my child has silent reflux? Help!

Hi,
My child is 3.5 months old. I believe she has silent reflux but not
sure. I did take her to GI ped. and he thinks it's silent reflux. He
put her on 1 ml of zantac twice a day (been 4 days now...) My child
refuses bottle when she sees it coming, even before she takes it. She
does not throw up but refuses the bottle. So, it's very hard for me to
feed her. The only time I can get her to feed is when she is deep
asleep. Therefore, I can't feed her in the daytime. It's a very
frustrating situation, because she is only taking maybe 10 oz in 24
hour period. I don't know what to do...do I need to tube feed her? I
do not want to force her to eat when she refuses, because I'm afraid
she might get food aversion and make situations worse. If you have any
suggestions, please help me. thank you.
Julie

In article ,
(julie) wrote:

Hi,
My child is 3.5 months old. I believe she has silent reflux but not
sure. I did take her to GI ped. and he thinks it's silent reflux. He
put her on 1 ml of zantac twice a day (been 4 days now...) My child
refuses bottle when she sees it coming, even before she takes it. She
does not throw up but refuses the bottle. So, it's very hard for me to
feed her. The only time I can get her to feed is when she is deep
asleep. Therefore, I can't feed her in the daytime. It's a very
frustrating situation, because she is only taking maybe 10 oz in 24
hour period. I don't know what to do...do I need to tube feed her? I
do not want to force her to eat when she refuses, because I'm afraid
she might get food aversion and make situations worse. If you have any
suggestions, please help me. thank you.
Julie

How is her weight? If you are breastfeeding (and I see by your
crossposting, that you are also posting there) how can you be sure she's
getting so little?

If her weight and energy level and all that are doing OK, I wouldn't
worry about the amount she is eating -- absent a serious problem, all
trying to force her to eat when she doesn't want to will accomplish is
to set food up as a power struggle. I know how hard it is to watch a
child that YOU think must be hungry not eat -- but it babies commonly go
through periods where you'd swear they are living on nothing but air!
(Breathaterians . . .) Trust her to know if she's hungry, don't try to
force her to eat, and pay attention to her general health, not to how
much she's eating.

meh
--
Children won't care how much you know until they know how much you care

"julie" wrote in message
om...
Hi,
My child is 3.5 months old. I believe she has silent reflux but not
sure. I did take her to GI ped. and he thinks it's silent reflux. He
put her on 1 ml of zantac twice a day (been 4 days now...) My child
refuses bottle when she sees it coming, even before she takes it. She
does not throw up but refuses the bottle. So, it's very hard for me to
feed her. The only time I can get her to feed is when she is deep
asleep. Therefore, I can't feed her in the daytime. It's a very
frustrating situation, because she is only taking maybe 10 oz in 24
hour period. I don't know what to do...do I need to tube feed her? I
do not want to force her to eat when she refuses, because I'm afraid
she might get food aversion and make situations worse. If you have any
suggestions, please help me. thank you.
Julie

As the GI doctor for a different medication if you think the medication
isn't working but you might want to give it another week or so on the zantac
because it's one of those things that you're not going to see an overnight
difference with. Zantac did absolutely *nothing* to help my daughter's pain
from the acid reflux and her prescribed regimen of giving it 1/2 hour before
meals and at bedtime was too difficult to follow given her strange
feeding/sleeping schedule. Prilosec can be compounded into a suspension
(but it's very expensive) and prevacid has a powder that can be mixed with
water into a yummy strawberry flavor. Both only have to be dosed about
every 12-24 hours. By the time my daughter was put on prilosec (she's now
on the prevacid), she was over 3 and had developed a nasty case of corrosive
esophagitis and was very averse to eating anything because of the pain she
experienced shortly thereafter. NG-tubes work well int he short-run (she
had one from 5mo-9mo then got a g-tube), but they can cause sensory issues
in oral-motor development that are sometimes difficult to overcome later
when moving on to table foods. (i.e., don't want anything coming near their
face like a spoon or fork during feeding or becoming averse to
toothbrushing, etc.)

Other general tips for helping keep the acid down is to put the baby in a
car seat or bouncy-seat for at least 1/2 hour after feedings to let the food
get past the stomach so that the acid doesn't come up. Even carrying the
baby around can exacerbate the problem during that first half hour.

Leigh in raLeigh
mom to Aaron (8yo, ADHD) and twins
Edward (4 1/2) and Claudia (4 1/2, Down syndrome, reflux due to
hypotonia)

"julie" wrote in message
om...
Hi,
My child is 3.5 months old. I believe she has silent reflux but not
sure. I did take her to GI ped. and he thinks it's silent reflux. He
put her on 1 ml of zantac twice a day (been 4 days now...) My child
refuses bottle when she sees it coming, even before she takes it. She
does not throw up but refuses the bottle. So, it's very hard for me to
feed her. The only time I can get her to feed is when she is deep
asleep. Therefore, I can't feed her in the daytime. It's a very
frustrating situation, because she is only taking maybe 10 oz in 24
hour period. I don't know what to do...do I need to tube feed her? I
do not want to force her to eat when she refuses, because I'm afraid
she might get food aversion and make situations worse. If you have any
suggestions, please help me. thank you.
Julie

Call the doctor. Ask her what to do.

