Omeprazole suspensions - ways to give

[Boodle17]

My 11 week old had been taking omeprazole suspension (not tabs/capsules) since week 5. He is breastfed so was giving it with half to 1oz of expressed breast milk OR formula if I hadn’t any expressed stuff.
He was taking it ok up until last week. Now he is totally refusing a bottle wether it has the omeprazole in it or not. We cannot for love not money get him to take it straight with syringe. It’s only 3mls. Tried pinching nose/blowing face/frida baby medication dummy, we even tried mixing it with a bit of sugar water in the syringe/dipping the frida baby dummy in s bit of sugar etc. he just leaves it at back of mouth and screams so he ends up choking in it and it’s very traumatic. I’ve never seen anything like it.
my question - can I mix it with say 10-15mls of apple or prune juice in a bottle?
or any other suggestions?
I know he’s only 11weeks and really babies shouldn’t have anything but milk until 6months but he really needs the omeprazole, he’s like a different baby with it so I’m willing to ignore the advice

Don’t put it anything especially not milk or juice. As you’ve found out they start to reject all bottles and juice is a no no for babies.
Use a syringe and squirt small amounts into the side of the mouth, rub under the chin keeping mouth gently closed. This will stimulate swallow refle. Repeat until done.

I'd just persist with the syringe. Keep aiming for back of cheek pouch, lots of blowing on face to get swallow going, then boob straight in mouth as soon as last bit is in. Or alternate bit syringed in and boob.

We use a medicine dummy. When tiny it was soooo much easier than just the syringe. Still do it this way at nearly 7 months

Thanks. I think I’d have to film it for people to believe me when I say how traumatic it is and how determined he is not to swallow. As soon as a tiny bit is in his mouth (I aim for cheek and far back) he just gets into a state and ends up inhaling it and it’s just not safe. In fact I’m pretty sure yesterday he inhaled some as he ended up really choking on it.
ive also tried syringing in whilst breastfeeding and it just puts him totally off a feed, cries until he’s exhausted then I have to let him sleep then feed him as I wake him up. He’s already having weight gain issues due to the reflux so he needs the meds.
apart from the advice that babies should t have juice etc before 6m a s there ANY other reason why I can’t try it with prune juice

I trained under one of the top
Paeds in Portland for reflux and he said that sometimes a 3/5ml of apple juice with crushed omeprazole would help to get the medication down

When I give I tuck baby under my arm. Slightly tilted with head down for gravity

Pin their arms down with my other arm and the syringe down side of their cheek and do it fairly quickly so that it is swallowed in one

It's a mean to an end

Same as putting nesquik in neocate - or drops of vanilla

better they have that to drink the milk if refusing with a cmpa then reduce the flavouring once used to it

Same with omeprezole. Yes ideally don't do it but not the end of the world if you do

Baby needs the medication

Thank you tfats so helpful. I think I’ll ask to try the tablets as he has the suspension abs it tastes like fishy menthol it’s horrid!

Before dissolving the tablet snap it in 2 and dissolve both bits. This exposes the beads to the water before the film on the tablet has pulled back and helps with absorbance.
Do 1 ml of recently boiled water then 9ml of cooled water this helps to get it into solution
Give it a good swirl before pulling up the syringe. If the solid blocks the teat of the syringe do not push it. Pull the syringe back and the pellet will go back into the syringe. You can add more water (plain water) to the syringe after you have drawn up the 3ml from the suspension to help give all of the medicine from that 3ml.

whilst the dissolving advice on this post is correct the amounts to administer is likely to be incorrect due to the prescribed amount and differing tablet strength. Just follow the prescription label

I only used 3mls as that is what is mentioned in the original post.
You take up what ever is prescribed. My daughter has been on it for 3 years with pretty every dose imaginable!

I understand but 3mls of a solution of 5mg in 5ml is obviously different to 20mg in 10mls so it’s important not to get that confused!

@Superscientist

please don’t do this - omeprazole is not evenly dispersed in water so you either need the suspension or a half a tablet for example. NOT 1 tablet in 10ms and take 5 ect.

This is very dangerous advice and babies have died from people not understanding strengths so always follow advice from a Pharmacist or Dr.

Apologies I didn't think anyone would be recommended to dissolve into 5ml as that is insane given the aqueous solubility of omperazole being just 0.3 mg/ml at room temperature and it's hard enough to get 10mg into 10ml as it should be in 30ml to fully dissolve!!
But that is ignoring that some GPs/doctors have little appreciation of the ADME properties of drugs. (I work in drug discovery)

So yes use substitute the 3ml and 10ml in my description for whatever your prescription says. If it is dissolved in 5ml and you find it is impossible to give speak to your GP or pharmacist to get the instructions adjust it. With my daughters latest dose what they GP prescribed just wasn't going to happen - dissolve 40mg in 10ml - there was no chance of this happening so they changed her directions to something more realistic.

Omeprazole comes in dispersable tablets or capsules both of which can be dissolved albeit the capsules take much longer. We routinely did this on the children’s gastro ward many years ago

Omeprazole solution comes in 1mg in 1ml 10mg in 5ml and 20mg in 5ml. With a tablet or capsule it really doesn’t matter what you dissolve it in as long as it fully dissolves and you give the correct mg/ml

@Wishiwasatailor

dispersible and soluble are 2 different meanings. Omeprazole is not soluble in water but does come as a dispersable tablet meaning if one table is dispersed in water and the while amount taken that is ok, but a proportion of that water cannot be taken.