Friday, June 26, 2009

Reflux for Dummies

I had heart burn almost the entire time I was pregnant.

It started at 6.5 weeks. I was on vacation, and really thought that I may have caught some sort of Mexican fire breathing disease while on our cruise.

After that? I started sleeping in the big comfy chair in our living room. Sitting up like the elephant man. For the next thirty weeks.

No amount of Tums Smoothies could tame the fire breathing dragon living in my uterus (but those things taste like candy and sometimes I still eat them because they don't have very many calories and my thighs are YOUGE and don't really fit in pants).

So I'd like to think karma is biting Olivia in the ass with this whole reflux thing. And normally I'd be really excited to see someone Get Theirs. You know, like when someone rides your ass for 20 miles, passes you, then gets pulled over. Stuff like that.

Knowing what it feels like to have a burning in your chest and throat as soon as you lay down? Makes it so sad to watch your baby writhe in pain while eating or trying to sleep. Many desperate visits to the pediatrician with little to no sympathy left me shaking my fists at the heavens and swearing like a trucker.

And threatening to shove a bottle of Mylanta directly up the pediatrician's ass.

It is possible that you have landed on my blog via Google (and Oh.My.Sweet.Baby.Jesus people come here from the CRAZIEST google searches. I need to do an entire post on that soon - an example? Big Clown Underwear). Perhaps you have searched for one of the following:

-My Baybee Breathes Fire: HALP!
-Why Does My Baby Have Reflux, Does God Hate Me?
-Is It Weird To Be Sexually Attracted to My Pharmacist?
-Will I Ever Sleep Again, If Not Can I Main Line Coffee Straight From My BUNN?
-Mylanta is Bullshit
-My Pediatrician is Useless
-Silent Reflux Is A Stupid Name Because It Makes Babies Scream
-I'm Getting Drunk, Who's With Me?
-Why Can't Dr. Google Prescribe Me Some Prevacid?

I did all sorts of desperate Google searches and found all kinds of really great information. And since I have so many important things that I don't feel like doing, I will sum it up for all you lazy whores out there...

Reflux doesn't necessarily mean ungodly amounts of spit up.

Olivia has silent reflux. She rarely spits up. Instead, the acid comes up her throat and then she swallows it. Because she loves to burn her throat twice?

So. If your baby arches her back and cries while eating (and for hours after), and refuses to sleep laying flat, but doesn't spit up? Be suspicious.

You know how you barf in your mouth sometimes? Olivia would kind of do that, make a sour face, then scream her freaking head off.

Get Thee to a Pediatric Gastroenterologist!

Much to my disappointment, I've found that doctors aren't really brilliant and caring. I mean, if you expect to go to your pediatrician and encounter some person who agonizes all night long over your babies issues? You're stupid. I know this, because I am stupid.

Your pediatrician is probably useless.

Pediatricians know the basics about reflux. They can give you limited solutions, and then will most likely give up, claiming that they've done everything and that it will pass when your baby starts to sit up or eat solids. OR TURNS ONE. And you will just have to deal with the crying (your baby's and yours) until it passes. (Vodka, anyone?)

My experience with my pediatrician ended when I was told to let my 3 month old cry it out because there were no other treatment options outside of Zantac or Pepcid. I had been asking for a prescription for something like Prevacid or Prilosec for over a month and was repeatedly told NO. "NO! Those aren't any more effective than Zantac!" Sensing my rage and fearing for his very life, he then made a call to a pediatric gastroenterologist and got me an appointment the next day.

If loving the pediatric gastroenterologist is wrong? I DON'T WANT TO BE RIGHT. More on my infatuation later...


Zantac is an Asshole.

There are a few ways to treat reflux.

1. The first line of defense: Mylanta and Rice Cereal. The Mylanta is supposed to coat your baby's throat, the rice cereal is supposed to hold the food down.

(Psh. Whatever. I'd like to know if this ever worked for anyone. It gave Olivia HORRIBLE stomach cramps.)

2. Next! Zantac or Pepcid.

These types of drugs are H2 blockers - they are supposed to block the acid from shooting up your baby's throat and causing Screamapalooza.

I've found that this is a temporary solution to a somewhat permanent (in the short term) problem. They are really weight sensitive and need to be increased with weight gain. And they tend to become less effective when your baby takes them for an extended period of time.

Olivia was on Pepcid for a week with ZERO improvement. We switched to Zantac, because we love futility, and that worked for a week, then quit working. Then we'd up the dose, which would sort of work for a week, then stop working. When we finally quit using Zantac, her dose had quadrupled over a month. Stoopid.

3. FINALLY! Prevacid or Prilosec.

Mmmm...the good stuff. Like tasting Grey Goose after living on the $3 bottom shelf vodka.

