If your baby or toddler is using reflux medicine, maybe it’s time to quit. Here’s why, and how.
This is one of my least favorite findings in a little one’s history. Why? Because the longer reflux medicines are used, the weaker a child’s digestion becomes. The weaker your baby’s digestion becomes, the harder it is to absorb food and nutrients. This creates a domino effect of trouble! Just click through this FDA powerpoint presentation to the Pediatric Advisory Committee to see what I mean. From fractures to fecal impactions, it’s not pretty. A
Most parents report to me that reflux medicine seems to help a little at first, especially for quelling colic and crying. But soon, the benefit fades.
Then the baby becomes more picky, appetite more sluggish, stools more constipated and slow, belly more bloated. Feeding gets harder, not easier – and the reflux medicine dose goes up. After a few months, we have a fussy eater who is having tantrums about feeding, who is dependent on Miralax to have bowel movements, and growth pattern has slowed down. After a few years on reflux medicines, it’s common for me to be looking at a stunted child who is barely getting taller; who is epically picky, cranky, or anxious; who is struggling to learn, behave, or develop normally; and who is so stuck on Miralax even at ever increasing doses, it doesn’t work so well anymore.
The whole point of these medicines is to weaken stomach acid – presumably because too much acid is irritating the esophagus. Reflux medicines (“proton pump inhibitors” or PPIs) are the second most prescribed drug for infants and children, behind antibiotics. Does your baby even need it?
These medicines were created and approved for use in adults who may actually have too much acid gurgling up from the stomach into the esophagus. But this may not be what is happening in a baby or toddler’s digestion. Reflux medicines are not FDA approved for use in infants (kids under a year old) but are routinely prescribed anyway. Even if actual reflux was the issue, the only way to know for sure is to put the baby through an invasive procedure with something called a pH probe. A probe is stuck down the baby’s throat in “dip-stick” fashion so that a reading on the stomach’s acidity can be taken. Infants may need sedation and hospitalization to get through this procedure. Obviously, it’s all too easy for your pediatrician to hand you a prescription instead and say “try this”.
Before you try that, you should know that there are many drug-free options that work well, and leave your child’s digestion in tact. Try these instead – because reflux medicines have been found to have these negative side effects:
• reduce uptake of iron, zinc, calcium, and magnesium
• increase risk of breaking bones
• impede absorption of vitamin B12, and reduce serum levels of B12
• enhance fungal (yeast) infections in the gut or esophagus
• reduce the helpful bacteria in the gut (which makes digesting food even harder) while encouraging pathogenic bacteria
• cause bacterial infections of the small intestine
• cause Clostridia difficile infections, a hard to treat bacteria that causes diarrhea
• seizures under certain predisposing conditions
Yuck! Imagine all this going on in a tiny infant’s gut, which is just getting started in learning to digest and absorb food.
Basically, these medicines weaken stomach acid – and thus, make the stomach less capable of digesting anything. The ability to digest and absorb food is gradually weakened. Effects from using these for more than a few weeks? Examples from my own practice include linear growth grinding to a halt (kids can’t grow taller), delayed bone age (kids’ bones are not growing normally), and fractures of hip, wrists, or spine – in kids. Other nutrients become harder to absorb too, especially vitamin B12. Anxiety becomes prominent – and this is not surprising, as we learn more about how gut bacteria are linked to mood and anxiety.
But that’s not all. Changing the acid level of a human digestive tract means you change which microbes can grow there. The microbes we carry in our intestines do a lot for us. They help us digest food, communicate with our immune systems, and help fight off invading infectious microbes that can make us sick. Using reflux medicines favors microbes that are not ideal – such as Clostridia difficile (linked to seizures and autism like features in tests on rats) and fungal infections (Candida or other yeast species). These definitely do not help your baby or child. A healthy gut has a pH that will favor helpful species, like Lactobacillus strains or Bifido strains.
So what to do? Try these steps – and learn more detail in my book Special Needs Kids Go Pharm Free. The first chapter is all about babies, from feeding to colic to sleep, reflux, and more.
1) If you’re breastfeeding, trial a diet without the usual suspects. Remove dairy, gluten, nuts, eggs, or soy. Some babies fare better when brassicas are removed (cauliflower, broccoli, Brussel sprouts). Don’t remove all these foods at once. Experiment with rotations. Always put back in a strong, nutritious replacement for any food you take out. Use ample organic fats including eggs, ghee, meats and poultry, legumes, and vegetables. You may need to use alternate protein supplements to keep you strong and energized while your own diet is restricted. A gentle whey protein like ImmunoPro Whey may be well tolerated for you. Or, you may need a collagen protein support. You can find these in my practice supplement dispensary here.
2) Change up the feeding routine. Cow’s milk, pea or rice protein concentrates, and soy proteins are not what your baby was built to digest. So, if you’re using a formula based on those proteins, change it. This alone may ease reflux symptoms. Use a partly digested (“hydrolyzed”) formula instead. This one is organic, with lactose as the carbohydrate (just like breast milk), and hydrolyzed whey protein instead of whole cow’s milk protein – very gentle! Formulas like Nutramigen or Alimentum are made with hydrolyzed casein protein and may work too. These aren’t organic and may contain GMO ingredients, but may be better tolerated than a standard whole milk protein infant formula. For toddlers, plant based options exist. I don’t like using pea or rice protein concentrates in my practice – these seem tough on baby and toddler bellies in my experience. If almond is safe, give this organic option a try. Your baby may also do just fine with a goat milk formula option (which I’ve only found here so far – see all their options for ages and stages), or even a camel milk formula recipe (not commercially available …yet!).
3) Switch to organic, GMO-free formula and foods as much as you can. GMO ingredients in conventional formula and foods are injurious to your baby’s gut biome. Read here for why I tell my patients to avoid GMO foods. More scientists are expressing concern that GMO foods alone may be triggering autism in our children. This simple step can help your baby’s gut.
4) Use probiotics. Lactobacillus retueri is a strain that has been shown to reduce colicky symptoms and crying. Bifido bacteria are crucial for healthy gut biome development, as are other Lactobacillus strains. Consider starting with a simple product like ProBiota HistaminX probiotic. To order, tap my practice supplement dispensary here, set up an account, and order. You can also start with a product that only contains Lactobacillus called Primadophilus L. reuteri, also available in my dispensary.
5) Use an herbal tincture designed for babies and toddlers, in a glycerite base, that supports digestion. These are often called “digestive bitters” – there are many brands – and they can gently support normal stomach acid secretion and digestion. Here’s an example of one of my favorites. For a baby under one year, 1/8-1/4 teaspoon is plenty before or just after a feeding.
6) Put Epsom salts in your baby or toddler’s bath at night. This is calming, and delivers both magnesium and sulfur via absorption through skin. Sulfur is a key mineral for many digestive functions. Dissolve one half cup in the bath and soak for twenty minutes.
7) Clear fungal infections. If your baby had thrush, he may need some stronger medicine to clear any lingering fungal load from the digestive tract. Fungal infections alone can alter the acidity of the digestive tract, and keep it sub-optimal – thus causing more reflux! See my blog on fungal infections and how these affect the GI tract.
These are so easy to do. Use these steps to prevent ever getting on a reflux med, and to help your baby or toddler wean off. Let me know how it goes!
Thank you for sharing this information. It really opened my eyes to how harmful these medications can be for our little ones.
I apologize in advance for the long post. We’ve been trying to help our little girl for some time now, and we can’t seem to find anything that works.
My little girl, Violet, who is now six months old, suffered a possible brain injury at 11 weeks of age. No MRI was conducted because the risks outweighed the benefits. But as her mother, and the person who spent every second with her, I saw the changes and the struggles she now has.
Before her accident, I had noticed some eczema on the side of her cheek. This is my first child, so I wasn’t sure if it would go away on its own or if I needed to put medicine on it. After her accident, she began constantly swallowing and choking on her saliva. She did not want to be placed on her back most of the time, and eventually stopped batting/grabbing at her toys. Her pediatrician referred us to a GI, but they wouldn’t be able to see her for months, so she prescribed Violet Famatodine because she said it sounded like silent reflux. We tried the medication for a week, and saw no improvement. So, we took her off of it. But, as time went on, her eczema worsened and her feeding became horrible. She used to be a good nurser, and slowly got to where she couldn’t even breastfeed anymore, and I was pumping and bottle feeding her. But even that was a task. She had bloody mucus in her diapers a few weeks after. She was constantly straining to poop and crunching her body inward when I brought her in for feedings and in the middle of the night. She was miserable.
Another week goes by, and we make several ER visits because she’s not wanting to eat, and constantly falling asleep at my breast. Not wanting to interact, and just a shell of her former self. The ER doctor also mentioned that it sounded like reflux and that the medicine, Famatodine, takes longer than a week to show improvement. She suggested we at least give it two weeks to see if it helps. So, we tried it again. After two weeks, she was still constantly swallowing and gulping. Still struggling to eat. Bottom line, it didn’t help. So once again, we stopped the medication. Shortly after, she began making a horrible grunting/straining sound non-stop. She was even more miserable.
When we were finally able to get into the GI, she found microscopic blood in her stool, and with the symptoms I gave her, she said it sounded like an allergy. So, I started with the most common, cow’s milk, and removed it from my diet. After a month or so, her stools improved immensely. No more constant blow-outs, no more excessive mucus, and she began to eat more. Although, she still struggled to eat much at a time but we still saw improvement.
Then, my poor girl got COVID and her appetite went to crap. Once she seemed to get over that, she began teething. Since COVID, her appetite has just been horrible and she doesn’t even seem to “want” to eat.
Something else to note, we had gone to see and ENT in between all of this, and her esophagus was inflamed.
We went back to the GI for a follow up visit, and no more blood in her stools, she was pooping once a day or once every other day. She was sitting now and head control was good. So she suggested we could try to start introducing some stage one purees. I had mentioned to her that she was still constantly swallowing, I could hear her regurgitating, wet burps and breathing after feedings, and occasional spit up but not much. She said usually starting solids helps with that, but we could also try reflux meds again since we had the milk out of her system, and that could have been working against the medication.
So, here we are, a little over two weeks of taking the medication and now with purees in her diet. She has been constipated twice, struggles a lot to pass stools, is still constantly swallowing, hates being on her back, horrible appetite, wakes up screaming at night, straining a lot throughout the day, wet breathing from time to time, and the list goes on.
After reading your article, I stopped giving her the medication. That was about a day ago now.
We have done several swallow studies, and no aspiration. Some penetration, but her coordination seems to be off from time to time. We also start feeding therapy in a couple of weeks. But I feel like her swallow is fine, it’s something else. Either just her coordination, a sensory issue, or horrible reflux. Maybe even a combination of those.
I have been doing everything I can to get her help and make her daily life more comfortable. It has been a struggle, and I’ve been trying for months now.
She has stopped cooing since her accident, and does not babble. She does giggle and tries to squeal sometimes. But a lot of the time, she seems to get choked up when trying to make sounds or like it’s uncomfortable for her.
I know you may not have ALL the answers I’m looking for, but I wanted to reach out and see what your opinion and thoughts were in hope that it might point us in the right direction. I have been contemplating giving her probiotics. I also now have to supplement with formula because I just don’t produce enough with just exclusively pumping.
The formula we use is Similac Alamentum and the Probiotics I have but have yet not given to her is the ProbioMed Infant by designs for healthy kids. She was taking .4ml of Famatodine, twice a day before we stopped.
Thank you in advance for any information you may have for us. It has been a long stressful journey, and I just want to give my girl the best.
Sorry to hear all that you have been through! Indeed this isn’t a forum for answers to the complexity of your baby’s case – but – a few points jump out for me. One, what was the accident? Was this a head injury, a fall, a car accident, a vaccine injury, a birth trauma? Vaccine injuries are real – my own son suffered a severe one at birth from his newborn dose of hepatitis B vaccine and he was further injured by follow on doses. These can cause head trauma, neuroimmune injury, and injury to auditory and vestibular function with lasting effects. More recently, the medical profession has begun to appreciate the effect of head injuries on the gut – so it would not be surprising if these issues are related for your baby. Next, the medication may be truly necessary if she indeed has erosive esophagitis. In that case, close monitoring should continue with your GI doctor while you use that medication and they should resolve her feeding discomfort by referring you to a pediatric dietitian who can work with you on alternative formulas and hypoallergenic foods. You mention that her allergist found her esophagus to be inflamed, but allergists don’t perform endoscopies of the esophagus and stomach – so I’m left wondering how that diagnosis was made and if it’s correct. Endoscopy with your GI doctor may be the way to emphatically find out what is going on in her stomach, esophagus and upper small intestine. Lastly, you don’t mention a neurology work up. Ask your pediatrician for this referral. A neurologist can assess your baby’s status for milestones and basic neurological functions that govern digestion, eye movement, sleep pattern, gross motor skills, startle reflex and more.
