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Acid reflux in infant - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: GERD
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2584 Questions
User :   Can I give my 8 week old baby milk of magnesia or maalox for painful acid reflux? He has been on zantac for 6 weeks with no success :(
Doctor :   Hi
User :   hello
User :   pleased to meet you!
Doctor :   May I ask you a few questions to undersatnd the problem better and help you better ?
User :   of course
Doctor :   May I know if it is Silent GER or GERD ?
Doctor :   Or Laryngopharyngeal Reflux or Secondary GER ?
User :   GERD but he doesnt vomit a huge amount usually, he spits up continuosly from one bottle to the next
User :   I dont quite understand the second question..
User :   He is on Neocate for suspected MSPI also, it helped a lot with his tummy pain and the mucous in his stool
Doctor :   Ok.
User :   He is back to the Paed in 4 weeks time to be reviewed but the poor little man is suffering so badly I hate having to wait that long. The infant gaviscon hasnt helped him and makes him very constipated.
Doctor :   It is very common in children who are not breast fed, not to worry.
Doctor :   I shall advise you on this
Doctor :   If Zantac has not helped much,
Prevacid (a brand of the proton pump inhibitor - lansoprazole). However, since acid blocking drugs interfere with the body's natural digestive process, important nutrients such as iron, calcium and folic acid are not absorbed well. Given the formative stage of baby's development this could be one of several undesirable side effects. As stomach acid also forms part of the body's immune system by killing undesirable bacteria in the gut, these drugs make baby more susceptible to stomach infections.
Doctor :   Please do not start on maalox now,
Doctor :   As it can cause unnecessary diarrhea in infants at this stage.
User :   Which is the "lesser of evils", taking a chance with a proton pump inhibitor or have him suffer so much? He cannot even sit in a bouncer chair for more than a few minutes and it starts bubbling up his throat, hurting him and causing really awful hiccups that agravate it even more :(
Doctor :   I would say taking a proton pump inhibitor, and as i suggested , it is an undesirable side effect but we have to cope up with it as we cannot see the baby undergo the agony, so please give important nutrients such as iron, calcium and folic acid as drops or substitutes.
User :   Never mind lying on his back, he can just about stay on his back long enough to have his nappy changed! He also sleeps on his tummy :(
Doctor :   Dont worry, please follow some more tips that i enlist : Doctor :   1.Handle baby gently and burp often.
User :   We do :)
Doctor :   2.Try to keep baby in an upright position during and after feedings.
User :   We do!
Doctor :   That is good.
Doctor :   3.After feedings, try holding baby upright for a half hour or let baby lie upright on your chest.A 45 degree incline would be ideal, since any more than that might actually put too much pressure on his or her stomach and make things worse.
User :   We also do this, on our chest is definately his most comfortable position
Doctor :   That is very good, please continue to do so, And hope as he grows it will decrease and he would get better.
User :   Hopefully but it is so hard to see him in pain and so exhausted but unable to sleep :(
Doctor :   In case he devleops a wheeze or pneumonia or any abnormal lung sounds or any chronic sinusitis or rhinitis, do take these as alarm signals and immediately see your Pediatrician.
User :   of course
Doctor :   Almost all babies of GERD, will have this problem which peaks form 1-4 to 8 months but as age progresses to one yr, most cases resolve on their own.
Doctor :   Please do continue with the medication, dont worry, before you change to the medication that i Have advised please discuss with the treating pediatrician.
Doctor :   Do you have anything else to ask ?
Doctor :   Thank you for consulting me.Take care.
Doctor :   Bye fo r now
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