These are Proton Pump Inhibitors. They mean business. They stop the production of stomach acid altogether. Which makes sense, right? Just shut that shit down! Nip it in the BUD!

We've been giving Olivia Prevacid for a few weeks now, and things for her have dramatically improved. We did have to up her dose once already, but she has gone from eating 13 ounces of formula per day, to 18-20. And she almost never screams and arches while/after eating.

We have also been trying to transition her to sleeping on her back. And I'd write about that now, but I think that it would be better with pictures, which I don't have because I am too busy and important to have taken them already. Plus it's so much more fun to write blogs with impossibly long sentences.

(She was also switched to Nutramigen AA Lipil formula - AKA The Lexus of Formula - and that helped too. More about that later, too, because if this post gets any longer, people will probably come set my house on fire.)

**Next post will finish this up, and will have lots of linky goodness.**

26 comments:

Anonymous said...

Hi Jen - love your blog, have read for the last year, your post with the high waisted mommy jeans made my husband pee his pants. Anyhow, I've been following Olivia's reflux issues - I'm a family nurse practitioner - and I have prescribed zantac, but when that doesn't work, refer out to Ped GI specialist. The bummer for us, is the specialist is a 3 hour drive one-way, so it's a pretty big deal. So - I'm curious about what the GI told you about the prevacid: risks, absorption problems, long-term treatment or only for a specified period of time, will there be a trial taper and when, etc... (Just selfish questions to help me at my job:). And curious if she got an ultrasound to look for pyloric stenosis, maybe she did and I missed it. Hope the medicine continues to work and hope the back sleeping is successful. And really, good luck with everything. BTW, I felt the same way about returning to work, it was a given and I knew I needed it for my family and my personal mental well-being... Emily

MagaliesGarden said...

Oh Jen, reading your posts is like seeing a possibility of my future. I'm nearly well-done (38 weeks prego) and I have had excruciating heartburn forever. Pepcid should be called Poopsid because it's worth just that...it's not working for me and I cannot imagine being a baby and suffering with this. You have me thinking that perhaps my baby will be born with Silent Reflux as a result of my Pepcid popping addiction - and I'm afraid. Oddly enough my relief is coming from a small glass of milk with a tablespoon of honey mixed into it - that is holding back my lava for just long enough to stop crying. Thanks for all the details on how to combat this for babies because I think I might be referring back to these once she breaks out of uterine prison and turns on the acid machine. Hang in there...despite her volcano-esque tendencies Olivia is a darn cutie patootie...more pictures!

Heather

Stacy Woodruff said...

Did you really suffer through your entire pregnancy with heartburn like that and not demand something better? I have heard of lots of women doing this, because their OB initially says Tums or Rolaids only, but my OB assures me that this is complete bullshit. Nexium is my friend. I have fire-breathing disease even when not pregnant, but when I finally got pregnant, I tried to do the tums thing for the sake of the baby. I lasted for about 2 weeks before I had to switch to ranitidine(zantac) and then about 2 weeks more before I had an appointment with the gastroenterologist who in conjunction with my OB assured me that Nexium would be just fine because bleeding ulcers are bad. Since switching back to the Nexium, I have not had heartburn at all, and I am now 33 weeks along. Life is good, baby is healthy, and I do not breathe fire. If my baybee should have reflux, I will kick and scream until they put him on the good stuff.

Sandy said...

How you can go through all of this and still make me laugh is beyond me.

Google searches are HILARIOUS. I just blogged recently about what happened when I used google to find out what to feed a baby on a cruise.

battynurse said...

What a dumb ass pediatrician to say that prilosec is no better than pepcid. Totally different medications. And if Pepcid was so freaking wonderful they wouldn't have bothered to create prilosec and nexium.

Peeveme said...

So glad you found something that works. What relief for all of you.

And pleeez do a post on search words. Mine are crazy (Lord help the poor saps who were looking for a nice benediction and landed on my blog) so your must be...really out there!

SmartAssMom said...

You could try a lactose free formula like Enfamil Lactose Free...it's like the Audi of formula - not quite the Lexus, but more than the Honda.

That combo and Zantac finally helped my daughter's silent reflux. If you call grunting silent. Which I didn't, by the way.

sarah said...

At two weeks my (mack ass) Pedi Rx'd Prevacid for my baby's acid reflux. He had the horrible arching back terribleness and ate *ALL* the time (cause it helps make neutralize the acid.)

He is a month old old and is more comfortable but we are still having a problem with a comfortable sleep position. I think you are about to post about this...

I'm REALLY hoping you have some great advice.

No pressure....

Meghan said...

