reglan

[Michelle]

Hello everyone, I have a 7 week old girl with reflux and has colic moments at random, sometimes morning, sometimes night. She is on reglan and zantac for the reflux. Sometimes she seems like she is still in so much pain. I have seem where people have noted scary side effects of reglan. I would like to know what those are and what doses they are giving there babies. I usually only give it to her once a day due to the forceful bm that usually follows. I also would like to know if prevacid is truly better than zantac.:confused: Do babies outgrow the reflux, and at what age? My baby is breastfed and I try to avoid gassy foods and caffeine. Help:conf4

[Roni]

It's important to remember that not every child will have side effects from Reglan, Shae was on it and never had any problems. But in answer to your question the side effects are as follows:

More common side effects may include:
Drowsiness, fatigue, restlessness

Less common or rare side effects may include:
Breast development in males, confusion, congestive heart failure, continual discharge of milk from the breasts, depression, diarrhea, dizziness, fluid retention, frequent urination, hallucinations, headache, high or low blood pressure, high fever, hives, impotence, inability to hold urine, insomnia, menstrual irregularities, nausea, rapid or slow heartbeat, rash, rigid muscles, slow movement, swollen tongue or throat, tremor, vision problems, wheezing, yellowed eyes and skin
In addition, Reglan may cause symptoms similar to those of Parkinson's disease, such as slow movements, rigidity, tremor, or a mask-like facial appearance.

Especially in older people, Reglan may produce tardive dyskinesia, a syndrome of jerky or writhing involuntary movements, particularly of the tongue, face, mouth, or jaw. In children and adults under 30, Reglan may cause involuntary movements of the arms and legs, and sometimes loud or labored breathing, usually in the first day or two of treatment.

Reglan may cause intense restlessness with associated symptoms such as anxiety, agitation, foot-tapping, pacing, inability to sit still, jitteriness, and insomnia. These symptoms may disappear as the body gets used to Reglan, or if the dosage is reduced.

Again, don't let that scare you too much, just decide how serious her symptoms are and if they warrant using the Reglan.

As far as the Zantac and Prevacid, yes, there is a big difference. Prevacid is a different class of drug altogether than the Zantac.

Zantac is an acid blocker (Histamine (H-2) blockers). This class of drug works to reduce the amount of hydrochloric acid released into your digestive tract.

Prevacid is a proton pump inhibitor and is perhaps the most effective way to reduce acid and relieve reflux pain. These drugs work by shutting down the 'pumps' in the acid producing cells in the stomach. This almost completely stops acid production. Proton pump inhibitors are typically tried after histamine blockers (Zantac) have failed, as the cost can be more than double that of the histamine blockers.

Perhaps switching from Zantac to Prevacid or Prilosec may help enough that your daughter won't need the reglan. Is she a puker?

Yes, she will outgrow it, probably around 7-12 months or so...although it will probably get easier to manage before that.

I hope this helps some...good luck.

Roni

[Michelle]

Thanks for the reply, it was very helpful. We called the Dr today who said that Previcid was not recommended for children under 2 years of age. She told us that she would have to send us to a Gastro Specialist and they may do it there, but she would not. We are not even sure if Sarah is that bad off, what are your thoughts on it, and is one more popular than the other? ( Prevacid or Prilosec), should we insist on a different medication?

[Roni]

Did he tell you that none of these medications are really recommended by the drug companies for children under two? They are all adult medications, unfortunately, the powers that be don't think that this condition warrants enough time and energy to develop meds for kids so we have to make do.

A GI will likely have no trouble prescribing the prevacid, if he won't just ask about Prilosec instead...actually, either one should work fine...they are both proton pump inhibitors. Shae was on Prilosec from the time she was almost 5 months old until she was almost two. Then I finally asked about trying Prevacid instead b/c she still seemed to be in pain. I can't really tell a whole lot of difference between the two, I don't think one really worked a whole lot better than the other, besides everyone is different. One person may swear by Prilosec and one person my swear by Prevacid, just a trial and error thing.

Again, as far as whether she needs it or not is more easily decided by you and your husband. Just decide how bad off she is, is she uncomfortable for an hour or so after eating sometimes or is she screaming in agony for hours on end every single day. Also, make sure you are already doing all the lifestyle and non-medicinal changes that you can on your end to help ease the symptoms. My daughter's website has a listing of all this if you need it. Also, PAGER (pediatric adolescent gastro esophageal reflux association) is a wonderful resource for information.

Hope that helps some.

Roni

[wardgirl]

Hi Michelle!
Will is coming up on 4 months old and has suffered with Reflux since around 2 weeks old. He started out on Zantac first and that didn't seem to be enough so the doctor put him on Reglan also. They just upped his dosage because he weighs 16 1/2 lbs now. He gets 0.9ml of the zantac and 0.5ml of the reglan. He is doing alot better on these medicines. He still has his bad days though where he pukes abit more. But in general I would say they have helped him.

I asked his doctor about seeing a GI doctor because his pediatricians have done all that they can for him. I wanted to see a GI doctor so I could maybe find out how severe his condition is and what do we have ahead of us. Plus, I would like to know if we are doing right by him with these medications. Maybe there is something else we should try. It took awhile to get an appt. and it isn't until March 10th. Even though he has been doing better I still want to take him. I have to admit the side effects of Reglan scared me abit when I just saw what Roni posted. I don't want my little Will to grow breasts! LOL...nervous laugh there! You are early in the game so if I were you I would try to get an appt with a GI doctor. I'm doing it because I feel like maybe I'll get more information and questions answered. I feel I should have done it alot sooner.

