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Pediatrics/7 week old with bad reflux

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Question
Hello,

My son is 7 weeks this Tuesday. For the past two weeks he has developed terrible reflux. He will spit up after most feedings, sometimes two-three times. He cries for hours,3-4 hours straight in the morning and most evening. It is very difficult to get him to eat. He will cry and scream while feeding and move away from the bottle. Although he latches on to his pacifier or bottle with water very quickly. We took him to our pediatrician and she put him on zantac. We have been using it for 4 days but his eating has not improved and he has spit up 5 times this morning already. I have heard that soy based formulas cause constipation which we already have an issue with (going on 36 hours with no dirty diaper). I was considering Similac alimentum ready to feed. Can you advise? Also i have read online that many people move from Zantac to Prevacide.

Thank you
Nick

Answer
Hi, Nicholas,

I am answering this assuming he does indeed have reflux.  It would be unusual for a formula intolerance to present like this at this age. If one would think it would be a forumula intolerance, than virtually all will be better on a protein hyrolysate formula like alimentum.  

Be sure the dose it at a 5-10mg/kg/day level.  If it is and this is really GERD, then is this dose is not working, what most of us would do is add a Prevacid/Prilosec type of meds.  The Zantac should be working, at a high enough dose, after 3-4 days.  

Occasionally babies will have something that looks like GERD, like eosinophilic esophagitis, but will not respond to standard GERD meds.  

Hope these thoughts are of help to you.  Send me an update on how it all turns out.

Good luck, Dr. Olson

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David Olson, MD

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I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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