Baby has acid reflux, help!

QUESTION: When my baby was 2 weeks old he was diagnosed with acid reflux. Since that time he has been put on Cimetidine and Propulsid four times a day. I have not noticed his spitting up to be getting any better; in fact, I believe it might even be getting a little worse.

We have taken him to a specialist at a local children's hospital and her advice was that as long has he continued to gain weight she did not see any reason to do any testing. She advised us to continue the medication in order to protect his throat. I left out of there still not satisfied and $200.00 poorer. With all the medicine my baby is taking should he still be spitting up?

Another question that I have is that lately my baby has gone from eating every 3 hours for twenty minutes at a time to eating every 3 hours for 5 to 10 minutes at a time. It does not matter how long he eats he still spits up the same amount. He seems to be satisfied and happy.

Is this normal?

Reflux is not normal, but you need an in depth explanation of what is happening to your baby and what the medications may do for him. Acid reflux is a description of what happens when the stomach acid is not contained in the stomach, but comes back up the esophagus. This can be due either to too much stomach acid, a poor sphincter muscle at the top of the stomach, or a combination of both.

The danger is that the acid can burn and irritate the esophagus, may reach as high as the vocal cords or the mouth, and may even come into the airway and cause aspiration pneumonia. The medications your baby is receiving are to reduce the amount of acid the stomach makes and to decrease the amount of time the food stays in the stomach. IF however, the baby's main problem is a weak sphincter muscle, no amount of medication will help this, and the medications are just to try to prevent irritation of the esophagus by the irritating acid.

One thing to remember, is that breastfeeding neither caused this nor will cure it, and changing to formula will also not cure it. Under no conditions would I recommend you to stop breastfeeding for any reason for reflux. It may or may not be of consolation to you to say that many babies have reflux, and they will grow out of it. Does the reflux bother him? Does it bother you? Is it just a laundry problem or his he truly uncomfortable because of it? Spitting up in and of itself is not a symptom of reflux. He needs a barium swallowing study to really diagnose reflux. If he is uncomfortable, you need to get another opinion.

A pediatric surgeon would say to fix the muscle with surgery. A gastroenterologist may say to continue the medications. What do you want to do? If you don't think the medications make any difference, than why is he taking them? Why did Discuss it with your doctor, and if you get no good answers, go to another doctor. The fact that he now nurses for 10 minutes instead of 20 is just a developmental step reflecting his improved nursing skills that came with his advanced age. The spitting up may just reflect your abundant milk supply. Under no circumstances would I consider that you stop breastfeeding for spitting up, or even for reflux. Keep looking for answers to your questions.

Debbie Rabin, OTR, CLC

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