Omeprazole dosage for 7 week old with reflux

[Danielp87]

Hello, I have a nearly 7 week old daughter, she has just been diagnosed with cows milk allergy and reflux. She has just been prescribed Aptamil Pepti 1, omeprazole 2mg and 1.5ml dosage, we are using carabel to thicken her formula.

I have a couple of questions hopefully people with experience can help with. We are unsure if the dosage is strong enough for omeprazole, I don’t want to find out a month down the line with no changes that she should be on a higher dose, if anyone else can help with their dosage.

also using the carobel to thicken the formula, how many scoops would you recommend for 4oz, it doesn’t seem to thicken up much after using 2 scoops and waiting 10 mins.

we cannot put her to sleep for more than 10 mins in her Moses basket, so the days and nights are awful, we tried the gaviscon but it just gave her severe constipation. We just want to see her be happy and pain free.

thank you.

Do you have the omeprazole suspension or tablets? I think the suspension is 2mg/ml so 1.5 ml would mean your baby is on 3 mg which seems about right as a starting dose. You always start low and it increases depending on weight and with time. My baby started on 2.5 mg at 2 months and at 3.5 months was increased to 4 mg. I hope to keep it this low and continue to monitor symptoms as the higher you go, the harder it is to wean off and also Alder Hey told me it also causes tummy discomfort with the higher doses so it’s weighing up the benefits for reflux over tummy discomfort. The max dose a baby can go on is 20 mg a day I think.
carobel wise, again the infant feeding team at Alder Hey told me you don’t want it so thick like custard and to always still expect some sick as that’s normal for babies. When we used it, I added a heaped scoop to 5 oz and told the infant feeding team and they said that was ideal. So for 4 oz I’d try a scoop but I see that’s not working.
However, I would say it may not be the carobel or omeprazole that’s the issue. My baby was first put on Nutramigen formula and did really well for about 3-4 weeks until symptoms started returning. He was eventually put on the amino acid formula Neocate (the next step up from things like Aptamil Pepti 1) and is a different baby! Far less reflux to the point we don’t even thicken the very thin formula and can be on his back no problem now. So maybe your LO needs to try the next stage of formula for cmpa to be comfortable.

With Omeprazole they start off on the lowest dose possible and then increase it gradually until you notice a marked improvment.
It can take quite a while to get the dose right though and as baby grows, you have to keep increasing it.
DD was prescribed the tablet version which is dissolved in water and syringed into her mouth.
She was started straight on 10mgs. It worked immediately for her but we were advised it normally takes 6 weeks to get a full effect from it.
She is now on 15mg.
The highest dose is 20mg.
Im hoping we can stop it once she is weaned.
Youre very lucky to have the liquid version of Omeprazole though! We were told we had to dissolve tablets as the liquid only comes in big bottles and cost over £100 each!!!

I cant comment on the thickener though as we havent had to use that luckily.

Thanks for your replies. Yes she’s on omeprazole suspension, I was confused as it says on the bottle it’s 2 powders and add 64ml of water to the bottle, I shook it and it sounded like liquid, so had to ask the chemist if they added the water and they did. The doctors were useless at first it wasn’t until the health visitor came and got in touch with the doctor and we were prescribed omeprazole and the formula. Someone at my work had used neocate with great results so maybe we have to go down that route. She’s been pretty bad this weekend, seems to be crying and murmuring constantly and won’t settle. I just went her to be out of pain and get her sleep. Does the neocate need thickening too.

A lot of people do thicken it as it is so thin. Like I said we tried carobel but he seemed to be more unsettled when we used it and turns out some babies can also react to carobel! I spoke to the infant feeding team and it seems in the UK the only things you can thicken it with or use to help keep the milk down is carobel or gaviscon.
In the end we just used neither and maybe because he’s a bit older or maybe it’s because a lot of the reflux in cmpa babies is caused by the allergy so now he’s on the right formula his body isn’t trying to push it back out but his reflux isn’t that bad anymore (unless you pick him up too quickly and it all comes back up 😂) so we don’t thicken the neocate. Plus as long as he’s putting on weight and isn’t in pain from the milk coming up (which he isn’t) I just accept the sick now haha.
you could also try a slower teat with the thinner milk. We also did that until he became too frustrated with the flow but it helped him not to choke on such thin formula and help him take his time.
I completely understand how you feel. It’s very upsetting watching your baby be in pain and not knowing how to fix it or getting it fixed takes time and trial and error. Even at 4.5 months old, I dread feeding times and whenever he cries, I immediately panic and worry it’s reflux pain or tummy discomfort and don’t know what to do even though he’s on everything he can be to help things. It’s also very exhausting so make sure you try and take time for yourself as well.

Hiya, I know this was posted a while back but what was your consistency of the oral suspension omeprazole? The first lot I was given was like water but I've got a different one now where you mix two powders with 64ml of water and it's white and thick (bit like Calpol consistency). Is that right? Don't want to give to my LO in case it's not correct. Thank you

Firstly aptamil pepti one isn't the right formula for cmpa - we are on that and my DR is adamant she doesn't have cmpa - I would agree to but at the time I was wondering
Pepti still has cows milk in so if she has an allergy she shouldn't be on this

I use carabel and 2 scoops is perfect for 6oz
Shake well for 1 minute and leave 6 mins so not sure why it's not thickening for you x