Saturday, February 21, 2009 Hetal asks

Q: 6 week old with acid reflux

My 6 week old was diagnosed with acid reflux a few weeks back.  The doctor put him on Zantac, which seemed to help a little, but has now switched to reglan.  I'm concerned about the side effects and safety of it's use in infants.  My baby weights 7lbs 11oz and was prescribed 1mg 3x a day.  Is this too much? 

 

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Answers (2)
Jan Gambino, Health Guide
2/21/09 2:49pm

Hello!

It can take some trial and error to develop a treatment plan for reflux. While Zantac is ann effective medication for many babies with reflux, other babies need something else. Reglan is different than Zantac. While Zantac reduced acid, Reglan is a motility medication and helps the food move through the digestive tract faster. Reglan may cause worrisome side effects so be sure to note any hand tremors, jerky movements or excessive fussiness to the doctor. I cannot give you advice about the dose. Some doctors start with a small dose and increase while others start with a high dose and then decrease if needed. I would ask the doctor for more information.

There are several other treatments for reflux: positioning, sleeping on an elevated surface, special diet, small, frequent meals, thickened formula or breast milk...I wonder if you and the doctor have discussed any of these treatments in addition to the medication.

Let us know a bit more about your little guy-What are his symptoms and what have you tried so far?

Best wishes,

Jan Gambino

The Reflux Mom

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2/22/09 2:38am

Dear Hetal, Jan is right! Reglan is not a reflux medication. Is your son vomiting a lot? or eating very poorly and losing a lot of weight? Generally reglan will help him empty his stomach contents faster, however, as Jan suggested and as you suspect--Reglan has worrisome sideeffects.

 

Many drs will start off with Zantac, up the doses once or twice and then move to a Proton Pump Inhibitor (PPI) which actually helps reduce production of acid by switching-off the acid producing glands in the stomach. This action is very temporary and the baby's stomach will begin producing normal amounts of acid once the treatment is stopped.

 

There are two commonly used PPI drugs in infants: Prilosec (Omeprazole) and Prevacid (Lanzoprazole (sp?))-- most kids improve tremendously with PPI's and Reglan is generally not required unless there is a motility issue (which is not uncommon with reflux). However, now a days, drs prefer something like erythromycin instead of reglan for motility. Some drs will also prescribe a sugar solution called "lactulose" that causes infants to have nore bowel movements and this itself improves reflux. A constipated child struggles more with reflux so the key is to relieve constipation. Hope this helps. Good-luck!

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By Hetal— Last Modified: 11/26/10, First Published: 02/21/09