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Dear Michelle, It sounds like you have been dealing with reflux for a long time. It is hard work, isn't it? There is much support and information on this site. I hope other parents will join our discussion and give their ideas and support too. Prevacid is a strong medication for GERD. I know the dose can vary from child to child so ask the doctor if this is indeed the highest dose possible for her weight and symptoms. Some doctors also add another medication such as an acid reducer or a motility medication. Each child is different so I want you to discuss the situation with the doctor. I wonder if a Ears Nose and Throat specialist was consulted-perhaps for the adenoids? Would there be any concern about aspiration or congestion? asthma? snoring? sleep issues? swallowing problems? Some toddlers have trouble with silent reflux-stomach contents comes part way up the esophagus (food pipe) and causes coughing, choking and breathing issues. If that is the case with your daughter, a consultation with a pulmonolgist may be needed at some point. Take care and let us know what you find out. Best wishes, Jan Gambino The Reflux Mom