Thanks for this post. So helpful and is helping explain a lot of things I was starting to wonder about. My baby is now 8 month. Around 3 months, he showed clear signs of bad reflux (arching back, crying fits, not tolerating being on stomach, excessive amount of spit up and vomit). His ped prescribed famotidine 0.3 twice a day. My husband, his dad, and his grandad all have terrible reflux and Barrett’s esophagus so we weren’t shocked that our baby was now having similar problems. I didn’t want him on medicine and noticed his symptoms didn’t improve much along with his diapers starting to have blood in them, so I stopped the medicine. I eliminated milk and soy from my diet (he’s EBF) and he got much better. No exteme reflux and no more blood in stools. Around 6 months, he had a lethargic/vomiting episode that landed him in the ER for fluids. They found a small bowel small bowel intussusception on US and it resolved on its own thankfully. They also did a stool study to look for the cause and found Giardia. He did a round of antibiotics. It’s been about a month since that, and I’ve been so frustrating that his reflux has gotten terrible. Worse than it was before I cut out diary and soy. I have also had a breast rash develop.. Could this be because of the antibiotics he had to do? Do we have trush it sounds like? Seems like it could explain the reflux coming back. So many moving parts the doctors keep saying are unrelated, but they seem very related to me… Is getting tested for trush next best options? Any other advice? Thanks so much for this resource…
It’s possible that the medicine that helped clear the Giardia (and I’m assuming repeat testing was done to illustrate that it was cleared) disrupted microbiome in other ways, including possibly exacerbating a fungal burden. For this possibility (intestinal candidiasis), your doc can prescribe a 10-14 day course of Nystatin to clear any suspected thrush. Nystatin is typically safe and approved for infants, unlike reflux medicines, which as this post explains are only approved in specific circumstances and for a short duration. If you see thrush on the mouth/tongue, or white specks / white fluffy bits in stool, this is thrush (Candida infection) and it is likely throughout the GI tract also. This will make for more reflux, rash, and misery. Treating it could fix the problem quickly and I have seen the be the case more times than I can count. Good luck, hopefully your doc will be willing to help.
Hello! I have a 4 month old (3 month adjusted) who has rsv at 1 week old. He was given antibiotics due to the pneumonia. The next month he became an incredibly fussy baby. Ped prescribed omnaprezol which I haven’t given. I switched to Holle goat. He’s better but in the mornings is incredible fussy with a stuffed up nose. He clicks a little when he drinks and is fussy often after bottles but i the mornings is the worst. He only naps about 30-40 minutes. The only place he sleeps well is upright or in his car seat. I ordered that herbal tincture. Do I just use it after his bottle? How many times a day would you suggest. I was considering Pepcid but I just don’t know. Also when he spits up it’s usually about an hour after. Except in the morning. I feel like he has a lot of drainage at night.
I suspect a fungal dysbiosis in this scenario. If your doctor is willing, a ten day course of Nystatin (oral not topical) may restore appetite. This can correct the dent put in the developing microbiome early on, from the antibiotics. I have seen this work very well, very often. Perhaps your doc will be willing to try this measure.
Thank you for this info. My 2 month daughter was prescribed with lansoprazole last week after weeks of significant spit up, crying, discomfort and coarse voice after crying so much. She started the Lansoprazole 3 days ago and spit up has improved a great deal.
I’m concerned about her now looking more lethargic and about other potential side effects, but also worried that the other alternatives I’ve tried before haven’t helped:
She’s about 80% breastfed and I had eliminated coffee, dairy, soy and gluten before starting the lansoprazole without much improvement. I found that other foods might be potential culprits in her case (acidic foods, eggs, chocolate, etc.), and so the diet is becoming very hard for me. I use fórmula when I don’t have enough breast milk supply, I haven’t found Similac alimentan available in Canada as there seems to be a shortage, got neocate and she doesn’t love it. I myself am also taking HMF super powder probiotics and a complete digestion enzyme with meals.
What are your thoughts?
Good to hear that the medicine did ease symptoms. Remember it will be 4 or 5 more months before her stomach is approaching the status where it is making enough of its own acid to digest food better. In the meantime, go with what serves you best. If you need to wean, wean. It’s not ideal, but if it helps you and her both rest more, eat well, and thrive, then fine. You might re-check before too long to see if she can wean off the medicine or lower its dose as time goes on.
Hi there, we have a premie he’s currently 5 weeks old , born 34 weeks 5 days early. We noticed there was some spitting up after feeding 3 days ago, brought baby to pediatrician. Dr. Prescribed flomaotadine 0.4 ml once by mouth daily. Baby tolerated food well for about 1 day, called Dr. He then added a second dose to see if this would improve reflux. I’m now at day 5 , my mommy instinct is saying this baby is now in worse shape, arching of back, wriggling, followed by inconsolable crying after being fed and when trying to rest , regardless of position and even with a 30 degree incline. I feel like the pepcid is the culprit, after seeing him change overnight with this being the only change. Baby is exclusively breastfed, or I pump to bottle to make sure he is eating. I take a probiotic and just started the baby on one as well. Thoughts on stopping this medication before his gut does a complete 180?
A young infant is going to have spit up, especially if born early. If the spit up originally didn’t cause a whole lot of trouble, then my suggestion would be to let it ride. The reflux medicine will downgrade digestion just as it’s trying to come on line at this age. If anything, some gentle digestive bitters or Colic Ease drops may be a better move. Go easy on the probiotic for now – this can be hard to tolerate when the baby’s stomach has been buffered by a reflux medicine.
What about thickening the formula with carob bean? Are there any side effects/concerns with that?
If this is well tolerated and triggers no new undue discomfort than this is perfectly ok, according to this research. If SIBO is active, then prebiotic foods or ingredients worsen symptoms – every baby is different. We don’t give breath tests for SIBO to babies, so it’s worth a try – start with a small dose to watch for tolerance.
Hello! How would you administer the HistamineX Probiotic for an 11 month old? He’s struggled with silent reflux pretty much since day 1.
Open the capsule and dust a bit onto food, bottle, breast or tongue. Close the capsule and repeat the following day. Don’t throw out capsules that aren’t emptied, simply close them back up and repeat til a capsule is empty. Work up slowly to full capsule, as tolerated. If not well tolerated, move on to next options.
What about babies that have cleft lips and palate and just swallow a lot of air? My baby is on famotidine but would like to wean her off. She is 9 mo old. So I think most of her reflux is caused by a lot of air in belly and hypotonia /weak spinchter muscle
This is a special circumstance for sure. Your best bet may be to work with a pediatric occupational therapist who specializes in feeding, if you aren’t already doing so. If your doctor hasn’t made that referral for you, request it. Digestive bitters and other non-drug tools can still help, but the key in your baby’s case may indeed be correct mechanics when feeding and swallowing. A pediatric OT can guide on this. Your pediatrician can refer you for this service for free or low cost through your local Early Intervention (Zero To Three) Program, if your insurance doesn’t cover it.
Hi there! Thanks for this superb article! Very helpful.
Question for you. Above you said the following:
5) Use an herbal tincture designed for babies and toddlers, in a glycerite base, that supports digestion. These are often called “digestive bitters” – there are many brands – and they can gently support normal stomach acid secretion and digestion. Here’s an example of one of my favorites. For a baby under one year, 1/8-1/4 teaspoon is plenty before or just after a feeding.
That means 1/8-14 per day, before or after feeding?
You can use this tincture with feedings more than once per day, yes, before or after a feeding.
Wow comments from resent months! Seems to be a common problem. My 12 week old was prescribed a ppi (Prevacid) and in 3 days we saw a massive change. His spit up stopped, but he screamed for hours on end, couldn’t sleep, couldn’t pass gas, and was very hard for him to have a bowel movement. I stopped the drug immediately. We did try the natural route first, and got him probiotic drops but that wasn’t fairing well with him either and we had to stop that too . We’re seeing our pedestrian this Friday so I’ll see what he has to say, but my husband and I already decided no more drugs.
Is ProBiota HistaminX probiotic different than BioGaia drops?
Anyone heard of Nat Pho’s? I’ve been reading about that in siding in digestion.
Yes the ProBiota HistaminX is different, it is a good deal more potent and specifically omits strains that are histamine promoters in the gut.
I’ve got an 8 week old daughter that eats breast milk by bottle 3 oz every 3 or so hours. About 3 weeks ago she started to spit up large amounts (like what would fill my palm in the burp rag. I’ve talked with her Dr, who is a family physician about it and he didn’t seem too concerned. Finally after she had a day where it seemed like she kept nothing down, his NP prescribed .5 ml (2.5 mg) Omeprazole once daily. It’s not fixing her spitting up, which I know it’s only job is to make the spitting up “more comfortable”. She’s been on it for 3 days and it hasn’t seemed to help at all, it may even seem like it makes her more fussy. She gets the Gerber Sooth probiotic and Vitamin D drops once daily as well. Her Dr also said to do the probiotic over gripe water. She’s gaining weight okay for the time being. Born at 37 weeks, at 4 lbs 14 oz and last weighed at 7 weeks she was 8 lbs 1 oz. Should I take her off the Omeprazole and find a different probiotic? I’ve also done some research on MSPI, so I’m considering cutting out dairy and soy, and I’m already gluten free per my own allergy. Could this be something that helps as well? I feel like I’m constantly feeding her as she spits up a large amount of her milk and then cries until she gets full (usually another oz or so). It’s exhausting!
If the omeprazole showed no benefit – and actually made her feel worse – then no need to keep it. And if gripe water suited her comfort more than probiotic, use gripe water. It does take about six months for a baby’s stomach to acquire the level of acid that can more smoothly digest feedings. I can’t advise in detail in this forum, but hope to have more detailed resources available for parents soon.
Hi Judy, my little one was born 6 weeks early and she’s 6 months and 2 weeks old now (5 months corrected). 4 months ago, she started refusing to breastfeed and I started pumping and bottle-feeding her as it’s easier for me to push the bottle to her mouth. But she can’t even take half an ounce. Dr has prescribed her omeprazole 1.2ml once a day and it didn’t work, then he increased the dose to 1.5ml once a day again and she’s still in the medication but nothing seems to work except that she started crying out of hunger where she wasnt. But when I offer her the bottle, she literally pushes it away and arches her back out of refusal. When this continued, I came up with an idea of feeding her at night when she’s completely sleeping and it worked, she then takes about 2 to 3 ounces at a time and she just opens her mouth when you just put her in a feeding position, even though it takes up to an hour to get her to drink 2 -3 ounces. If I fail to feed her at night, she literally doesn’t take any for over 12 hrs unless she takes a nap during the day. I have to clinics and the hospital 8 times in the last 3 months as she was forcefully vomiting and It breaks my heart seeing her like this and doctors can’t understand me, they think I am over reacting, this makes me even sick. I am now sleep deprived as I have to wake up every 3 hrs, pump and feed her as feeding her takes longer. She takes up to 10 to 12 ounces a day which she was taking way more than that when she was just a 5 weeks old baby. At 6 weeks, she was able to take 4 ounces of milk from my breast in just 5 min (we were test weighing her in the hospital as she had been admitted there because she was forcefully vomiting). I was hopeful that when she starts solid food she will get better but things are still the same. I excluded dairy from my diet for the last 2 months but didn’t see any changes. She has a green watery mucus stool once in 2 or 3 days. My mood depends on her; if she takes more, I feel happy otherwise, I don’t even feel like eating. I don’t remember a day that I didn’t cry and blamed myself. I am emotionally broken seeing her completely refusing to feed as a baby, let alone little ones, as an adult, I can’t even stay for 10hrs without eating. Please advise me on what will work best for my little one. Thank you in advance!
I’m so sorry to hear it’s so hard. It sounds like the vicious cycle is a little stuck: Reflux medicine -> weaker digestion -> more reflux medicine -> more weakened digestion -> baby can’t comfortably eat -> baby’s feeding, growth, and sleep patter falter -> baby’s misery increases -> mom’s exhaustion and misery ensue -> REPEAT! It’s a terrible cycle. The good note here is that she did well at six weeks. What changed? Did booster shots change the pattern? It can take 1-2 weeks for changes in stools or gut biome environment to occur after routine shots. I’d suggest pausing those (as a breast fed baby, she has your protective antibodies anyway), and letting this settle down. You might find a naturopathic doctor in your area who has experience with weaning off reflux medicine and gently restoring her digestion.
My son was just placed on Pepcid a few short days ago (6 weeks old). After the first 2 doses we saw a huge change in his sleeping and his overall happiness until yesterday evening. We have been combo feeding ( 1/2 breast milk 1/2 formula) to transition him to full formula and out of no where my baby is now screaming in stomach pains. He’s been on the same formula for well over a week and never had any issues until now and the only factor IMO that has changed has been the Pepcid. Can this cause excess gas in his intestines? My baby sleeps better at night but overall is more un happy I don’t know what I should do. Did the Pepcid just make everything worse?? Have been having to give him simethicone for the pains. I don’t want to feel like I need to keep feeding my baby these medications for him to be okay. (We have him on soy formula at the moment due to milk sensitivity)
Your doc sounds like they’re stuck in 1999, choosing Pepcid and soy formula for this dilemma! It’s no secret I’m not a fan of H2 blockers and PPIs for young infants. Multiple studies have shown they are of no benefit at this young age. Stomach acid doesn’t quite get up to speed for babies this early on, and using drugs to reduce it further has not only proven to be of virtually no value, it can ultimately delay development of good digestion. The initial success your baby had is common, as is it being followed quickly by lots of new pain and discomfort. Lowering acid – an essential-for-digestion mechanism – with Pepcid, then changing to soy at same time – may have been too big a double whammy. Soy is often just as irritating and poorly tolerated as milk protein. If breastfeeding is out of the question, try a hydrolyzed whey formula instead like Similac Total Comfort instead, or Holle Stage 1 Goat Milk Infant Formula. Goat milk sensitivity is less common than cow’s milk protein allergy or sensitivity and because the protein is slightly different, many CMPA babies tolerate it very well. There may be organic versions of these as well.
