Our expert, Jan Gambino, is a writer and mother of teenagers with acid reflux (GERD). Each month she will answer selected reader questions about GERD and infants, children, teens and their parents. If you want to submit a question, write a SharePost here.
My wife and I are at our wits end with our 4-month-old son. He has been a challenge since Day 1 as he was born with a cleft palate, missing his soft palate only, but making feedings less than fun. At first the doctors thought he was colicky. This eventually changed to severe acid reflux/GERD. He has been on Domperidone, Ranitidine and, now, Prevacid. We thought the Prevacid was working or helping but it has been 4 weeks on a full dose and we feel there is no change. He is gaining weight and is approximately 14 pounds and will be 5 months old in February.
My wife pleaded with her doctor, who has been excellent by the way, to have an ultrasound or further internal investigations done but the doc did not feel it necessary. We accepted that. In your experience, is there something further we can do to help eliminate or minimize the problem faster than watching the days go by in a fog?
Thanks for your time.
You are a good dad for writing and searching for answers to help your little guy feel better. I know it takes the entire family to work together to find a treatment plan for acid reflux. You have the added challenge of finding a treatment plan for the cleft palate too.
Let's start with the acid reflux. Please check out the acid reflux symptoms list and let me know what symptoms you are seeing. Many babies have Gastroesophageal Reflux (GER) and some babies have Gastroesophageal Reflux Disease (GERD). Most babies benefit from careful homecare such as holding upright after a feeding, smaller meals offered more frequently and sleeping on an elevated surface, such as a wedge.
A doctor may try other treatments such as a special diet or medication. It sounds like you have tried several types of medication so far. It is a lot of work for the doctor and the parents to keep adjusting the treatment plan until the symptoms have calmed down. Keep in mind that the goal of GERD treatment is to reduce pain and discomfort. The vomiting and spit up may continue but should cause little or no distress. If there is a great deal of vomiting leading to weight loss or anemia, it might be necessary to do some testing.
You and your wife asked the doctor about doing a test to assess your son. I am not a doctor, so it is difficult for me to know either way. In this country, the guidelines for treatment advocate a trial of medical treatment (medication, diet, positioning) to diagnose reflux. Testing is only indicated if there are complications. It is possible the doctor has decided to wait a bit longer before making a referral to a specialist (pediatric gastroenterologist) for testing.
It is possible that the cleft palate needs further investigation and treatment. The cleft palate may cause feeding issues that trigger acid reflux symptoms. I wonder if you have access to a Cleft Lip/Palate Clinic or feeding program. Often a team of specialists at a clinic or feeding program can guide you in special techniques for feeding. A feeding clinic may need to use a test such as a barium swallow or upper GI to visualize the path of the food and assess his swallowing skills. The same type of testing may also indicate the severity of the reflux. Again, testing may not be necessary since a skilled therapist may be able to evaluate and treat the feeding problem just from observing your son eat.
My daughter had many feeding challenges, so I know it can be extremely stressful to the family. No one else understands how difficult it is. As a parent, I often received feedback and advice on how to feed my baby, adding to the stress. I encourage you and your wife to join our community for support and information. We are here to listen if you want to vent or ask questions.
We hope you find this general medical and health information useful, but this Q&A is meant to support and NOT replace the professional medical advice you receive from your doctor. For all personal medical and health matters, including decisions about diagnoses, medications and other treatment options, you should always consult your doctor.
Published On: February 14, 2008