Hi Jen, I too love your blog and since we both have the kids with GERD and have the same docs with no brains except in their #$@...well anywho. I love reading where it all takes you and glad to know I'm not the only one ranting about my daughter's fight with the docs online and how frustrating it is to have no answers from those that are supposed to be "in the know". We too have done the Zantac, Nutramigen...battle and now are on Prevacid daily but alas my daughter ended up with an NG tube last month due to her other complications. The Prevacid did help I only wish we too had been given it sooner rather than later...do they like insane mothers showing up in the docs office with screaming tired,hungry babes??? Sometimes I would love for them to spend a day in our shoes with these kids to see what we live with each and every day.

Meghan said...

Hi Jen, I too love your blog and since we both have the kids with GERD and have the same docs with no brains except in their #$@...well anywho. I love reading where it all takes you and glad to know I'm not the only one ranting about my daughter's fight with the docs online and how frustrating it is to have no answers from those that are supposed to be "in the know". We too have done the Zantac, Nutramigen...battle and now are on Prevacid daily but alas my daughter ended up with an NG tube last month due to her other complications. The Prevacid did help I only wish we too had been given it sooner rather than later...do they like insane mothers showing up in the docs office with screaming tired,hungry babes??? Sometimes I would love for them to spend a day in our shoes with these kids to see what we live with each and every day.

Meghan said...

Hi Jen, I too love your blog and since we both have the kids with GERD and have the same docs with no brains except in their #$@...well anywho. I love reading where it all takes you and glad to know I'm not the only one ranting about my daughter's fight with the docs online and how frustrating it is to have no answers from those that are supposed to be "in the know". We too have done the Zantac, Nutramigen...battle and now are on Prevacid daily but alas my daughter ended up with an NG tube last month due to her other complications. The Prevacid did help I only wish we too had been given it sooner rather than later...do they like insane mothers showing up in the docs office with screaming tired,hungry babes??? Sometimes I would love for them to spend a day in our shoes with these kids to see what we live with each and every day.

Anonymous said...

Most conventional health care professionals wont agree with this but...

I have found that reflux is often a cow's milk intolerance. This includes all cow's milk products. As you know, if you're nursing, she's eating what you're eating.

Reflux or spitting up is a baby's only way of rejecting something their body can't handle. If it is a milk intolerance or allergy, it can eventually turn into eczema, then respiratory issues like asthma and allergies, chronic ear infections & colds, etc. You might want to try an experiment and avoid dairy products yourself and see what happens. She'll thank you for it and you might be surprised by feeling better yourself. It might sound crazy but it worked for me and several other mom's I know.

calliope said...

awesome post!
We are dealing with the reflux over here too. It isn't as bad as what you guys are going through (oh man does it sound bad) but it still sucks. We also have this weird connection between gas & reflux. W would need to burp and couldn't so then the food and acid would just sort of pool with no where to go...ok just stopped myself from writing out our entire issue. But just wanted to sort of do the nod of recognition.

Tiffanie said...

well, i am glad that you may have found a solution for olivia:)

smittenkitten05 said...

My son had silent reflux too, but fortunately for us, our pediatrician was incredibly caring and flexible. He told us that the best treatment option was Zantac combined with Prevacid or Prilosec, which we've been doing 2x per day since 3 months (he's 9 months now).

Secondly, he encouraged us to switch formulas to Enfamil AR, which is thickened with rice. Like you said in your post, the idea is for the rice to weigh the stomach acid down and keep it from getting into the throat.

All of these things combined turned him into a completely different, happy baby. Good luck to you, I hope you find something that helps Olivia!

Jojo said...

Hi There
Long time reader of your blog...always amusing! My LO is about 6 weeks younger than yours. Like the previous poster, I had GERD going into the pregnancy. Before I was pregnant I took Prilosec OTC, but Dr suggested taking Zantac while pregnant. That only lasted a few months until I had my first gall bladder attck. I ended up on Prilosec til I delivered, and so far no ill effects in my little girl. Tums, Zantac, Pepcid are pretty wimpy in my opinion, and really only useful for episodic heartburn, no good when it is chronic. If it happens again to you, definitely use the good stuff yourself! Also, glad to hear that Olivia finally found relief...can't understand why the non-GE Drs wouldn't precribe the stronger stuff for her...maybe they need to drag stuff out for the money?

andrea said...

i am so glad the new stuff is working.
G seems to be hanging in there with the Zantac...but I think that is all about to change though since everyday she cries a little more...

i am glad you posted this!

Sally said...

This makes me want to go make out with my pediatrician. We took one of our boys in with reflux, and he prescribed Prevacid right away. He said we could start with something milder, but they usually didn't work so there was no reason to waste time.
He took Prevacid every day for about a year, and never had any problems, aside from some gross poop. I heart Prevacid and I'm so glad you got your sweet little girl some. Also, it tastes like candy.

See Sherm Blog said...