My son has been on Famotidine from 1 month – 12 months. His symptoms got a little better but he still seems uncomfortable. He wakes up crying at night every 1-2 hours and I swear it has to be his Famotidine. I’m looking into stopping the Famotidine and starting him on bitters (Gaia kids tummy tonic) after reading the above comments. Is that the best route I should take? Do I need to wean him slowly from his Famotidine or just stop completely? How long should I give hike the Gaia Tummy Tonic? Thank you for your help!
Parents differ with their feedback to me about what works best. Some kids do absolutely fine – better even – with a “cold turkey” approach, that is, simply stopping the medicine. Others need a gradual reduction in dose while the digestive bitters are gradually ramped up. Get your doctor’s opinion on your child’s case, and give your own intuition due attention too. Often, moms tell me that is what worked best.
Hi! My 5 month old daughter was just put on Pepcid due to her spitting up/vomiting constantly and dropping from the 24th percentile to the 9th in less than a month! She is exclusively breastfed, but I don’t give her vitamin d drops… should I be? What else do you think I should do?
Well, if that isn’t confirmation that Pepcid failed, I’m not sure what is. In my opinion, this medication should be reviewed and possibly withdrawn. It isn’t translating into good growth and gain, which is the whole point.
Next, your doc should be reviewing the feeding schedule with you. How many ounces does she get in a 24 hour period? Does she keep it, or is she losing feedings with projectile vomiting (not cool), versus a spot of spit up here and there (Normal.)? What are her stools like? Are they runny liquid with mucus, or yellowy gold mush? How much time does she spend crying (this is physically demanding for young infants, like a big calorie burning gym workout for you or me). Ask for a referral or resource for a lactation consultant for help. You might also find support through La Leche League. The key is assuring that she’s getting enough of your milk, and able to digest it.
Vitamin drops don’t help babies gain weight. There’s no harm in using them at this point, but they won’t be a primary driver for gain and growth. The one nutrient to scrutinize at this moment is iron. If you had anemia in pregnancy, this can make growth, gain, feeding, and sleep more difficult for your baby.
Lastly as always I would suggest deferring further shots until your baby can comfortably eat, sleep, grow, and gain weight. If you are using those at regular intervals at this age, they can disrupt these essential tasks of infancy. Your baby is protected with your immunoglobulins through your breast milk for now.
My 3 month old has similar symptoms to the baby above- lots of crying, obvious digestive discomfort, was losing weight but is now slowly gaining. She’s been on Pepcid for 5 weeks. Her stool is runny liquid yellow with mucus and white chunks (exclusively breastfed.) Can you say what that kind of stool signifies to you. It caught my eye that you mentioned it. I tried 3 weeks of no dairy with no improvement. Trying eggs and citrus and tomatoes now.
Glad to hear that your baby has reversed the trend and begun gaining weight. Now that she has been able to do that, talk with your doctor about weaning down slowly off the Pepcid. Mucus in stool suggests inflammation is active in the gut, while white chunks may be poorly digested milk protein, or fungal (yeast) overgrowth. Neither are good signs, and can impede her comfort, feeding, growth and gain. Ask your doctor for a stool study for Helicobacter pylori and for fungal overgrowth. Clearing either of these microbes may improve things for her significantly, if she isn’t already on her way and feeling good.
Hey judy! What are your thoughts on silver in a 3 month old to clear away fungal/yeast in the GI tract? Had CMPA discovered at 5 weeks and still struggling with mucous sour stools. Silent reflux is soooo bad still. Feeling defeated. I have cut out dairy, soy, eggs, nuts, gluten from my diet. He is EBF on a daily probiotic. I want to tackle the gut and wanted to know if I can give silver over antifungal medication?? If so what is a appropriate dose/length to give?? Thanks so much!!
Remember that babies’ stomachs don’t produce much stomach acid before they hit 6 months. This is normal. Some gentle digestive bitters might ease symptoms. Working with your baby’s preferences for feeding times can help too, and this will likely be a moving target in these early months. Next – on the fungal burden piece, have you confirmed with stool testing that this is an issue? If you have a fungal culture result that is positive, work with the provider who ordered that test. Use the sensitivities indicated on the panel to choose a treatment agent. Silver may or may not be an effective measure. Follow your provider’s guidance on using any anti fungal agent and on how to use probiotics as well. High potencies and multiple strain products may be hardest to tolerate in young infants when there is a lot of reflux. Simpler strain options may work better. Lastly, check into homeopathic tools with a classically trained homeopath. There is a wealth of options that work gently and can be quite effective for babies. A favorite book of mine to start learning about this is this one.
Hi Judy, I just came across this article. My little one is 5 months old and was just diagnosed with Laryngomalacia. He was gasping and dealing with a bad strider terribly early this week which ended us up at the ER after they thought it was croup and 2 dosages of steriods did nothing. The ENT put him on .4 dosage of Pepcid. He’s been super fussy at night and constantly pushing gas and pooping. They said keep giving it to him. I’m not sure if It’s the Pepcid or my diet. I hate giving him Pepcid and not sure when I could get him off it. Any recommendations? They did say I can give probiotics which I plan to start soon. I’m also wondering if he has an allergy to dairy or other foods as I’m breastfeeding. Any tips would be helpful, thank you!
Pepcid is a milder strategy than proton pump inhibitors for reducing stomach acid, and may help some at first. But this is always the dilemma: The baby’s stomach acid may already be too low to begin with, and this can cause reflux. If nothing gets better with a few doses of Pepcid, or if things get worse, there’s your answer: Your baby needs more digestive support, not less. This is where digestive bitters or Gripe Water may help. Removing trigger foods can help some also. Probiotics can worsen reflux and discomfort if you use potencies that are too high or formulations that are too complex. If that happens, you can try a simple Bifido blend like Klaire Factor 4, or stick with a single strain like Lactobacillus reuteri to start. To explore these options, look for an email inviting you into my FullScript dispensary and search there for these items, which are among the better quality, stringently tested products that I recommend. As always, I wonder why so many little ones are unable to digest their food, breastmilk, or gentle organic hydrolyzed formulas. It’s all about biome – moms need healthy gut and vaginal biomes pre-conception and at delivery, and babies need time without interference from shots to develop their gut immune interface. We’ve all learned to use antibiotics with discretion, but we have not yet learned this lesson with inoculations, which are given aggressively and in multiple doses in the first year. These too can disrupt the delicate gut biome progression that babies and toddlers need to avoid allergies, have an appetite, digest food normally. eliminate comfortably, grow, and thrive.
I got my son 2 of the 3 Hepb shots and all the other 2 month recommended shots. Doctor prescribed Pepcid because he may have acid reflux. I am very skeptical in giving him the Pepcid she prescribed because I don’t like the fact that tge FDA says not to use in kids under 12 years old and my baby is 2 months old. I don’t know if maybe I should try it for a couple of doses and see if it helps or not. I’m also not sure if I should continue his shots since I’m breastfeeding or maybe see about continuing with amtge Sears delayed schedule. Any advice on all this I’d appreciate!
Your baby’s stomach is on its way to learning how to make enough acid to digest food. This will take at least six months. If he can sleep and eat well, and have comfortable eliminations, then he may not need medicine for this at all, and it will only add to the challenges he’s faced with taking several doses of antigens already in shots. Kudos for breastfeeding – he is receiving your immune protection, so you can feel reassured that this is as good as gold for keeping him away from infection. I personally favor individualized care around the shot schedule. What your baby is due to receive in the first year are repeat doses of what he has already received, and he may not need them in addition to being breastfed. Discuss with your doc. Check into digestive bitters for infants as an option to ease colicky symptoms too. These are natural compounds that are safe to use and often effective.
I have a four week old daughter who spits up a lot. Doctor has said it’s acid reflux.
I’ve done all the things. Feeding lying down, cutting out coffee, caffeine, soy, dairy, and nuts. Burping more, staying upright after feedings. Colic drops, probiotics.
She’s still spitting up quite a bit and her little vocal chords sound so hoarse. She doesn’t cry too much and is semi easily comforted. But I feel her voice is getting worse.
Some spit up is surely usual at this age. If you’re not seeing any skin changes with this (rough patches? redness? hives/bumps?), and her growth pattern is steady, then this may be a simple fix with a mild herbal digestive bitters tincture, rather than turning yourself inside out with elimination diets and special formulas. I’d suggest this one for a young infant. As usual, I’ll add here that I am not a fan of the US shot schedule for infants, which IMO is too aggressive, and which I have seen disrupt too many babies in my nutrition practice tenure of 20+ years. If symptoms are not resolving I would suggest you consider delaying the schedule until your baby’s gut/immune interface can organize.
Hell, thank you for this post. My daughter is 6 Years old. Has been on famotidine 2 months because of feeling something in her throat, random belly and chest pains and a dark poop she had, Dr said to stop at 2 months, I did and she is telling me her throat feels weird again, vomited at school, upper stomach pain, Dr said to restart famotidine for another 2 or 3 weeks. Please help, is this safe? Ghank you in advance
This drug may be necessary if your daughter has inflammation in her throat tissue. At this point, your doctor might suggest a procedure called upper endoscopy to figure out what is going on. This will give a direct view of her throat with a tiny camera through a scope. I would welcome this option at this point, to sort out whether she needs the medication and what other measures might help.
Hey thanks so much for the info in this article. My grandbaby has acid and her mom did too. They put her on acid reflux med 3 weeks ago and it’s still not helping and we also asked him to change her formula but he wouldn’t and had her admitted to the hospital because she wasn’t gaining weight. As of tomorrow we are taking her off the med and I am looking into herbal tincture to give her instead. We also switching doctors. Thank you so much.
Hi Judy! Loved this article. I was wondering, does this still hold in 2022? Have drugs improved in any way? A gastroenterologist prescribed esomeprazole (Nexium) for our baby and we’re wondering if we should use it…
Hello, to my knowledge, histamine blockers (H2 blockers) and proton pump inhibitors (PPIs) have remained unchanged. Nexium is approved now for “short term use” in children ages 1-11 years old. This would typically mean for 1-3 weeks. Longer term use of years, as I have found in cases in my practice, can engender many health concerns, and this has been the cause of a number of lawsuits. For non-pharmaceutical strategies, talk to a naturopathic doctor (ND).
Hi Judy! I tried to schedule an online meeting with you but there doesn’t seem to be availability for this month nor next month. 😭
I’ve read your amazing informative article and read most of your answers to the comments but i still had a question in regards to the schedule and all the supplements you’ve mentioned.
– Gaia Herbs GI feel good
– Vitanica Digestion Tonic
– Gaia Herbs Kids, Tummy Tonic
– Seeking Health ProBiota infant
– WishGarden herbs Colic ease
For a 6 month old baby with silent reflux and discomfort (drinks hipp ha pre) which supplements would you give him? How many times a day? & What time of day is best for each supplement?
My doctor only recommends nexium. Your help and advise would be greatly appreciated!!
Hmm… another Nexium question! A popular prescription this month for some reason. It’s a proton pump inhibitor, that is, the strongest type of reflux medicine. The herbal items you mention are worth a try and you don’t need all of them – just one can do the trick. I would start with WishGarden Colic Ease and use per label instructions.
My daughter is 2.5 years old. She complains a lot lately that her tummy hurts (sometimes it may be the cry wolf effect) and this morning I was thinking my goodness did I do this to my child? At around 2 months I want to say she started on lomeprazole. She was regurgitating so much of her formula (large/multiple handfuls) that we were referred to a GI who prescribed this. She had the common back arching, super fussy, crying all the time symptoms etc. We tried like 10 different formulas and ended up on Alimentum which still didn’t completely help but she tolerated better than others. She also had borderline pyloric stenosis and had multiple ultrasounds to keep an eye on it. We took her off of it around 9 months. She’s mostly a happy kid now with the usual 2 year old tantrums but when she says her tummy hurts (now multiple times a week almost every day) a little voice in the back of my head thinks, could I have done this? Does it have that long term of an effect? She has gone through also 5 rounds I would say of antibiotics in her lifetime due to ear infections or strep. Anything you suggest? Have I ruined her? 😥
No you haven’t ruined your daughter – ! She may need some support for her gut biome. If she’s already had several rounds of antibiotics, this can throw the helper bacteria in the gut off balance, and set up anything from some intermittent stomach pain to difficulty stooling to a fungal dysbiosis (in which case you’ll likely see a bloated belly, big sweets cravings, and even more than the usual tantrums). Ask your pediatrician to check her stool for H pylori, a type of bacteria that can cause chronic stomach aches. If her growth pattern is slowing down, make sure she has not become sensitized to gluten with a deamidated gliadin antibody test. This requires a blood draw with your doctor.
