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  • Q&A with Australian Health Practitioners

    How long do babies put on Omaprazole have to rely on medication?

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    Children's Health Heartburn/GORD Parenting
    Our boy was diagnosed with reflux at 4wks. He is approaching 8 months. His dosage has never been adjusted i.e. 5mg/day. His weight has doubled since he started on Losec. We found that he needs medication as symptoms are the worst when he isn't given any, or given a lower dose (this, our GP had advised to trial). He still feeds on milk and solids (real food, not mash or pureed food). We avoid giving him acidic food. Then, there's the other problem. If Losec ‘blocks’ stomach acid secretion, would this be a problem when it is needed in the right amount to digest food?

    What do we do in the mean time? I've been told to give him two shots of 5mg/day but I'm uncomfortable without proper medical advice. At this point in time, our appointment with a Paed Gastroenterologists is months away.
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    Anonymous

    Hi there, I am not a Dr but I am a mum who had a son with silent reflux (ie: reflux without the vomiting, just the pain). I suspected he had it since around 3 weeks of age but he only started Losec at 7 months which is quite late as far as reflux babies go. I tried to wean him off at 12 months and 18 months with no success. I gave both tries a good 10-12 days. Then eventually right before his 2nd birthday I tried again and he was OK and is now 3 and happy.

    As far as weaning goes, I had excellent advice from my paed gastroenterologist (Dr Avi Lemberg in Sydney) You have to try this VERY slowly, reducing the dosage amount by little bits like 0.25ml and seeing if this is tolerable. Keep at that does for 4-7 days (a week is best) and then drop again. At 12 months I found my son was not able to tolerate any drop in dose whereas at 18 months I was able to get him from 10ml down to 5ml with him still happy so I kept him at this new dose until trying again at 24 months. At that time, I did the weaning process very slowly and kept him on a dropped down dose for one week before dropping again.

    My gastro then advised once off all medication to to keep him off - even if not happy - for 2 weeks. This gave the true indication as to whether or not his reflux had rectified itself. In any case by 24 months, my gastro likes to do further investigation ie: an endoscopy for kids who are unsuccessful at weaning off and they need to be off losec for at least 2 weeks for the procedure to see the true damage. Most kids should outgrow reflux by 12 months and if not then by 24 months so I would say your son is just too young. Wait until he is 12 months to try again.

    Quick question - why would you want to up his dose (despite his weight gain) if he is happy?? It is best to be on the lowest dose tolerable.

    In regards to your question about stomach acid and what it is used for - I have reflux myself and have a complication from it and so 2 years ago I started losec and need to remain on it indeffinitely. Stomach acid is mainly responsible for the breakdown of protein and for destroying bacteria in the stomach so I make sure to take vegetable based digestive enzymes with each meal to aid in digestion - it helps alot. Obviously you can't give enzymes to a baby (as far as I know) but something you can do is give a really good, practitioner brand probiotic in his bottle before bed to populate his stomach with healthy bacteria. I take this too. I hope this helps you. Good luck.

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    sleepy_mum

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    Hi, there!  

    Thank you very much for sharing your experience and doctor's advice.  Dr. Lemberg is the Paed Gastro we're seeing in Nov.  

    I learnt that Losec dosage for infants needs to be adjusted as they grow.  Most people say it can be reduced when they sit up, which I found to be presumptuous.  

    Assuming the Losec is well-preparead and hasn't lost its efficacy (we abide by the expiry), we found 0.9ml/day to be tolerable but up to 8-10 days.  3-4 days without any medication is bad news!   Whilst at the GP for his third routine vaccination a month ago, I asked this same question I posted.  The GP wasn't prepared to comment, but he said I could try dropping it 0.5ml since he is already sitting up.  I wasn't convinced but gave it a go anyway for 2-3 days.  Our boy didn't like that.  It was also around that time that he began to eat solid food (we take the BLW approach) but not drinking enough water.  

    He's been back on 5mg/ml 1ml/day for 3 weeks now.  He still exhibits symptoms such as having regular wet burps, sour-smelling breath, occassional regurgitation and hiccups, appearing to be in pain, and screaming excessively.  He also has sleep issues such as taking cat naps, having disturbed sleep, disliking lying down in general - it's also interesting to note his sleep position (lying on his stomach, occassionally tilting his head and/or tucking his hand under his belly, sticking his bottom up) as though to relieve pain or discomfort from reflux or constipation.

    We have many questions.  We just know his gastric system isn't doing so well (as opposed to just experiencing ‘separation anxiety’ or requiring ‘sleep training’).  Is his reflux really under control?  We're assuming the current dose is right for his size.  Is his constipation making his reflux worse?  We're picking less-contipating and acidic food, and increasing water intake - this has improved his bowel movements and reduce wind (he sleeps slightly better in the evening).  Is it food sensitivity that's aggravating his reflux?  He's exclusively breast-fed so I'm testing with not having any cow's milk protein in my diet and taking lactose-free milk instead.  Thanks for mentioning probiotics.  I've always been wary of mixing anything in the bottle as it changes the composition of the breastmilk, but there should be forms of probiotic that can be given directly.  I shall explore. 

    By the way, would you know if there is an optimal time for Losec to be given?  I know that most medication has recommended hour to be administered for the body to respond optimally - this is to do with the circadian biological clock in humans.

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