My seven-month-old baby was started on Prevacid and bethanechol at 3 months of age. She's fine now but how long will she need to be treated and how do we know if it's gone?
Q: Baby with reflux
Answers (3)
4/22/08 11:50am
This is a timeless question: Is the happy baby's reflux controlled or resolved? And it's something I face every day in my busy practice. Let's first touch on the natural course of acid reflux disease in infancy.
Symptoms of acid reflux in infancy typically appear during the first couple of months but may not peak until four months of age in many cases. At that point I typically tell parents that what they see is typically what they've got. In other words, symptoms tend to plateau after four months and progressively improve. For those parents with sick babies, knowing that things likely won't get worse is typically a source of relief.
Symptomatic reflux in infancy usually resolves anywhere between four months of age and a child's first birthday. So when we're faced with a baby like yours at seven months of age it's probably quite safe to assume that the symptoms underlying her Prevacid and bethanechol are less impressive than at four months of age when her meds were initiated. But we don't know and we won't know that until well pull the safety net of acid suppression away to see what lies beneath.
So a good pediatric gastroenterologist with tell you that while the odds are in our favor that we can withdraw medication at this point, only a trial off of mediations will give us the answer.
4/22/08 7:04pm
Hi,
My name is Beth Anderson. I'm the director of www.reflux.org and also the author of The Reflux Book. I'm not a doctor, but I can give you some ideas that you can discuss with your doctor.
It can be difficult to tell whether the reflux is gone because your daughter's digestive system is working better or whether the medicines are eliminating the symptoms. Most doctors use this trick to help decide which is happen with your child.
Your child's doctor may stop raising the medicine doses and see what happens as your daughter gains weight. If the symptoms of reflux start to come back, then the dose may need to be raised to match her new weight. If the symptoms don't come back, she may not need the medicine any more. The doctor may have you lower the dose a bit or even stop the medicine and see if the symptoms return. It might take a few weeks till you can be sure.
You should not alter the dose on your own without discussing it with your baby's doctor. The doctor might want your baby to be on medicine a bit longer to make sure her esophagus is fully healed.
You might want to review the full list of symptoms of reflux in babies and toddlers. Clues like acid-smelling breath might mean she still needs her medicine. As a parent, the doctor relies on you to watch your baby and report what you observe.
Good luck. I'm glad she is doing better.
Beth
4/24/08 3:24pm
Hi GERDmom,
It's always difficult when our children are ill. Especially when they are too small to tell us where it hurts!!
There is a good overview about Infact Acid Reflux here. In this article, it states that "Your child's doctor or nurse will discuss GER with you and suggest
treatment if needed. The potential complications of the medications
will be explained. Most infants don't need medications and will outgrow
reflux by 1 or 2 years of age."
It's good that the prevacid and bethanechol are working for your daughter. It is interesting to note that bethanechol is usually prescribed for urinary issues but is also prescribed for acid reflux. There are some things you can do for her that do not involve medicines. You might like to read some of the information available here.
Tracy Davenport is a resident expert here and has written many articles about baby and childhood GERD, having learned from experience with her own child. You can read all of Tracy's shareposts here. There is a very good series of articles here about baby rights when they have GERD and section one in particular about giving babies medicine for GERD.
Tracy also has a good list of lifestyle and diet changes you can do to help your daughter be more comfortable. You can read the entire article here, but here is a sampling of the list.
-Eat your big meal at lunch instead of at dinnertime.
-Eat at least two to three hours before lying down. Eliminate late-night snacking.
-Avoid foods that are known to lead to heartburn.
-Sleep with your head and shoulder on an incline.
-Make sure your bed clothes are loose-fitting.
-Sleep on your left side. Studies have shown that this position aids
digestion and helps with the removal of stomach acid.
-Sleeping on the right side has been shown to worsen heartburn
Dr Todd Eisner has written at length about taking medicines for GERD and the expected curing or healing time for the condition. In one share post here, Dr Eisner tells a user that it is difficult to know how long it will take and that sometimes lifestyle changes will help.
I hope this gives you some information you can use when discussing your daughter with her doctor. Please stay in touch and let us know how you and she are doing!
Vicki M
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