Hi Judy, I found your article just as I received my sons prescription for Famotidine. He will be 13 weeks tomorrow and since 1week 6 days he’s struggled with bad gas and what I am now discovering also silent reflux. He’s not a vomiter or spit up but he does choke, gag, cough. He’s gaining weight just fine which is why doctors have not really taken my concerns seriously. But his gas pains and or reflux pains interferes with his quality of life. He can’t drink a bottle (breast milk fed only) with hunching over in pain and this is after a few ml not even an ounce! Or he’ll suddenly get very stiff in my lap and soon enough he’s practically standing and so uncomfortable. We’d have to spend the next half hour trying to get gas out before he’ll even consider the bottle. His bottles are usually 125ml roughly slightly over 4 ounces and most feeds he’ll only take 2 ounces of it due to the pains and choking. I’ve tried MyLicon probiotics, BioGaia which I so desperately wanted to work for me but it left him without a bowel movement in 2 weeks so I finally switched to mama natural that has 10 strains not sure if it’s too much but it’s finally got my baby to have regular bowel movements. His being back up would disrupt so many naps he’d push and push all day. But his gas and reflux disrupts feedings and makes it difficult for him to go to sleep. He’s always kicking and hunching in my arms and crying or giving me the sad lip like why don’t I fix it and I’m trying. It also wakes him up from his naps and has his evening sleeps so miserable for him. We saw a neurologist because he started do this head jerking and head spinning in his sleep. The EEG was normal but we were told it could be due to gas and reflux pain. He scratches his face and pulls his hair in his sleep due to the discomfort and I just want to help him! All naps are in my arms since the discomfort wakes him up almost immediately once put down and his nighttime sleep always ends with him in my arms once he’s had enough of the tossing turning kicking face scratching and hair pulling. I’m 2 weeks in on eliminating dairy eggs and soy. I saw tiny health has a test to see what our baby’s biome looks like abd us lacking so we can choose the right probiotics and make the right changes.! It’s expensive but seems so worth it. After being told for the last 10 weeks my son (a happy baby who only cries when really hungry) told he has colic that should resolve at 12 weeks abd now that it hasn’t he’s been prescribed meds. I just need help and hate not helping my baby.
As always, my first question is …. did your baby get a dose of hepatitis B vaccine at birth? More boosters at 8 weeks and 12 weeks? If yes please stop. These are disruptive to the developing nervous system, brain, and gut, and frankly IMO unnecessary for a breast fed infant receiving and protected by mom’s immunity. Fighting words I know, but that’s my opinion. The neurological features you mention are especially noteworthy with respect to vaccinations, as all of them are known to cause neurological symptoms including seizures and tics in some children – not all babies can tolerate vaccinations, or tolerate the dosing schedule in which several are given at once (the norm in some developed countries like the US, UK, New Zealand, Australia, Canada). Beyond that, he clearly has discomfort worth intervening for, and hats off to you for finding a probiotic that helped him pass stool. I would work through the steps mentioned here (just updated) and find a classical homeopath (example here) for dosing on gentle homeopathic remedies that can steer all this in the right direction.
Hi Judy, my 2 yo daughter was on omeprazole for 4 months when she was 2-6 months old. I have just read a journal article saying that the use of PPIs can cause bone fractures in kids even years after the cessation of these meds. Do you know why this happens and if the body ever recovers from this? A worried Mum!
The reason why this happens is because drugs like omeprazole reduce stomach acid. The stomach must be extremely acidic in order to initiate digestion, break apart food so it is available for further enzymatic action, and to absorb minerals. The extreme acidity of the stomach is normal and desirable (but painful reflux is not). Over time, if it is blunted for too long, protein and mineral uptake into bone tissue will suffer. Bones become more fragile and prone to fractures, and growth may be stunted. I have witnessed all of these phenomenon in my own practice.
Thanks for the explanation! Would 4 months of 5mg daily omeprazole at 2-6 months of age have caused this? (when she was 6 months old I completely stopped all meds) If so, is the damage to her bones reversible? I gave her probiotics for a long time afterwards and still do, on and off. She’s 2 now.
As far as I know there has not been research on prolonged PPI use in infants, to assess bone density at age 2 years. There is no question that these drugs reduce absorption of protein, B12, and minerals. In cases in my practice where children had used these drugs and suffered stunting and/or fractures, the drugs were used for over a year, and in some cases, for over two years.
Hi, can we go off omeprazole immediately and try some of your recommendations to prevent any further damage as it does not seem to be working 9 months later. He’s 10 months old and seems to not be getting better as they up his dosage as he grows.
I don’t typically suggest going cold turkey off this medication if a child has been using it longer than FDA approved, eg 4-8 weeks. I would suggest gradually reducing it while you slowly introduce measures to restore normal digestion and eliminations. A key player in this strategy in my practice is gradually increasing the digestive herbs that I suggested above. You can find them in my online dispensary here or on amazon at link in blog above.
I have twin girls who are 1m old. One of my girls has had a hard time with spitting up since she was born. It pours out of her mouth and nose. I am only breastfeeding. She is gaining weight like normal and gained 17 ounces in 13 days. However, the spitting up was increasing in frequency and amount so our pediatrician prescribed famotidine daily. I have given it to her only two days but she is still spitting up. I rather not give her medicine at all and definitely going to stop giving her it after reading all that can happen to her digestive system. Any advice on what to give her?
Good news that your baby can gain weight well despite losing so much of her feedings. You might consider gentle herb drops for babies that aid digestion and ease colic, like WishGarden Herbs Colic Ease. Even though you haven’t mentioned gas per se, this herb blend helps the stomach release more digestive juices to help settle the stomach. You might also find there are some foods your baby doesn’t tolerate in your own diet and can consider eliminating major allergens like gluten or casein.
The tonic you suggest says not to use for heartburn/GERD, and doesn’t indicate that its safe for infants. So why do you recommend it?
My little girl is 6 months old and has battled reflux since 4 weeks. I haven’t put her on medication because it doesn’t seem to be the answer, but I want to find something that will make her feel better. Going through this for another 6 months potentially seems just…terrible. I already use an organic formula with partially hydrolyzed milk protein, and we use a probiotic. (Unfortunately the reflux ruined our breastfeeding).
Hi Lauren, I recommend it because it has worked well in my practice.
Supplement companies must complete costly and additional work to be able to make claims on their labels, especially for anything used in children. Drug companies can afford this as pharmaceuticals are so wildly profitable, while supplements are far less so. Thus, this leaves supplement companies often in the position of not being allowed to use language implying that their products “treat” anything. This is thanks mostly to the pharmaceutical industry’s alliance with the FDA, which is charged with oversight for foods and supplements as well as drugs. To this point, an oft-heard sarcasm is that the “F in the FDA is silent” – meaning that they tend to focus on drugs and not foods or supplements – because of the profitable partnership the FDA and Pharmaceutical industry share.
If you’d like products only approved for treating reflux in children per labeling, your doctor can give prescription or over the counter drugs that the FDA has approved for use in children.
I’m crying as I’m reading this. My baby is 2 months old and she has been arching her back, jerking, making faces as if she eats something bad/sour/, having eyes wide open/crossed during these episodes, suddenly crying in her sleep, snorting, wheezing, coughing here and there, unable to sleep when being put down, as well as minor spitting up. Sometimes she would be dead asleep and her eyes would suddenly open and her body will arch/jerk. We are on gelmix and Nutramigen ready to feed (2oz every 2 hours), and now The pediatrician is putting her on lanzoprazole at 0.8 mg per day. We’re on day number 4 and I’m scared to death that I’m doing something wrong, especially when I just read today that it’s not approved for infant under 1 and the wean off can be brutal. Please help me with your advice
Hi Olive, I’m so sorry that your little one is having such a hard time. Be sure to let your doctor know what you are observing. If you haven’t seen improvement quickly, talk to your doctor about reducing the dose of medicine or changing strategies, so your baby can settle down and be comfortable.
I have twin girls that were born at 29 weeks. They are now 3 months old. We have had multiple choking issues with one of our girls and they keep saying it’s reflux. They are both on eleacare because they were having bloody stool through out their NICU stay. They believed it stemmed form a milk allergy. Stopped breast milk, tried nutramigen but elecare was the only thing that stopped the bloody stool. However it now is causing my one daughter to only go to the bathroom every 3 days! Anyways it’s been a long road in the short 3 months they have been here. They think they have reflux but the only symptoms they have is the choking on feeds. They are not fussy, sleep well and don’t spit up much. Any help or suggestions would be greatly appreciated. They started them on Prevacid and I stopped it because I don’t think it was doing anything and I am also not completely convinced of the diagnosis. These babies had 60 days in the NICU on antibiotics and a whole bunch of other things. They are thriving but the choking has started on elecare.
Hi Allison, your little ones need to build a functional gut microbiome. They’ve missed this so far with their early arrival and aggressive measures in NICU including antibiotics. Choking, gagging, the milk protein intolerance, the bloody stool – all of these are signs of a disrupted gut microbiome. You will likely need more than some probiotics to restore this. Your providers should do some stool testing to rule out H pylori, Clostridia, fungal burdens, or overabundance of other species that don’t support digestion for infants. These are generally non-pathogen strains, but they can engender inflammation, weaker digestion, and stooling difficulties. This testing is not typically offered in mainstream GI practice especially for infants, but I would encourage you to ask your team to do this for you (they may not know how, but you can ask). At the very least you should begin a high potency probiotic like Seeking Health Infant Probiotic.
Hi. My pediatrician prescribed my baby pepcid at 4w. She didn’t pay attention on its side effects like she constipated within 2w. She put baby in prune juice for 2w. And now at age of 3.5m my baby has lost appetite and she has no clue and said me to keep freding her doses of pepcid. Its day 3 and ahe has not developed her appetite. I want to know how long it takes pepcid effects to vanish completely?
I am afraid my baby will develop deficiencies and she will stay short heighted.
Since the Pepcid can disrupt the helpful bacteria in the baby’s gut, and invite strains that are more disruptive, these may stay that way until you intervene. You can use gentle herbal digestive bitters to encourage normal stomach “juices” to return. These invite the helper bacteria to return as well. Look at products like Gaia Tummy Tonic or Wise Woman Herbals digestive bitters, and look for products in glycerite. Ask your local naturopath (ND) for guidance – these are health professionals trained in the use of non-drug tools like herbs or foods.
I wish I had read this article earlier. My baby has digestion issues. She got constipated on gentlest and pro total comfort. We started her Reguline and she got super fussy. Her feed started to reduce. She started to develop constipation. We changed her to Alimentum and she lost her appetite in 4 days. Her doctor doesn’t listen me. She is watching a weight difference of 1.5m. Advising me to continue famotidine though it’s mentioned in side effects notes that loss of appetite may happen. I have stopped pepcid today and after reading this, I will not give her it again. She hasn’t gained even 1cm of height in 1.5m.
I wish I had read this article earlier. She started pepcid at 1m and now she is 3.5m. I have messed up her stomach and everything in her body.
Many many thanks for this valuable information.
Well, you haven’t ruined anything at all. Quite the opposite – you’re listening to your instincts as a mother and nurturer and your baby will benefit. If she can be no more fussy off the medicine than on, then it’s reasonable to wean off. I corrected the link in the blog for a gentle product to support and normalize stomach secretions and digestion. Stick with your good instincts!
Hello Dr. My son is 2 yrs old and right after his 2nd birthday (8/21) he got a stomach bug that turned into vomiting blood. After meeting with a GI and doing a endoscopy, we found out he had a stomach ulcer which probably evolved due to untreated acid reflux. He is now on Omeprazole twice a day and recently we’ve noticed more spitting up if he plays to vigorously and sometimes throwing up actual food. His GI wants to keep him on this for 2 yrs but I’m concerned about the long term effects and if the meds are no longer effective. Any suggest or feeds back?
What an ordeal – and kudos to your team for finding the issue quickly. I agree that two years sounds like a very long time to keep this medicine, after the initial healing phase. In my opinion it should not take two years for the tissue to heal, unless there is poor nutrition, an inflammatory diet, or dysbiosis in the gut that exacerbates it for that long. There are herbal supports that might be useful here, and your best option is to speak with a naturopathic doctor studied in the use of herbs in young children. You might start here to find one in your area.
Hi ! My son is a premature 34weeks /4 weeks old and was diagnosed with Gerd . Doctors ran all tests including swallow test and concluded he has reflux. He was hospitalized for losing his breathe apnea and gerd. Doctors prescribed him Prilosec , Is there anything else i can give him instead of this medication?
It wouldn’t be unexpected for a baby born a little early to have difficulty with first feedings, with swallowing, or to display symptoms of GERD – this is normal, and not necessarily indicative that medication is needed. You can use digestive bitters tinctures in a glycerite base to aid digestion in infants and children. This may work better. If Prilosec is not making a difference or if symptoms are worse, consider a tincture like this one and use with feedings.
Can the Gaia tincture be used on a 7 week old? How many drops per day?
I am comfortable with this, with supervision. Reach out to a naturopathic doctor (ND) who is experienced in working with young infants for guidance.
My son is 13 months now and we have finally dropped his last dose of nexium. We knew it was making everything worse but I was scared of the pain he would be in with the rebound. We have pushed through the rebound after being on it since 5 months old. Will he heal now that he is off the medication?
Good for you for weaning him off. The body is always endeavoring to heal and progress, at any age. Give as varied a diet as you can so he can build a diverse microbiome in his gut. Yes this can be restored.
Ignorant and judgmental post. My son is 20 months old and HAS to be on acid reflux medicine. He was born without an esophagus and the procedure he had to repair it requires it.