On Sat, 15 Nov 2003 18:35:44 GMT, "Leigh Menconi"
wrote:

Other general tips for helping keep the acid down is to put the baby in a
car seat or bouncy-seat for at least 1/2 hour after feedings to let the food
get past the stomach so that the acid doesn't come up.

This sounds like a good idea, as does the idea of strapping a child
onto a wedge at night, but I've read two studies that demonstrated
that at best it does nothing, at worst it makes reflux worse. I can
get the citations next week if you like.

PF

On Sun, 16 Nov 2003 02:00:24 GMT, (PF Riley) wrote:

This sounds like a good idea, as does the idea of strapping a child
onto a wedge at night, but I've read two studies that demonstrated
that at best it does nothing, at worst it makes reflux worse. I can
get the citations next week if you like.

Those sound very interesting (not to mention counter-intuitive). I'd
like to see those, especially if they also say anything with respect to
keeping the kid vertical as opposed to partially horizontal for that
half hour. Thanks PF.

"Kathy Cole" wrote in message
...
On Sun, 16 Nov 2003 02:00:24 GMT, (PF Riley) wrote:

This sounds like a good idea, as does the idea of strapping a child
onto a wedge at night, but I've read two studies that demonstrated
that at best it does nothing, at worst it makes reflux worse. I can
get the citations next week if you like.

Those sound very interesting (not to mention counter-intuitive). I'd
like to see those, especially if they also say anything with respect to
keeping the kid vertical as opposed to partially horizontal for that
half hour. Thanks PF.

The thinking is that many of these bouncy chairs and car seats allow the
kids to slide down in them and become "smushed". When you see one of these
kids in this position it is not hard to imagine that the intra-abdominal
pressure is increased. Presumably, something that keeps the head elevated
and the back straight, without folding over the middle, would be better.

--
CBI, MD

On Sun, 16 Nov 2003 19:01:05 GMT, "CBI" wrote:

The thinking is that many of these bouncy chairs and car seats allow the
kids to slide down in them and become "smushed". When you see one of these
kids in this position it is not hard to imagine that the intra-abdominal
pressure is increased. Presumably, something that keeps the head elevated
and the back straight, without folding over the middle, would be better.

That makes sense; the wedge part not helping doesn't make sense to me,
but I'd like to look at the studies. My youngest had what I understand
to be typical preemie reflux, and his isolette allowed his head to be
elevated, plus we used a firm wedge at the head of his crib mattress for
a while.

On Sun, 16 Nov 2003 14:39:17 -0500, Kathy Cole
wrote:

On Sun, 16 Nov 2003 19:01:05 GMT, "CBI" wrote:

The thinking is that many of these bouncy chairs and car seats allow the
kids to slide down in them and become "smushed". When you see one of these
kids in this position it is not hard to imagine that the intra-abdominal
pressure is increased. Presumably, something that keeps the head elevated
and the back straight, without folding over the middle, would be better.

That makes sense; the wedge part not helping doesn't make sense to me,
but I'd like to look at the studies.

The wedge part would make sense if you presume that gastroesophageal
reflux is largely influenced by gravity. I honestly think it is not.

PF

"PF Riley" wrote in message
...
On Sun, 16 Nov 2003 14:39:17 -0500, Kathy Cole
wrote:

On Sun, 16 Nov 2003 19:01:05 GMT, "CBI" wrote:

The thinking is that many of these bouncy chairs and car seats allow
the
kids to slide down in them and become "smushed". When you see one of
these
kids in this position it is not hard to imagine that the
intra-abdominal
pressure is increased. Presumably, something that keeps the head
elevated
and the back straight, without folding over the middle, would be
better.

That makes sense; the wedge part not helping doesn't make sense to me,
but I'd like to look at the studies.

The wedge part would make sense if you presume that gastroesophageal
reflux is largely influenced by gravity. I honestly think it is not.

PF

I do think it is largely *influenced* (not caused) by gravity since in many
cases, the problem is the immaturity or hypotonia of the sphincter between
the stomach and esophagus. A child whose sphincter closes off properly
after feeding would not have problems in a horizontal position. In my
daughter's case (hypotonia related to Down syndrome), her entire digestive
system is slow due to the hypotonia so the acid remains in her stomach even
longer than most (which is why she suffers from constipation on the other
end). I agree that an improperly seated child (car/bouncy seat) could slump
down and this slumped position could exacerbate the problem; proper
positioning and propping up with rolled up towels to prevent that solve that
problem.

Leigh