Mary

[Michelle]

Hi Mary, thanks for the reply. I want to know how it goes at the specialist for Will.:)
We are not really sure if Sarah needs to see the gi specialist or not. She has periods where she is real good and doesn't spit up or vomit at all, then she has periods where it seems like she cant hold a thing down. I would like to know what all the specialist can do that the pediatrician cant, as far as tests performed and treatment. Are the tests invasive or painful? What will the tests show? Are there more meds we can try?
Sarah has gained weight well, she was 5lb15oz at birth seven weeks ago. She now weighs approx 10lb. She goes to the pediatrician next week, so we will know exactly how much(1st set of shots then):cry4 She breastfeeds full time and is a vigorous eater, has been since day one. At three weeks is when the spitting up started, no big deal, all babies do this. Then it progressed to vomiting regularly, which was accompanied by crying at times. She also started pulling off at times and arching her back at feedings. We took her to the pediatrician and we had an ultrasound and upper gi done. The dr wanted to rule out pyloric stenosis. We started her on zantac and reglan. We have since stopped the reglan due to painful stomach rumblings and very loose stools. I think since breastmilk is like a natural laxative compaired to formula, the reglan stimulated her too much.
Anyway, she pukes everytime she is placed in her swing or carrier, which makes going anywhere stressful. She cries when she's put in them anyway. I think I'm the only person with a baby that HATES the swing witha passion!
Does your baby spit up milk curds? Sarah does and she always cries when she does, as if they are very acidic and burn. It breaks my heart and I feel helpless.:cry1
Sorry so long, just wanted to give everyone some background on my little drama queen.

Michelle

[wardgirl]

Hey Michelle!

Actually, Sarah sounds just like Will did at that age. Somedays he seems ok maybe alittle mouthful here and there comes up but other days he would projectile puke. Yes, it is very frustrating as he spits up alot of the times I put him in the swing but definately always spits up as soon as I put him in the carseat. He actually loves the swing though if he is in the mood for it.

About the GI doctor from what I understand they can go different routes as far as medications. I don't think the test are too invasive. I think they consist of ultrasounds mainly. Will's pediatrician had a upper GI done and it ruled out pyloric stenosis. LOL....I was so confused because I thought the upper GI was gonna tell me about his reflux then the doctor came out and said he doesn't have blah,blah,blah....and I was like "You mean he doesn't have reflux?!?" and the doctor said "oh, he very well may have reflux, we weren't looking for that!"

Will still has his good days and his bad days. Even with being on the medcines he rarely has a bottle where atleast a mouthful doesn't come up afterwards. Which I would say is normal for any baby pretty much. But then like last weekend he was spitting up all weekend. We were traveling alot though seeing family members so I wondered if it wasn't the traveling that made him spit more.

[Roni]

Michelle, the GI doctor can't really do a whole lot more than the pediatrician, they just have more experience with it and are more willing to try different medications. Ultrasounds aren't usually used to diagnose reflux. The upper GI is generally the first test used for it, although it's not the most reliable because the child has to actually reflux in the few minutes while the test is being performed in order for the test to come back positive for reflux. Since Sarah's already had the upper GI done there's no real need to do another one I wouldn't think. Perhaps a reflux scan? Very similar to the upper GI except that the bed they lay on records the reflux episodes over the course of an hour.

The other thing they could do is a ph probe, although that's a little invasive so I don't know that it would be that necessary. At any rate it's when a small tube will be placed through the nose into the esophagus. The test may be slightly uncomfortable while the tube is in place. Once the pH probe is placed, tape will be placed around the tube and on the nose to keep the probe in place. Placement of the probe in the esophagus will be checked. This may require a chest x-ray. The pH probe is attached to a recording box. The recording box has buttons that you will push during the study. The probe would be in place for about 24 hours.

You will keep track of symptoms, when you/your child eats, body position (lying down, sitting or standing) and peak flow measures using the buttons on the recording box. This will show haw many times the esophagus is exposed to acid in a 24 hour period.

Even more invasive than the ph probe is an endoscopy. The will be put to sleep and slide down a thin, flexible plastic tube called an endoscope down her throat. A tiny camera in the endoscope allows the doctor to see the surface of the esophagus and to search for abnormalities. If you have had moderate to severe symptoms and this procedure reveals injury to the esophagus, usually no other tests are needed to confirm GERD.

The doctor may use tiny tweezers (forceps) in the endoscope to remove a small piece of tissue for biopsy. A biopsy viewed under a microscope can reveal damage caused by acid reflux and rule out other problems if no infecting organisms or abnormal growths are found. I don't know that her reflux warrants a scope either but that's something to decide with your GI.

As far as more meds, generally the proton pump inhibitors that I mentioned above are the best line of defense and the last to be tried (because they are somewhat expensive). You should check out reflux.org (http://www.reflux.org) (the Pediatric Adoloscent Gastro Esophageal Reflux Association) for more information. Or you can can visit my website (http://www.infantrefluxdisease.com), there's information about all the diffierent types of medications that are used on that. The doctor will not have any more suggestions than the information that you will find within these two websites.

I hope that helps :) .

[analisa_roche]

Originally posted by Michelle
Anyway, she pukes everytime she is placed in her swing or carrier, which makes going anywhere stressful.

Hi, Michelle and everyone, I'm new here and so glad to have found you!

I'm wondering if you have tried a sling rather than the carseat for holding your baby when you are out? (Obviously NOT when you are in the car, though). :D