Thank you Lacey for sharing your story. Very challenging to be born without an esophagus and indeed this is a circumstance where this medication is warranted!
Hi my 7 week old had all reflux and colic signs. The main concern was extremely fussy at night not sleeping and occasional spit up that looked curdled. Doctor sent a stool test but in the mean time suggested 5mg of nexium. We started medication on Friday (a week ago). Some days seems like it may be work still some spit up but not curdled. However his stomach pains have increased. I started giving him gas drops which seem to help. I’m worried nexium is not doing much and would like to discontinue but keep reading not to do it cold turkey. Any suggestions since it’s just been a week.
Per usual, the medication is slowing, not helping, digestion. This can cause more pain and discomfort, not less. I’d consider an herbal tincture to aid digestion so that food can leave the stomach toward intestine, not backwards back up to esophagus. A product like this may help. Talk to a Naturopathic Doctor (ND) who is experienced working with infants for more help, if you pediatrician only knows how to use prescription drugs.
At one month old, we suspected our son was having GI issues. His spit up wasn’t normal because of the volume and frequency. He was losing weight and aspirating (which is horrifying for first time parents btw) so we knew it was serious. He was also very fussy. He had a swallow study done and the results said that he had reflux. It was so hard putting him on GERD meds. He was prescribed a daily dose of liquid famotidine. It seemed to help a little. He seemed less uncomfortable but the spit up never ceased. Oftentimes, it was worse than before. Because he wasn’t gaining weight, we had already introduced bottle feedings of expressed milk to track his intake. We also started to supplement with formula at this time. He had a bad go with the dairy formula so we tried a soy based formula. That first bottle changed everything. He immediately calmed after that first bottle of soy. It was crazy. Felt like magic. So we continued to use the soy formula and famotidine. We stopped giving him breastmilk because we felt there seemed to be too many variables with my diet that could be causing him unnecessary discomfort. He really was a different baby after that. No more fussing. So we’ve had good days and bad days, but the spit up never stopped. Our doctor upped his dosage to twice a day at 3 months. We’re now 6 months, and we feel like something needs to change. Our son still spits up with large volume and frequency (even more so at the end of the 30 day life of the medicine). We’ve started solids within the last month with hopes that things would settle down, but they haven’t. I’m afraid that we’ve caused our son long-term digestive problems because of his continued use on the GERD med but we feel like we’ve tried everything. We tried stopping the meds and the spit up was like from the exorcist. He’s been getting chiropractic care. We’ve tried probiotics & essential oils. It’s just so deflating and stressful when you’re playing with your son and while looking down at him, you see the milk you fed him an hour ago, suddenly come back up and fill his mouth. Is this normal? Has his esophagus developed properly? I’m desperate for change and relief for my little one.
This is a difficult journey, thank you for sharing it – yes, his digestion has been gradually diminished with the use of the reflux medicine. Even with reflux seen on a swallow study, there may be other tools to help. Confounding pieces are what type of delivery he had (C section or vaginal), if either of you have had antibiotics (in pregnancy, delivery, or after), what shot schedule you’ve followed, and what your own history is for gut health, antibiotics, and medications. A slow and gentle reversal of the process that landed him here can help. You might consider joining my Nutrition Cafe live zoom chat this week – these are archived for members if sessions are missed – this week topic is reflux, drug and non-drug interventions, and what foods may work best in this weaning process.
Have ties been ruled out?
Excellent point – tongue ties should be ruled out for sure, thank you Shanee. The procedure to correct them can be simple and transformative for feeding.
Ask your pediatrician to prescribe an ultrasound, what your saying sound identical to what we went through, turned out my baby has pyloric stenosis and that was causing all the throw ups.
I don’t understand why this isn’t the first thing doctors do before prescribing Anti acid meds.
Thank you for posting this. My son has been going through something similar. It started at 10 months, right as he started to teethe. He’s had hospital stays, invasive tests and has been on Nexium for two months. The GI specialist, ENT, Allergist have all said “it’s the strangest thing”. As soon as you give him food, he starts producing all of this mucus and he throws up. I’m trying so hard to find a way to support him more. Other than these episodes he is totally normal. Weight is slowly decreasing. He’s currently 14 months.
This sounds very difficult. I would ask your team to investigate inflammatory markers (stool calprotectin and other lab studies), mast cell activation and histamine status in the gut. I would also encourage limits on vaccinations until his immune system can calm down. Vaccines are potent immune stimulants that make big demands on the body. If he is already exhbiting signs of chronic inflammation, this warrants exploring and resolution, so he can eat and eliminate comfortably, and thrive.
My son was put on nexium under a month old. He would not eat. He refused to eat. I tried to stop nexium at 3 months, but the same thing happened. He is now 8 months old and still on nexium. He doesn’t drink enough (although he looks healthy) I know he only takes little bits when he wants more. He has only been able to manage two tablespoons of purée otherwise he will be screaming in pain if he eats until full. Recently he’s refusing food altogether. Doctors are not listening to me they just say the medication should fix it. I don’t know what to do my 8 month old is not eating, and drinking little bits (8- 10 oz a day in total each day). I can’t afford a natural path and I’m in tears worried over my son.
This does sound uncomfortable! Stay tuned for options on DIY helps for this via my FB page here and my newsletter here.
My 5 month old has been on Omeprazole for 3 months. His symptoms are much worse now than before. I think the Omeprazole has caused the all day pain, fussyness, colic, screeching. I’m in the uk and not sure where to start. Will his gut heal over time?
Yes his gut can heal. Let your provider know that the omeprazole is no longer working. My next Nutrition Cafe session (July 8) will focus on reflux and non drug strategies. Click the Learn With Judy tab above and navigate to Join Nutrition Cafe for details.
Hi Sarah. How have things developed for you?
My LD is on omeprasole and Nutramigen. Once/day usually in the morning ,she’ll take 3 Oz without fussing. The rest of the day it takes up to an hour to get her to drink 2-2.5oz Nutramigen. For 24 hours she takes about 15ozs. I am feeling like I need to be admitted on psychiatric ward,I cannot manage feeding her 6 times/ day and watching her being in pain. We see an osteopath weekly,we have seen 2 private pediatricians , we have seen the GP few times. We gave Gaviscone and carobel a try too,but those constipated her and did nothing about her discomfort. The only positive thing is that on Nutramigen she opens bowels daily without straining.
Sorry to hear this is so hard Anelia, thank you for sharing! Your daughter needs to have stomach acid restored to normal levels IMO. This will allow her to feel hunger, eat more normally rather than take an hour to manage 2-3 oz, and to have less pain. This may require a gradual and step wise approach depending on the status of her tissue in esophagus, stomach and upper GI tract. I would suggest scoping if this has not yet been done to rule out larger issues with her GI tract, eg, eosinophilic esophagitis, H pylori in stomach, or any other common triggers for pain after using reflux medicines for a long time.
Hi my baby is 6months 2weeks.
She uncomfortable during feed and after feeding, she doesn’t sleep well at night.
Hiccuping most of the time and checking. I tried to bump ,feed small portion and keep her straight for 30 minutes afterfeed but it doesn’t get better.The Dr put her on Nexium for 2weeks is it safe? Please help.
If you haven’t already, tell your pediatrician and expect a solution beyond Nexium – especially if Nexium isn’t working. Nexium is approved for children over a year old and adults, and only for 4-8 weeks. Follow tips in this blog post for alternate measures – I’ve just updated them with new ideas. There are many other possibilities besides arresting digestion in your baby’s stomach, which is what Nexium will do. It may provide a short term relief but can ultimately worsen the problem.
Would magnesium lotion and probiotics be a couple good options to combag the silent reflux and gas build ups my 1 month old has been having?
Hmm not necessarily. If it’s “silent” reflux, are you certain of the diagnosis? A one month old baby will normally have a good bit of spit up and some gas, but should be able to settle and sleep without pain most the time. Magnesium lotion is relaxing and soothing, but use only a small amount, eg 1-2 pea sized bits of lotion, for your baby at this age. Probiotics may help but less is more. Look for a product with Bifido infantis in it to start. If gas still persists to a degree that sleep, feeding, and eliminating are impeded or disrupted, then it’s time to think about new options for feeding, whether you alter your diet some while breastfeeding or you make a formula switch if you’re bottle feeding.
Since my daughter turned a month old, she started with severe reflux followed by painful feedings. It took several formulas until we arrived at elecare hypoallergenic made out of amino acids. We’ve been given omeprazole which made it worse, then Prevacid which seemed to maybe reduce the spit up only a tiny bit. Then we were advised to add oatmeal to her bottles for thickening at 3 months which seemed to upset her stomach, bloat and constipate her. Then they changed Prevacid to famotadine which also seems to upset her stomach. We have tried all preventative measures, frequent burping, sitting upright, sleeps elevated etc. she has a dairy allergy and can only tolerate the elecare but it’s super thin. I think I want to stop meds and just continue on probiotic. Any suggestions? I’m at a loss. She has seen multiple doctors including GI and was even checked by ultrasound for pyloric stenosis which came back normal
This is a common story! Her digestion has been slowed by the medications and interventions. At first these can help calm symptoms but then after some time, food that enters the small intestine is not ready for next steps of digestion. It causes dysbiosis – disruptive bacterial overgrowth – and this in turn causes more symptoms. The solution can require stool testing to assess where the gut microbiome has landed after all the medications and special formulas. Correcting the microbiome so that microbes can support rather than impede digestion is key. For details, you can work with me one on one. A faster option is joining my Nutrition Cafe live chat series. This week’s topic will be reflux, silent reflux, which foods might work best when weaning off these drugs, and drug and non-drug therapies. These sessions are archived so members can review anytime. If you join, you can also send me questions ahead of time if you like.
Hey Judy! When my little one was born she was only 5lb 13oz so the hospital put her on Similac Neosure. Between that and my breast milk she did great. She was on it for another week (even though the hospital switched her to gentle ease before we left) because I had many of the little ready to feed bottles left over.
The moment she switched to Gentle Ease all her problems began. Screaming bloody murder for hours on end, acid reflux that you could hear burning up her throat, projectile vomiting- her 7yr old brother saved her life, but that’s a story for another time, etc. Her pediatrician suggested that it may be a dairy allergy so she made me cut it out of my diet (because I half and half bottles) and switched her to Alimentum and put her on Pepcid. She began the meds a little younger than 3 weeks old at 0.3ml which helped a little at first but no longer does. The Alimentum didn’t seem to help with much of anything except weight gain (I forgot to mention she lost a whole pound after birth and couldn’t gain it back). Now at 6 weeks, the Alimentum is causing so much gas that she’s miserable and she’s on that same dosage of Pepcid twice a day. No changes. I personally think that they may have jumped the gun on the medicines and “milk allergy”. Her brother was sick with HFM around the same time as the severe vomiting and I slightly wonder if she had symptoms from that. Is it safe to introduce a milk formula back into her diet to trial and error it? I know either way she’ll be fussy from switching at first…… I still consume dairy and tried strictly breastfeeding her for a few days and she did GREAT, but I don’t have enough supply for her needs. I also would like to ween her off of the meds, as they aren’t helping anyways. What can I do to help my 6 week old? I have severe acid reflux and I’ve had many gut issues throughout my life- as well as more antibiotics than I could ever count. Hundreds even…. I want what’s best for my girl it I’m afraid I’ve caused permanent damage with the meds.
If breast milk seems to be her charm, consider purchasing donor breast milk if your supply is low and sticking with that.
The main difference between Similac Neosure and Gentle Ease is that the Neosure includes lactose, which is one of the naturally occurring carbohydrates in human milk. Otherwise both formulas you’ve mentioned have whey, casein, and corn syrup in them. This suggests to me that the lactose was a key helper and we know this is the case – it plus other starches found in human milk (human milk oligosaccharides, or HMOs) are critical for building a healthy and protective gut microbiome in infants.
If you can’t get your hands on donor breast milk, you can make a homemade formula that uses lactose (which you can buy) – recipe here. In my opinion, regarding that recipe, omit the nutritional yeast and use a B vitamin supplement instead like this one or this one. Keep in mind that B vitamins have a strong taste and if you add it to an entire bottle your baby might refuse the bottle, so consider mixing those separately with a little milk and giving via oral syringe.
If you’re wondering why I’m not a fan of nutritional yeast, it’s because it is a Saccharomyces strain of yeast that works fine for some but can be very disruptive for others and is apparently, so far, not identified as a beneficial microbe in early infancy. It is also used to make (genetically modified) hepatitis B vaccines, which is given to newborns and young infants. In my clinical experience Saccharomyces cerevisiae or boulardii both have potential to be quite disruptive for the gut long term when injected in this vaccine, or when taken orally for longer than 1-3 weeks.
Thank you for this article. I feel like most doctors don’t get to the cause of the issue. Being involved with Le Leche League made me realize how many babies with reflux are caused by dairy/soy protein intolerance.
Same happened with us. Finally we had gone through a lot. Advise is to try Homeopathic medicine
I hope your kid is doing better.
My daughter has moderate low muscle tone throughout her entire body and hated eating food too. It took us a long time to figure this out.