I was just given this link to your blog because I am going through the same thing with my little guy (who will be 6 weeks old on Monday) and have been posting about it on my blog. We were first told to use rice cereal with breast milk and that was a nightmare. And now he's been on Zantac for 2 days... and I haven't seen much help. I swear gripe water works better than that crap. My doctor was soooooo hesitant to even give me Zantac though, I'm worried she'll turn me down the second I mention Prevacid. She wanted me to give rice cereal TWO WEEKS until I cried and said I cannot physically pump ALL DAY LONG and that it wasn't working for Rowan anyway.

Somehow I feel like she thinks I'm crazy when I start off with "I read on the internet that..." and she disregards my findings. The Zantac has actually seemed to stop the massive spit ups a bit, but the screaming is still there. And it breaks my heart. I'm not sure how long I'm supposed to give this stuff either before I can really confirm its not working for boy.... and I demand something more powerful.

Anyway... I enjoyed this post. It was very helpful info. Thanks!

Anonymous said...

Hi Jenn...frequent lurker. My (now ten year old!) baby had reflux to beat the band. We slept sitting up together in the rocking chair for five months. Nutramigen with rice cereal did finally help, but by the time it did I was ready for the loony bin. I hope you have finally found the "fix" and Ms. Olivia gets better soon!

KimboSue said...

Glad I can always count on you for tried and true recipes for disaster...I mean healing babies. Will let you know if I have a Screamapalooza...

Parsing Nonsense said...

Oh my gosh, reflux is the WORST! I had it really bad in college and it's definitely the stuff of nightmares.

You could try switching her to an all-ice cream diet, that did wonders for my reflux :)

LStewart said...

If I didn't know better I would say I was reading the story of my grandson. He's pitiful. We have done everything under the sun and nothing seems to work. This week Zantac was introduced. Day one was awesome ... day two was 'ify' ... Today ... well today didn't start off the best in the world. We're going to take your advice and request a pediatric gastro visit. Lil Bit is due for his 4 month checkup next week. With a visit to the ER on Monday I realized he isn't growing and he seems to be H.U.N.G.R.Y! all the time. He will take a 6oz bottle and 4oz of it will come back up and the screaming ... OH MY LAWD! No wonder the little fella sounds hoarse. Luckily his Pediatrician will listen and it's not difficult to have him do what you want to have done so hopefully we'll see a peds gastro soon and Lil Bit will get to be the angel we know that he truly is ... minus the screaming and misery. Thanks for this information!

C said...

Hi, I just wanted to comment and thank you for this post. My 4 year old had reflux as a baby-with projectile vomiting. No mistaking it. I now have an almost 5 week old son who HATES the world. At least it seems that way by his incessant screaming all the time. But he hardly spits up. So I kept telling myself it was just gas. The worst freaking gas ever. Until I came across your blog. Today, I had enough. Went to the ped and they actually diagnosed him with silent reflux and gave me a prescription for Prevacid (wow! My daughter had to start with useless shitty tasting Zantac). So, we start the good stuff tomorrow. I just hope the dose will be enough for him.

Rebecca M. said...

I agree with the 2nd anonymous (June 26, 2009 7:13 PM) - most reflux issues, in adults and babies, is actually cow's milk protein intolerance. (This is not the same as lactose intolerance, which is exceedingly rare in babies but affects virtually all adults - as we grow older, we stop producing lactase, the enzyme responsible for digesting lactose, because only babies need to digest milk sugar.) Humans are not meant to consume cow's milk, which is produced for the nourishment of - wait for it - baby COWS. Human babies can receive cow's milk (and other offensive) proteins through their mother's milk, causing myriad health problems including GI issues. Dairy elimination requires 2-3 weeks to see full results, which most people - if they're even informed about this issue - aren't willing to try.

Most doctors don't know about this, but that's not because it's crazy Internet quackery. You have to realize, cow's milk has enjoyed a vaulted place in our public consciousness for decades (if not centuries) as a cheap, widely available source of nutrition - and oh yeah, because it tastes good. The modern dairy industry is incredibly powerful and working every day to keep cow's milk as a primary part of the American diet and keep any negative information out of the media and medical school texts. But talk to any doctor with a more holistic approach - such as a Doctor of Osteopathy - and you'll find out the well-researched truth. Cow's milk dairy causes more harm than good to most people. I know this personally - when I eliminated dairy, I was able to quit taking 3 prescription medications: one each for GERD, IBS, and allergies. It's worth considering for anyone - young or old - experiencing GI issues - or skin problem, allergies, etc.

Rebecca M. said...

I forgot to mention, seeing an improvement after switching to Nutramigen confirms the idea that the issue was cow's milk protein intolerance. Lactose-free formula would not help in this situation - or most situations, in fact - since the issue is the protein, not the sugar.