducing to half the dose for a week and then stopping. TBH that's not a huge amount of gaviscon.

Will she eat things like yoghurt and creamy sauces over veg, or is she adverse to all foods?

She eats 'dry' foods that she can feed herself but does not like cheesy sauces, pasta or slimy food (i.e. at Nursery they do hot dogs which she hates, also ham and fruit slices).

She happily eats all meats and rice and veg... albeit enough to keep a small sparrow alive. She also likes breakfast cereal as long as it is dry, once it is drowned in milk she hates it.

However, at Nursery (where she goes 2 days a week) she apparently eats everything apart from hot dogs. (Not that I really want her eating them!)Either they are making it up or she is leading me on a merry dance s

Will try halving Gavi dose and see what happens - many thanks

Hello all who have answered me so far and anyone else who can give me advise too.

I am off and away now until later tonight but do value all your input and am very interested to hear all information.

Many thanks

sounds to me that her bowel is possibly in ''shock'' or spasm. my 10 year old niece has bowel problems since she was 2. the crying and and trying to get out of the chair is very similar to my neice, the bowel spasms, tremendous pain courses through the intestines and sitting makes this extremely uncomfortable and painful. running around can have the effect of stopping the spasm and getting the muscles in the bowel to work better but not much. my neices problem is that the muscles in the bowel wall do not contract and expand properly and so the movement of the chyme along the intestines slows down, as it moves slowly, more water is able to be removed from the faeces which make it drier and harder which in turn backs up the poo and causes more problems.
as the spasms are not all the time, they are a result of eating/digestion, the rest of the time, my niece is perfectly happy until she tries to poo of course. the hard dry poo will cause blood as the anal canal will be torn if too much straining goes on (in later life this leads to piles/haemeroids etc)

we refused my niece to go on gaviscon so the GP put her on lactolose which is not my favourite thing but did help a bit. I wouyld suggest that your daughter s bowel needs ''retraining'' but at that age it would be very difficult.
the grey stools could be a sign of incomplete digestion and fermentation of the chyme (does she make a lot of wind either way?), meaning that the digestive system is not coping. the bowel is like a concertina. stretching lengthways and contracting to move the chyme along. when the ''folds'' become blocked or impacted by the poo, friendly bugs cannot cling to the bowel walls and so are washed out leaving the bowel bereft of bugs, also the enzymes that are injected into the intestines to digest often can't work as they cannot mix up properly. it is difficult to know what to suggest. if she was a few years older I would suggest quite a few things but at that age, I couldn't do it.

can you keep a diary though? write down what happens each day, foods she eats, what she is like and what her poo is like etc, often this way, a pattern emerges and corrective actions can be taken. this will be helpful for the docs too as it would give them an idea as to what happens and when.
only other thing I can suggest that is safe for a child that age is too make sure she drinks plenty of WATER and also get some ''babylife'' from solaray which has the bifidum infantis friendly bugs in it that a child that age needs, yaklut etc is useless for kids under five as they have the wrong bugs in them. the bugs will help digestion and movement. one last thing, my son had problems with bowel movements when he went onto milk after his mum couldn't produce enough, when we worked out why, we switched him to baby soya milk and his bowel prob disappeared. by removing the lactose and casein etc from his diet the bowels stopped reacting violently and reverted back to normal. a thought perhaps? (but discuss with doc first)

Wow misi that is a fantastic amount of information. I will keep a diary from here on in till our appointment on the 1st September and see if a pattern emerges.

Yes, btw, lots of wind! I will also try to get babylife. when she had gastroenteritus we were told to get her infant acidopholus - is that the same thing?

I am also wondering about cows milk. When she was born she had colic and the only thing that worked was Colief. Her older sister (half sister) had colic as well but went on to have diarrhea with cheese. I blame the father (hee hee) as they is what the two girls have in common!

Thank you so much for taking the time, I am going to cut down the Gavi and keep the diary - might be back posting to let you know what happens!

Off to do the bath then out to collect a new high (low) chair. Will check in later tonight.

wind then is def a digestion problem. infant acidopholis? hmm, yes, ok. sort of, not overly keen but there you go.....
in adults there are around 7 resident strains of friendly bug with another 500 or more transient ones. in kids under five, there are 2 main resident ones, bifidum infantis and an acidopholis (can't remember the actual strain). with around 250 transient ones. infantis is by far the most important as it seems to be the one more likely to digest less solid foods.
diary induces the body to produce mucos as sometimes kids lack the enzyme lactase to break down the milk sugars, mucos causes the bowel wall to become smoother in an effort to speed the passgae of the irritant (lactose), but long term exposure has the opposite effect, everything slows down and causes more probs. as there is a history of colic, a dietry change away from dairy is almost certainly going to have an effect, it is just the degree of the effect that will be interesting.
colief is good, it is what I used for my son when he changed to baby milk. the soya milk certainly stopped all his probs and he is fantastically healthy now, 4 years and 9 months old, 115cm tall, 12.2kg and well defined muscles. GPs often say soya milk is no good as it lacks protien and nutirents, rubbish!! billions of chinese, japanese and other far eatern kids grow up with soya in their diet

Right, will goodle 'Babylife' and get some on order. Just given milk and she is now asleep........and she took more than she has taken in a few weeks. Fingers crossed we can overcome all of these problems soon. Will give Soya a go as well to see how she reacts, the allergy doc at the hospital did say it could be the route cause of her reflux.

cutting down on dairy should help

Hi Nightcap - do you really think so? Do you know what it is about diary that causes the reflux probs? Do you have experience with diary vs Soya? Thanks x

dairy makes the body produce mucos, the mucos inhibits the digestive response and causes friendly bug death, when friendly bugs die off it enables the unfriendly bugs like yeast (candida) to flourish. candida hate acid conditions and secrete substances to reduce acid, this allows the yeast to grow even more and head for non acid areas like the lower intestines and the oesophogeal tract. when they have grown enough, they can hold the one way valve open and so allow the remaining hydrochloric acid in your stomach to head upwards and so cause acid idegestion, heartburn etc. by taking common antacids which are basically chalk and alkaline, it eases the symptoms but ultimately makes you dependant on the antacids as they actually do not treat the cause and you can get gradually worse. it is why antacids are the most widely prescibed drugs in the world, the most profitable drugs in the world and the most misused mis prescribed drugs in the world. without thier antacids, most big drug companies would see their revenues halve and profits wiped out.

but yes, most western people have developed to allow lactase to be continued to be produced by the body after weaning. usually this enzyme is stopped being made after weaning but as dairy has been part of western diet for so long around 90% of babies continue to poroduce this enzyme. in black and asian people this percentage drops to as low as only 10%. In the 10% of babies who stop producing lactase, they are the ones who will develop colic more and are more likely to develop food intolerances to dairy and have the mucos problem. lactase is the enzyme that breaks down the sugar in milk, lactose. other substances in milk that affect us are the protiens like casein but this is less of a problem than the lactose.