We went to a pediatric GI who sent us to get a test that involved her drinking a special liquid and getting an X-ray. The doctor found out that she had an extremely slow moving digestive system. Meds were prescribed and she is started growing. Meds are not my ideal answer. I’m looking for a alternative way, but now I have a girl who is gaining weight and growing. She even likes food a little more then before.
Hopefully this is old news and you have found a solution for your son.
Ps. Thanks so much to the author. I’m excited to take this
Information back to her GI and see what we can do to get
Her off meds for her GERD. Now that is a older.
Hi Judy, thanks for your blog on this. We are in a similar situation as others on this: we have a 7 week old who fusses a lot and can’t sleep on her back, and is a lazy and fussy eater. She has been gaining weight fine though. Doctors prescribed GERD medication: sucralafate and lansozaprole at 2.5ml 2x a day which seems aggressive to me for such a young infant. I would like to hold off and see if the situation corrects itself. In the meantime what can we do? I don’t see the actual products or methods recommended on this link? Could you send me a link? Could you also send me the FDA PPT you linked? I can only see the first page on the link that’s on this page and can’t get to the next pages. I would so appreciate it!! Thank you!
I no longer have a link to that entire FDA PPT, but increased risk of fractures in children on PPIs is reported elsewhere – such as here and here. I would suggest restoring the natural progression of digestive development with a tincture like Gaia Tummy Tonic, which I have used in my practice. The label says not for infants under six months old, but with supervision I have never experienced any issue with it. She may need restoration of a functional gut biome as well, and that is something I would assess with stool studies and symptoms (bloat, gas, stool pattern and consistency). All can be redirected – but as long as she’s using a PPI, you’ll be swimming upstream.
What dosage would you recommend for the tummy tonic? My baby is currently on Famotidine, after a trial w/ Omeprazole, which while helped w/ the reflux, but caused her other symptoms. Now she is constipated, which was never a problem before! I want to get her off meds and we are working w/ a functional medicine dr. but now I’m stuck waiting for her to poop for her poop test. I’m scared to take her off the meds b/c it was hell prior to her being on them, but w/ these side effects and fear of infection, I just don’t want her on them. Her reflux is also very likely due to food intolerances, I’ve altered my diet drastically and it’s helped some, but she still has reactions. It’s such an exhausting experience and my poor girl has been so uncomfortable for most of her her short life. She is 3 months old currently.
Work with your overseeing functional medicine doctor for dosing on supplements like Tummy Tonic, and for tools to immediately ease the constipation – s/he should assist you in that regard, and if they have not worked with infants before, find a practitioner who has. Constipation at this age indicates either a disrupted gut microbiome profile (especially suspect here is yeast overgrowth) – so, good to do the poop test – or, poor digestion of milk protein, which will be constipating if difficult to digest, especially if she is formula fed with a milk or soy protein product. There are several formula options out there that can work nicely and your provider should be well versed in these if s/he is accepting infants as patients. BTW – if you are doing a GI MAP stool study and yeast /fungal strains are negative, this is the one area of this test that falls short. This is why I often request a separate yeast mycology (culture) from a different lab at the same time that I request GI MAP.
Hi there! My daughter is 8
Weeks old today. Her pediatrician has changed her formula 6 times. She was on enfamil gentlease and had severe spit ups. They then switched her to similac alimentum. Within hours of the first feeding, she was screaming in so much pain due to gas bubbles in her belly. I called the doctor twice. Their response, either switch back to the other formula or ride it out for the 2 weeks. She was on it a week and it was absolutely miserable. She went from
Eating 4 ounces to 1. She screamed all day and night and was constipated. I took the decision into my own hands and had left over breast milk in the freezer. She took
4’ounces immediately. That next day she had a doctors appointment. She had diarrhea so they tested her stool for blood and they said it was positive and said she had a milk protein allergy. They told me to switch to nutramigen. Literally the day after that doctors appointment she had an appointment with the gastroenterologist. He tested her poop twice and said there was no blood but suggested pureamino. We stuck to the nutramigen ready to feed and she did really good on it. Once we switched to the powder she was having a hard time eating again. They diagnosed her with reflux and had her on famotidine. With the powder she screamed so again they switched her to pureamino. She took 4 oz instantly and we didn’t have a problem until recently. They switched her reflux medication to nexium
And she’s had nothing but constipation and gas. I again called the gastroenterologist because I feel the gas is so bad that’s what is making her fussy. He then prescribed her lactulose to help her go to the bathroom. My initial thought was why would you give a baby a prescription to go to the bathroom? I tried everything to try and help her pass the gas and go and nothing worked so I ended up giving it to her. She went but was still gassy and backed up and kept
Crying. I feel like I’m at a loss because nothing is working. I stopped the nexium but now she’s not eating again and is screaming in pain. What can I do? I feel like her doctors aren’t listening to me and just keep prescribing her medication without figuring out for sure what is wrong with her. How do I know for sure if she has that milk protein allergy?
Hi Stephanie, I’m sorry this has been so hard. It sounds like all the strategies so far are failing. I encourage you to stay abreast of new service I am offering soon called Nutrition Cafe. We will create bi monthly on line live sessions on specific topics and this is a topic at the top of the list.
My two month old daughter has recently been experiencing reflux symptoms. Spitting up a lot, grunting, clearing throat, lack of sleep, and fussy.
She is breastfed and I currently give her zarbees baby probiotics, mycolin for gas relief, and vitamin d drops.
I have a account through emerson ecologics and order a lot of the vitamins on their for myself. I currently take, a postnatal, iron supplement, biotin, vitamin d, probiotic and I’m on a progesterone birth control. Do you think any of these supplements are affecting my babies gut flora?
Any suggestions on products I should purchase through Emerson for my daughter?
I was looking at the tummy tonic for her through Gaia herbs but it is recommended to use at 6m?
Her dr prescribed 5ml of famotodine. I started it for a week and have seen no improvement. So I am stopping it
I also have a gluten sensitivy and occasionally cheat and eat gluten, could this be affecting my daughter since she is breastfed?
Thanks for any help you can give! I would love to sign up for a session with you but see your clientele is full
Hi Savannah, I can’t advise on supplement protocols for your baby here. But I can say that my big suspects in your story are the gluten cheats (yes that will affect your baby, if you have antibodies to gluten) and the famotidine. The reflux medicine is downgrading her digestion and gut biome. Gaia Tummy Tonic is workable in younger infants with professional supervision, I have seen it work nicely many times. Meanwhile – stay tuned for upcoming options on working with me, by signing up for my newsletter here, and following along on FB here. New options coming soon!
My 11 week old baby has started omeprazole for her reflux. It worked really well for 2 weeks but now she is erratically feeding again, pulling on and off and is spitting up quite a lot. Her feeds are also back to being short. I am worried about just taking her off it straight away, because people say that you shouldn’t. I am also keen to start her on probiotics to help increase her gut bacteria again. I don’t have milk or eggs in my diet at all so I know this isn’t an issue…
What would be your advice for weaning her off omeprazole and onto something more natural?
This is the usual drill for reflux medicines: Success at first, but as it reduces digestion, then it stops working – babies can’t tell they are hungry, because of the medicine. And, spit it will follow, as undigested food sits in the stomach. Follow all the suggestions in this blog on transitioning off of this medicine, and stay tuned to my social media for announcements on my Nutrition Cafe sessions that will focus on this issue.
My son has been on 5mg Nexium since 5 weeks old, except with CMPA and reflux. I have tried dietary restrictions as he is only breastfed. I feel like since then he’s gotten worse with diarrhea 5x day and facial atopic dermatitis (never this bad)
I purchased your book and suggested supplements (probiotic and tincture.) When do I give the tincture? Since meeting with GI, he wanted him on elemental formula but at almost 8 months he refuses to take it. Any suggestions? I also tried HOLLE goat milk formula. The silent reflux was BAD. since introducing solids he has vomited. So I stopped those. He is only on expressed breast milk but I fear feeding aversion. I am on your wait list was just hoping for some useful advice.
A digestive bitters tincture can be given with feedings, to encourage production of the stomach’s own innate digestive juices. If your son is vomiting solids, this suggests that the reflux medicine has downgraded his digestion so that food sits in the stomach and eventually is vomited, undigested. For solids, work with foods in the green column here for starters. Introduce any that you can. His gut biome needs correcting most likely, after months of reflux medicine – the new foods and some gentle antimicrobial or antifungal herb support can help build a functional biome back up. For more on this strategy, stay tuned for upcoming new services by following on FB here and opting in for my newsletter here.
What dose of digestive bitters is safe for a newborn?
This product from Gaia herbs, like most in this category, are not permitted by the FDA to give dosing for babies under six months old. Use it at your discretion for younger infants. This product was developed by a pediatric naturopathic doctor, so if you have a resource for one in your area, check with them for oversight specific to your baby.
My 6 month old daughter has been on omeprazole for 4 and a half months. We have taken her off it now and she’s ok reflux wise. I have come across quite a bit of literature saying that omeprazole can impair cognitive function as it blocks the neuro protein pumps as well! I’ve also read that the effects of the PPis last long after you stop taking them.
My question is, will everything be ok/ return to normal now that she’s off them? Or has damage been done that is irreversible? 🙁
No use in worrying. Good news is that your daughter is feeling fine off this medication. Gut biome diversity is key to optimal neuro-immune development and the first 2-3 years is a critical window. These PPI drugs reduce diversity of the gut biome. So, work on restoring this for her with a probiotic with Bifido and Lactobacillus strains. When she is sitting up well and showing eagerness around food, begin with solids that are gentle and helpful for building a healthy gut biome, like green beans, soft cooked and strained raspberries, pumpkin or butternut; avoid high FODMAPs foods at first, these demand a well developed gut biome to digest comfortably. Ideally, you’re breast feeding (this also nurtures a diverse gut biome) but if not, use a formula that contains some prebiotic, if she can tolerate it.
Thank you Judy. I’ve started her on biogaia and avoiding giving her the high Fodmaps. I have had quite a few antibiotics in the past and I wonder whether this has been part of the problem (she’s breastfed). I have ordered VSL#3 to take myself in the hope it’ll help her. Is this recommended?
Yes your history of antibiotics can impact your baby’s biome. I don’t know your baby’s needs for a probiotic choice without individualized work up and history. VSL3 is high potency and high diversity, which can feel bad with reflux, so you might start simpler (1-2 strains and lower potency).
My 12 month old son was just diagnosed with Subglottic Edema caused by silent reflux. He went in for recurring croup 3x in a 3 month period and has a constant stridor, which is what prompted the referral for an ENT. The ENT found he has 30% blockage with cobblestoning of his airway. They did a direct bronchoscopy and flex fiberoptic scopes. They prescribed him Nexium 10mg granules 1x a day. He has only been on it for 7 days now, but he has since developed a rash consisting of tiny red dots all over his body except his face and neck. No fever or itching or spots in the mouth. He also has become a completely different baby. He is so grumpy and fussy, like screaming until he makes himself sick. He is drinking breastmilk and eating solid foods. He is usually very happy and hardly bothered by anything, so this is polar opposite and has been like this for 3 days now. I took him in to his pediatrician and they didn’t think it was an allergic rash, instead saying it was a viral rash. They strep tested him and it was negative as well. I left there with literally no answers and still a fussy a baby. The ENT said for him to take it for a month, but I am worried about the side effects and it affecting his mood and digestion. I do give him a probiotic from our chiropractor along with whole milk Greek yogurt daily. Can you offer any insight on the sudden mood change and rash? I don’t get good feelings about him being on this and am looking g for alternatives considering g his airway as well.
As usual, my first question is – are you following the usual shot schedule? Did these changes follow a “well visit” with injections given per schedule? Changes after these may ensue within a few hours. But more commonly, these take 1-3 weeks to emerge, and will often show up as digestive symptoms, skin changes, screaming/crying/miserable affect, and changes to mood/behavior or milestones. Shots are potent immune stimulators and agitators. They are not benign, and first year “well visits” routinely call for multiple injections – with multiple viral or bacterial antigens in each needle. Manufacturers have not done due diligence to study how these may affect a young infant’s gut biome or environment – it is simply assumed that they don’t.
I’d pause that schedule to let his immune system settle down. Next, I’d ask for some work up on the source of the trouble. Some stool studies may be helpful, including for fungal species, which can be disruptive in the GI tract even without visible thrush. IgE food allergy testing may also shed some light on the inflammation source. If the Nexium has not improved the cobbling in throat, discuss weaning off it and measures to identify cause. Safe non-prescription anti-inflammatories for young toddlers (12 mos and older) include fish oils, curcumin, or glutathione. If your pediatrician does not know how to use those, contact a naturopathic doctor.
My daughter was given famotidine at a low dose once a day for a week when she was 6 weeks old for silent reflux symptoms. I discontinued use as soon as she seemed better. When her symptoms returned at 3 months the GI doctor upped the dosage and wanted me to give it 2x a day. I was reluctant and only gave her one dose a day for a week…then twice a day for a week – my gut said it wasn’t a good idea and I started researching and immediately took her off of it. Can this short term usage still cause problems? I’ve cut out dairy soy nuts eggs (and I’m gluten free) and plan to start probiotics this week. She is EBF. Her gut is healing – still mucous and small spots of blood that come and go but she’s gaining weight, mostly happy and meeting milestones. I just really hope I haven’t done irreparable harm and that I caught it in time. Thank you for your input.
