| My son had reflux, among other things, and was on Pregestimil with added
rice for weight. We started him on fruits and solids when he was around
8 months old, but as I recall, we just did cereal for about a couple of
weeks and then moved on to fruits and vegetables. It's possible that your
daughter is just not ready for fruits yet, so maybe waiting a while and
trying again will work better for her. I know that that has worked
for other people. In our case, we were lucky that once he outgrew the
reflux (which was before we started moving on to the solids), he did
fine with digesting anything we fed him. I wonder if there's a connection
between still having the reflux and not taking to the fruits? Maybe
waiting til she outgrows the reflux will be all she needs.
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I hope you are in the MAJORITY in that your child
outgrows the reflux. Unfortunately, our Chris is not
one of them (He didn't outgrow the heart arythmia
either, which most do) The reflux is an ongoing
problem for us.
Chris started showing the same symptoms you describe to the
point where at 10 months everything he ate was returning within
� an hour. Most of the time this was preceeded by a coughing
fit. It got to the point where anytime the poor kid coughed,
he was swooped up and dashed to the nearest available
sink/toilet/easily cleanable area.
A biopsy revealed that he had Esophagitis, an
inflammation of the esophagus caused by stomach acid backup.
As it has been described to us, this can be a Catch-22
situation. When the esophagus becomes inflammed, the
one-way valve (hiatal hernia? sp?) at it's base
stops working, allowing acids from the stomach to
back into the esophagus, causing it to be inflammed...
In some small children, it sometimes takes awhile for the
flap to start working. When it does (for most), everything
returns to normal operation.
In Chris' case, for reasons still unknown, this has not
happened. There are several medicines available to treat
the problem. As with many medications, some work with
some people, some not. We went through 4 of 4 available
treatments before finding one which worked for Chris
(Reglan. We also had tried Tagametand Zantack)
He was put on both Reglan and Pepcid (my spelling of these
may not be accurate). One is used to reduce/eliminate
the inflammation of the esophagus, the other to cause
his stomach to more quickly digest food which reduces
the reflux.
In addition, we were sent to a respitory specialist. This
was a result of the coughing. The theory was/is that the
Esophagitis/reflux may just be a symptom of another
problem. The coughing may bring on the reflux which
brings on the Esophagitis... After some tests he said
that we may be dealing with "hyperactive airways"
He prescribed an inhaler (I forget the name of the
medication). He explained that this was both a
diagnostic and treatment related medication. I.e.,
if nothing changed, he could rule out his hypothisis.
If he was right, the medication would help correct the
problem.
After 1 month of this treatment, the outward symptoms
cleared up. The episodes of vomitting decreased to
none. And the coughing went away. And we felt maybe
we were finally making progress. However, after ~4
months he started regressing again. Another biopsy
revealed that the Esophagitis was not getting any better.
Back to the hospital for another test. In this one,
a small tube is fed down his nostril into his stomach
and a ph monitor attached. He was then monitored
for 8 hours and different dosages of the medication
administered to determine effectiveness. It was
determined that the Reglan was working but that
the dosage was not high enough. So they increased
the dosage and sent us away for another 6 months.
Last month, he went back for another biopsy. Still
no improvement in the Esophagitis. :-( Yet another
ph probe test, this time for 24 hours. It revealed
that while the reflux and acids were being supressed
for most of the day, there was still a 3-4 hour period
when it wasn't. They need to see at least a 22 hour
clear period before healing will begin.
They then proposed a new medication, Prilosec
(Onaprazole). This has been approved for adults
but is still experimental in children. They have
had success with tough cases (Chris now qualifies).
The downside is that it is potent stuff. He can
only stay on it for 3 months at most. Any longer
could start affecting the function/structure of
the stomach. He also needs to have a blood test
every two weeks to monitor the level and effects.
He went back for another ph probe test last week.
At least they let him come home this time for the
24 hour period. The medication is working. Now we
wait again to see if it can control the inflammation.
If it does, after 3 months he returns to the Reglan/
Pepcid which does control it once it is healed.
The ph probe was certainly revealing! When he went
to bed, the ph reading was 5.6. When he got up it
was 1.6!!! I can't believe that our stomachs can
routinely handle acids that strong!
This has all been very frustrating to say the least.
Until the Esophagitis can be cured, they can not
tell whether the reflux will go away (doubtful) or
what could be causing it. The problem is that the
Esophagitis masks/clouds any other testing. If we
could only break the cycle. The alternatives after
this get pretty ugly and I'd rather not even think
of them just yet.
At this point the poor kid gets medication all day
long.
Digoxin for his heart arythmia - twice a day
Pepcid - before every meal and at bedtime
Prilosec - twice a day
And the inhaler - four times a day
Lyn and I have strongly considered investing in
CVS stock.
Oh, by the way, did I also mention that he had a
multi-cystic kidney removed at 4 months?
Despite all of this, Chris is a perfectly normal 3�
year old boy who can keep up with the best of them.
I should also say that our health plan (Harvard
Community/Acton Medical) has been great! All this has
been done at the New England Medical Center (Floating
Hospital) with consulting at Childrens (where his heart
and kidney work has been done) There has never been
a question about the referals or medication costs.
Now the kicker. His brother Reid, six months, is
beginning to show the same symptoms. While at the
hospital last month, Lyn spoke with a mother of
a 9 year old who was waiting with her. His reflux
had finally gone into remission at 4, but had
mysteriously just returned. And our specialist
told us that this does seem to run in families.
It's too early to test Reid. I'll keep you posted.
This was more long winded than I intended. If anyone
else has shared similar experiences, particularly
successes, I'd love to hear them.
Mark
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| Jodi,
Thanks for the note and your concern. Glad to hear your daughter
did outgrow it.
We have been delaying testing Reid for two reasons; foremost, his
problem/symptoms are no where near as severe as Christopher's.
We are still trying to figure out whether this is just normal
baby spitup and we are being paranoid or if he has a problem
(it does seem to be getting better). Also, with all that has
been going on with Chris, Lyn didn't want to deal with the
testing until after the holidays. Since it isn't critical, I
agree.
As far as the heart arythmia, this is the first I have heard
about reflux and a heart arythmia being related. Interesting.
We will discuss it with the doctors next time we are together,
more for interest than anything else. In Chris' case, I believe
they are unrelated.
As soon as Chris was born, his heart rate shot up to 300 beats/min.
That was an interesting 2 hours after delivery until massive
amounts of digoxin brought it under control.
He has a condition refered to as "tachacardia mumble mumble".
The theory is that he has some extra nerve circuits in his heart
that cause two beats for every signal (a normal newborns heart
rate is ~ 150 beats/min.) Relatively, this is not that uncommon
(about 1% of births). A place like Children's see's these cases
all the time. And, in about 90% of the cases, the child outgrows
the condition in the first year as the heart/nerves mature.
Guess which percentile Chris ended up in? )-:
He went through a series of stress tests when he was two. They
simulate increasing adrenalin (sp?) levels and monitor the heart.
If nothing happens, he is fine. In his case, he went into the
rapid pulse at the highest test level and only after about
an hour of testing. This said he hadn't outgrown the condition
but the odds of it ever happening are very remote.
When he gets older, we may be able to take him off the digoxin
if we want (we do!). If it happens, it is not life threatening
unless allowed to go on for >5 hours (the heart will fatigue)
Supposedly, when he is old enough to understand there are
relaxation techniques he can use to possibly stop the
event. And he would also be old enough to recognize the
symptoms.
Mark
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