Great news that your baby is feeling good, mostly happy, and growing. Look for comfortable stooling, sound sleep for longer stretches, and clear calm skin – all signs that the gut is also calming down. Reflux medicines immediately change the balance of pH in the stomach, and in turn, will eventually impact microbes that inhabit the GI tract. Once the medicine is withdrawn this may not self correct without other measures; the longer a reflux medicine is used the harder it can be to for the body to fix this on its own. If you are seeing her improve then it’s likely her stomach and gut are restoring normal function. As always, I will add: Vaccinations can interfere with gut biome too, along with antibiotics and reflux medicines. If you are vaccinating your baby on a usual schedule, this may also trigger reflux and digestive problems. If these become untenable then discuss how to do a different vaccination schedule with your doctor.
Hello I recently had to put my daughter 3 months on an antibiotic. for its prokinetic properties. She is my fourth and I have never been through anything like this. They said she has silent reflux. Gastric juices would just come up in her mouth almost 4 hours after a feed. She has choked and even been hospitalized. So against everything I have ever said about antibiotic I had to put her on something. The antacids only lower the acid but do nothing for the reflux itself. I’m praying this helps. I definitely want to encourage other moms to take the steps you listed above first. But if you are in
a situation like I am you will try anything to help your little one. I am wondering why they say reflux peaks at 4 months but then significantly decreases at 6 months?
Baby’s gut progresses quickly in first few months to “learn” to digest food calmly. Humans depend on bacteria for this to occur – beneficial bacteria strains like Bifido and Lactobacillus populate the gut and help digest food. These are disrupted by antibiotics and reflux medicines, so be sure to reach out to your care team for advice on probiotics or gentle digestible foods to introduce so that her gut biome restores itself nicely.
Hi, my formula-fed daughter is 6 months old and has been on reflux meds since 3 months. First omeprazole and now lansoprazole in the form of Prevacid fas tab. Before we started reflux meds, she would scream, arch, spit, and spill for 6 hours a day while we tried to get her to eat. She also projectile vomited often. She has cystic fibrosis which really complicates things. She wasn’t gaining any weight which was unacceptable in the eyes of her team of doctors. We started seeing a new dietician that wasn’t pressuring us to force feed, switched to a dairy and soy free formula, and there were no changes. She was diagnosed with reflux and started medication and there is a night and day difference now. Instead of 1 hour per bottle, she takes less than 15 min. She’s not an eager eating by any means.. but she eats and is gaining well (we also concentrated her formula). As I read this, I fear for her future and how the bad outcomes you mention will compound her cystic fibrosis symptoms. She is already on digestive enzymes, a fat soluable multivitamin, and the biogaia probiotic. She will have long long problems when it comes to growth and I don’t want this to compound it. I want to take her off of it but I’m worried things will return to the way they were before. Also, there is no thrush or other problems.. she gets checked every few weeks for infections and such. Just wondering what your thoughts are.
This is always good to hear a positive outcome with the medication strategy! Thanks for sharing. Tell your team to test for Candida and not just assume it isn’t there (because her tongue doesn’t look white or she doesn’t appear “sick”). Do a stool culture for Candida, check Candida antibody level, and screen urine for Candida metabolites. This infection is often under the radar – stop it before it gets traction and she’ll definitely benefit. See exactly what I’m talking about here.
Hi Judy! I came across your website as I am looking for a natural ways to address my daughter’s reflux. She was diagnosed with CMPA at 7 weeks and we switched to hydrolyzed formula as my breastmilk supply was dropping due to lack of sleep and rest. She was prescribed with Famotidine but we noticed it caused her irritability and gas so we decided to stop after 2 weeks. Since starting the hydrolyzed formula, she stopped grunting in her sleep and her projectile vomiting was reduced. However, we noticed congestion and wheezing at times. We tried so hard to avoid medication – following guidelines for reflux babies (upright after feeds, elevating head) which appeared to help but not with her respiratory concerns. We were prescribed with Omeprazole and the day after we first administered the first dose, she had mucus in her poop (same as when she had the Famotidine). I was looking at the Tummy Tonic and it’s not prescribed until 6 mons. Is it safe for 11 week old babies?
I have used Tummy Tonic in my practice for infants younger than 6 mos. The manufacturer has to tell you to use it with professional guidance at that age, for liability protection on their part. I personally know of no adverse reactions, concerns, or events in that age group with this herb (on the other hand, parents vaccinate at that age without question and there are thousands of adverse events recorded to those ) . I can’t supervise your use of it here, but you can ask your doctor or naturopath (ND) for guidance locally.
Hi Judy, my 18 month old niece has been on Nexium 5mg a day for 12 months. She was diagnosed with GERD. She had an endoscopy and there were sores in the GI Tract. She did not breastfeed and her diet does not include any animal protein. The dairy she was taking for 6 months after the endoscopy was Camel Milk [doc’s recommendation]. Every time we try to wean her off Nexium[as per doc’s instruction], on the second day she is extremely uncomfortable, moans a lot and by evening, she throws up with traces of dried dark blood [first attempt at 12months; second attempt 18months].
Her diet is oats or millet porridge, fruits [mainly banana, avocado, watermelon], then mashed meal [lunch and dinner] of arrowroot, sweet potato, spinach [or peas], carrots and squash which are steam then cooked with onions, 1 tomato, olive oil and coconut. For starch, we add the food to brown rice cooked in coconut.
My concern is she has bad/sour breath, her stool smells fermented and when she eats, her belly is distended. She has a great appetite and is currently curious about new foods. And she is also teething [regarding the magnesium and calcium absorption concern from the above blog].
We are in Kenya and would like to wean her off. Thanks
Why no animal proteins (besides camel milk, which is an animal protein). She is using a high FODMAPs list of foods in the context of weakened digestion and this explains part of the problem. She won’t be able to manage the foods she’s getting while on Nexium, which inhibits digestion and depresses the friendly bacteria needed to help digest those foods. Sour breath is often a sign of intestinal Candida – so, in addition to weakened stomach acid (due to Nexium), she has dysbiosis. These two problems need correcting before she can be weaned off the medicine. I use herbal and probiotic tools for this and base this on stool studies and symptoms – ask your local health care providers how to kill the intestinal fungal burden she likely has (Nystatin is usual, or, herbs if they know how – probiotics alone will not do the job). That one measure may go a long way in easing her discomfort. Re: Teething, her teeth can’t form well in the context of Nexium because Nexium prevents mineral absorption.
My daughter is 7 weeks old. She screams after every bottle she has and is sometimes inconsolable. She arches her back , has sour breath and her breathing is heavy / congested. She also has loose stools and is sick alot. What can you suggest to ease her discomfort. We are not using anything at the moment out of fear of making things worse.
Sorry to hear it! Though this may be common it is not happy, healthy, or necessary for your new baby girl to struggle this way. Use the ideas in this blog post before moving to a reflux medicine, they might do the trick. Sour breath may mean she has a fungal dysbiosis in her stomach. Have her checked for thrush with her pediatrician. Treating this may help her feel better too.
My daughter has sour breath
!? We are currently trying to wean her off Nexium. It’s been awful. I cut her dose in half to 2.5. Nighttime is awful she screams wakes up. Is there anything I can do ? Does the sour breathe From acid ? She was put on at 3 weeks and now she’s 4 months. Any tips? Is there anything I can do to help her ?
Tell the provider who prescribed this for you that this is going poorly. Sour breath can come from stomach acid or gas from fungal dysbiosis in the stomach or upper small intestine, which reflux medicines can cause. There are many brands of gentle herbal tinctures available for infants to encourage normal digestive juices. I often use these to aid this weaning process. See Tummy Tonic from Gaia Herbs as an example.
Hi Judy, thank you for sharing all this info. I have unfortunately learned alot of this invaluable info through the hard way of trial and error of trying to heal my son’s severe silent reflux and multiply food intolerances over the last 4 yrs. Unfortunately i fell into the trap of not taking my sons health into my own hands and followed ill advise from medical practitioners across the globe. In short he lived on losec 10-20mg from age of 4 months to almost 2 years old. We tried for a long long time to get him off, however he symptoms got worse, eventually doctors switched him to Singulair for another 1.5 years. He is on a strict elimination diet of dairy, gluten, eggs, nuts, coconut which he tested positive for igg intolerance. He is constantly bloated still, and has bouts of anxious, aggravated behavioiur, restless sleep and bedwetting. In the past year we have made the most progress, We did a hair elements tests, which showed his aluminum levels were off the charts and now been doing slow detox with heavy metal detox drinks and TRS spray. We also did a full stool analysis which proved that he had dysbosis, we tried herbal first and eventuallly he went on a course of nystatin. The most effective when taking him off meds was Restore which worked miracles for him. Since the last year we have rotated at different phases of prebiotics, probiotics-Klaire labs, glutamine, digestive enzymes. He also take NDR to remove toxins and sleep calm. I do feel like he still has leaky guts. We also did blood test for deficiencies and proved he was deficient in iron, magnesium, zinc. I am also introducing new foods grains and fruits into his diet aswell as gut healing jellies. I have not given him fermented foods yet as feel he still may have a leaky gut. My question is how can i find out if he still has leaky gut and is there some crucial part of the healing process i have missed. I believe the healing journey can take longer in some kids than others? what does this depend on? is there any crucial aspect of the process i am leaving out?Amino acids? or other. He still complains of pains in his tummy from time to time and is bloated. After two courses of iron supplement, he was ok for a few weeks, but now his dark circles and fatigue is back. he is still on zinc and magnesium and omega fish oils. Why is it he is still not able to absorb these nutrients from his food. Many thanks
Lots of hard work! Glad you are seeing progress. Two things determine how quickly this can go for a child: One, and this is THE number one piece, is growth status. An underweight or stunted child cannot repair leaky gut, period. Why? Because if growth pattern is routinely compromised even to a slight or moderate degree, food energy and the nutrients to build with are inadequate – little to nothing will be left for gut tissue repair. This is a big missing piece in many communities out there working with and talking about these kids. Growth patterns and food intakes need detailed assessment. There are standards for these, as well as standards of care for how to correct them. Using these correctly and replenishing with the right food – and, assigning them the right diagnosis codes – can not only speed the recovery, it can also help you get coverage for nutrition care. Learn more here about how to tell if your child is underweight.
The second most important piece is gut biome. This is one mistake I find over and over again in kids who’ve been working with these tools for a while, but not progressing. It takes many forms: Over-using fermented foods, GAPS gone wrong (that is, it left the child malnourished and caused new food sensitivities), relying heavily on nutritional yeast for a supplement (Saccharomyces boulardii or cerevisiae), leaving insufficient stomach acid untreated, too many probiotics, or inadequate corrections for Candida, parasites, protozoans. If your son can’t absorb nutrients still, he likely has any one of these problems. Meanwhile, dark circles at eyes and fatigue are flags for a number of possible nutrition deficits that stool and hair analyses will not show. I am not taking new families into my full practice, but hope to create more content soon to help parents gain more success with click-to-learn options. Sign up for my newsletter to keep posted on this, or follow me on Facebook here.
After reading this post…you will not love our story, but I’m eager to hear your feedback-our 2 year old just finished weaning off Prevacid, which she has been on since 2 months old. She is diagnosed with Cow Milk Protein Allergy, Soy, Peas, Strawberry, and Quinoa, sensitive to peaches, lentils, beans, and all legumes really. She was also diagnosed with delayed gastric emptying and is on erythromicin 3 times a day. She was on Aflaamino infant formula, but now can tolerate rice milk. I’ve always given her a probiotic, and she has been on the Klaire labs one for the last 3 months. Now that we have her off Prevacid, what can I be doing to help support her gut, especially motility to hopefully move things along faster and get off the erythromicin? Anything I can give her to assist her digestion?
Hi Sharon, I love your story! Though am sorry to hear of these struggles. There are likely many things you can do to assist digestion in this case but I would have to investigate that with you as a client. I can’t assess and guide you here. If you would like to get on my wait list for care, contact my assistant at 720-727-7105.
My 8 month old grandchild has only gained 7 pounds since birth and it has been a battle for him to gain weight. He has been on reflux and miralax for several months and was wandering if this is the cause for him not gaining weight. He drinks 6 oz of formula every four hours and is getting baby food three times a day. He’s having a hard time gaining.
These drugs can interfere with digestion and absorption and can slow appetite, feeding, and growth. If the parents are ready for help to redirect this they can reach out via my website here: https://www.nutritioncare.net/book-an-appointment/
Hi, my 9week old was recently prescribed Nexium 10mg due to reflux. He has had two bizzare episodes of stiffening, eye bulging and apnea. I’ve had to resuscitate him twice with back blows and suctioning until he started breathing again. The doctors believe he has what is called Sandifer Syndrome, not sure if you’ve heard of this, but it’s related to acid reflux. I’m not sure how to manage this… I want to prevent future episodes from occurring because their absolutely traumatic. I don’t feel comfortable setting him down or leaving him out of sight. He’s been sleeping on my chest at night because that’s the only way I feel comfortable that he will be okay & my husband is terrified to even hold him now. This whole ordeal has been awful. If the reflux is what’s causing these events I need to figure out a way to manage him appropriately. After reading your post I’m scared for him to continue taking nexium. He is currently getting breast milk through out the day and was getting similac spit up at night because I am an under-producer. I recently took him off the formula due to constipation, but now I’m thinking the constipation could be from the medication? Any advise would be greatly appreciated!!
Hi Katilyn, those are dramatic and frightening reactions. Reflux is typically caused by insufficient stomach acid, and the medications make that worse, hence the caution in using them. The flip side is that if your baby has such poor stomach acid that key nutrients cannot be absorbed, this too can cause seizure like events like stiffening limbs or “absence” stare. One of the nutrients that reflux medicines prevent from being absorbed is vitamin B12. Low B12 is a known trigger for seizure like events in infants. Have your doctor do a complete blood count, a test for methylmalonic acid, and serum B12. If any of this looks off, this can mean B12 is deficient and the quickest fix is a methyl-B12 shot (very safe and relatively painless as the needles are very thin). Some basic nutrition screenings can rule out if this or other nutrients are in play in this situation. For one on one help, contact my assistant at 720-727-7105 for an appointment or book from here.
My daughter is 20 weeks old. She has a very severe reflux. After each feeding, milk comes out. And also phlegm. A lot of it. And sometimes after an hour of feeding, phlegm comes out again. Or see-through spit with some milk. The doctor told us the phlegm may come from her nose. He simply told us to use Physiomer nasal drops. And he prescribed us Nexium 10 mg (5 mg dose for 14 days). He said after these 14 days, we will see if the reflux will go away. If not, then he wants to change the formula. My baby gets only formula (right now Bebelac 1, milk based). But I have a lot of allergies and my family too. I feel that the formula is not good for her. Especially with the allergy history of me and my family. But the doctor wants to wait.
What should I do??? 🙁
Reverse it. I would suggest changing the formula first. That often does the trick and will allow her digestion to continue to develop. Consider a hydrolyzed whey formula like Gerber Soothe, or the new Gerber A2 milk formula, or HiPP Comfort; or try a goat milk infant formula like Kabrita. Also, consider delaying or spacing out her vaccinations so she isn’t getting multiple vials at once (each vial contains more than one antigen) until her digestion settles down.
Our baby is exclusively breast fed (with one bottle at night) and was prescribed ranitidine at 2 months old due to slow weight gain, back arching, crying during nursing, spit up (but not that much), and a refusal to be horizontal (would scream and thrash around). Due to the drug recall, we were switched over to famotidine at 4 months and she is now 7 months old. Last 2 weeks I have cut out 50% in an attempt to wean but if I don’t administer any, she gets very fussy. Today we started on the Klaire Labs Therbiotic. How much of the probiotic should I be giving her?
I am also pretty sure she has a milk allergy. We tried Greek yogurt one day and every part of her skin the yogurt touched (mouth, chin, eye, hands) – raised up into angry looking hives, beyond what she might get from banana and avocado. Next two days was gel-like poop. Whenever I eat a lot of dairy, she gets rashes on her face and neck. We also tried a milk-protein cream once and it gave her skin red bumps all over. If I were to switch to formula, do you have any recommendations? What else should I avoid if avocado gives her mouth a rash?
Oh dear. There’s so many gaffes here .. where to start? I’m eternally baffled by the prescribing of reflux medicines for poor gain in babies and kids – because these reduce digestion, they make protein and other nutrients harder to absorb, and they trigger dysbiosis in the GI tract. Those are the three things you need to do to make a baby shrink. Even if these give temporary comfort, a baby is bound to fail eventually on these drugs, unless weaned off of them. Is this really the only trick pediatricians have? Palm to forehead…
The good news is you’re on your way. If she is able to manage that probiotic, that’s a huge win – it’s a multistrain product that can feel awful in a tummy that has used proton pump inhibitors like ranitidine or famotidine for months at a time. If she can’t, switch to a single strain like Klaire Factor 1. That may be easier for her to use for now.
Next, if you suspect a milk allergy, that may have been why there was reflux in the first place. Greek yogurt contains milk protein. This is another palm to forehead moment for me here – confusing lactose, which is milk sugar, with casein or whey, which are milk proteins. Yogurt has little to no lactose, but still has the exact same protein in it as fluid milk. In fact, Greek yogurt has even more protein in it than “regular” yogurt. So you hit the jackpot there, and through her skin reaction, got clear confirmation that yes, your daughter likely has a milk protein allergy… which will cause reflux, fussiness, and pain. And, weaker growth, and weird poop. We’ve ticked all the boxes!
You can try breastfeeding her on a strict no dairy diet. That means zero cheese of any type, no yogurt, sherbet, milk, half & half, cream, any condiments or processed foods made with milk or dairy ingredients, including baked goods, chowder, Thousand Island dressing and alfredo sauce, to name a few spots where dairy hides out. Even butter may need to go, but you may get away with using ghee (this is clarified butter, eg, milk protein solids are removed). If that’s too much for you, then try a goat milk formula such as Holle brand. Next you might try a hydrolyzed whey product like Gerber Soothe. Or, a hydrolyzed casein one like Alimentum or Nutramigen. It’s your pediatrician’s job to guide you here, but it sounds like they missed all the memos so far already, on what to do besides give reflux drugs.
Thanks Judy, how much of the probiotic should we be giving in a bottle a day?
Always start with a pinch and work up slowly to dose suggested for infants on the product label. If discomfort ensues, slow down – you can reduce the dose or withdraw it completely and let baseline comfort return. If no go at any dose, this means you need a different product.
Hello, can I ask about the evidence of the effectiveness of probiotics. I have a LO suffering with silent reflux and have been prescribed omeprazole but am trying to find a different way of managing but the research j have read so far suggests there is limited evidence that probiotics would help at all.
You can ask about the evidence behind probiotics by going into PubMed.com and search “probiotics and infant reflux”. This is a very vast topic, you will have a lot of reading to do! As for using just probiotics alone with a reflux medicine, this is not likely to work by itself, and may be poorly tolerated. BTW: Did you ask your pediatrician for evidence of omeprazole resolving reflux before using it?
Thank you for this post! We just started my 4mo on famitridine last night but after reading this I have a feeling he doesn’t truly have reflux and shouldn’t be on this medicine. Since reading your post I’ve been trying to find more information on dysbiosis.
LO is exclusively breastfed. His main symptoms are congestion, wheezing, mucous in poop, arching back during feeds and when laid flat, and sour breath. I went dairy free for five weeks and didn’t see much improvement, but when I reintroduced a little dairy one day, his symptoms got way worse. This led my ped to prescribe famotridine. LO has been on probiotics for a few weeks prior but didn’t seem to make an improvement. He also is a slow weight gainer (remaining in the 2nd percentile).
I’d like to explore dysbiosis with his ped but want to be informed on it since I’m afraid he might not be. I read in previous comments about asking for a stool test? What specifically should I ask for? And would anything other than probiotics be something I could start him on to test my theory? I’m not sure if I should stop the famotridine immediately and try other methods.
Take a look at Gaia Herbs Sweetish Bitters in glycerite. Give drops with feedings. This boosts digestive juices naturally.
Mucus in stool is a sign of an inflammatory effort. When this occurs the baby’s gut microbiota are being stripped away, just when they need them to develop. Sour breath is a sign of dysbiotic flora also. As I’ve said many times before, if you are following the usual vaccination schedule, this is likely interfering with the normal progression of gut flora development. At 4 months your baby has already had forty two (yes you read that correctly – 42) different antigens injected, delivered via 12 injections.
If your pediatrician isn’t informed on stool testing, speak with someone who is! You can work with a naturopathic doctor (ND), as this is definitely part of their training. I am not taking new families just now, but stay tuned for announcement on my Nutrition Cafe topics, coming soon – we will definitely be covering reflux in babies.
My daughter is two months old and she’s been on Prevacid since 4 weeks old.
I want to wean her off; any suggestions?
Should I start giving her the 2.5ml every second day then after a week, give her every third day, and so on, or cut the dose in half for week?
It’s a shame this drug was the go-to, so fast! But there are options to move forward. First I’d try a different feeding strategy to see if that suits her better. If you’re breastfeeding, that means tinkering with your diet, to see if foods you eat bother her more. If you’re using formula, switch to a hydrolyzed whey product like Gerber Good Start Gentle or Gerber Good Start Soothe. These as easier for babies to digest than other formulas. You can also use gentle herbal tinctures to help her stimulate her own gastric juices, which will help her digest her feedings too. If she had complicated birth with exposures to antibiotics, then she may need more help in restoring her own healthy gut bacteria. These help digest feedings comfortably too. This sometimes means using probiotics with an herbal or prescription tool to directly eradicate Candida or other disruptive microbes in the gut environment.
Hi, my daughter is 11 months and has been making a gulping type sound along with burping and just started exhibiting a sour breath. She was prescribed ranitidine but I have not given this to her. Any first suggestions for my diet or hers? She is still breastfed. Thank you!
Hi Cait, these are common symptoms of SIBO or SIFO, which is a small intestine bacterial (or fungal) overgrowth. If your baby has had thrush, had a C section birth, or either of you has recently needed antibiotics, ranitidine may make all this a little better at first but worse in the long run. This may instead resolve with a course of Nystatin (anti fungal medicine) which can correct the cause of her symptoms. Ask your doctor about that. Otherwise you can start with usual eliminations in the top 8 allergens.
hi. the sour breath was gone in a day so it must have been what she ate. No thrush, c sec or antib.
at her 1 yr her dr mentioned started the meds since we did not. she still will make the sound as of contents are coming up from her stomach anywhere from 0-2x a day. are we doing harm by not beginning the med as the “reflux” does not appear to bother her?
Not having seen your baby as a patient of my own I can’t weigh in on what might be harmful. Let your doctor know your concerns, and if you’d like more detailed guidance on nutrition support and digestion be sure to click my Work With Judy for details.
Hi, what product would you suggest for the fungal infection?
If your doctor won’t allow an anti fungal medication orally, there are many herbal options, and I will choose this based on each child’s case. Typically probiotics alone may not do the trick.
Thank you for this interesting article!
My 7 week old daughter is presenting all the classic signs of reflux. My lovely paed is reluctant to start reflux meds on such a tiny baby thankfully.
I have taken her to a pediatric chiropractor and I must say her winds and reflux have improved to some extent but she has terrible congestion which has been ongoing for weeks now!
Her spit ups aren’t bad but I can hear liquid rising after some feeds (I do hold her upright) and wet hiccups.
The congestion is bugging me the most as that keeps her up at night. I’ve raised her head – using saline etc
The doc also said if it was a dairy allergy she would have very loose stools very often and currently she only passes a stool every few days (normal mustard BF loose stool)
She is exclusively breastfed and on. Probiotics.
Could the congestion be from reflux? Or do these symptoms even constitute reflux at all?
I am in South Africa.
Hi Kate, one way to rule out reflux as a cause for the congestion is to try a gentle herbal support for digestion. Here in the US there are several herbal tinctures blended in glycerite commonly used for infants, such as Gaia Tummy Tonic or WishGarden Herbs Mo Betta Belly. Usual herbs for this task are peppermint, chamomile, or ginger root. If you have a local resource knowledgeable in using these who can oversee this with you then you might find the congestion symptoms improve – if the underlying cause is reflux. Other signs that can go with reflux are hard inconsolable crying, coughing, gurgling sounds, and hiccups. If nothing changes with a digestive aid, then look to rule out other triggers with your provider: Mold in your environment, milk protein intolerance or allergy, or environmental allergies.
Hi, I’ve looked into the tinctures mentioned above and the instructions states it’s for 6 months and up. Would it be safe for a 3 month old?
Hi Rachel, this is a scenario to have a professional on hand to oversee this for you. A naturopathic doctor (ND) who is trained in working with these tools for young infants can help (your pediatrician is not trained in the use of herbs). If you’d like to work with me on this, have a peek here at options.
I cut dairy from diet and have tried everything ( including probiotics). Nothing has worked. She is now on omeprazole at 9 weeks. I plan to wean her at 17 weeks and quickly then wean her off omeprazole once on food. Without omeprazole she is in constant discomfort. Is short term use really that bad or is it extended use where you see problems. I tried everything before giving in to it as hate doing it but can’t bare to see here in such discomfort
Hello Joanna, let your pediatrician know your plans to wean off the medicine. In the meantime, you have two options to see if there is a milk protein intolerance or other food intolerance (despite your dairy free diet, this can still occur) or if there is a disrupted gut flora environment making digestion harder. First, trial a semi elemental formula or an elemental formula. If that shows improvement then you may find it is best for her to be weaned off your breast milk to formula – sometimes this just works better for babies who have trouble even with mom’s milk. Second, you can use a functional stool test to check how her gut bacteria are helping or hurting her digestion. Best of luck with it and let me know if you’d like my help.
Hi! My 10 week old has been on prevacid for a week (7.5 mg in 1 2.5 mL dose daily). I would like to wean him off. What’s the best way to wean? Just to slowly reduce the dose?
Let your pediatrician know you would like to use this short term and ask how to wean off. Make sure your baby really needs this drug – it has been over prescribed and used loosely in recent years. That said, some babies are in a lot of pain and get some helpful rest from using it. Next, find the cause of the reflux. Does your baby have a milk protein intolerance? Gut flora imbalance? Correcting the feeding option and optimizing the gut biome profile can often make the reflux stop, without medicine. Once you have repaired those underlying problems, it can work well to slowly reduce the Prevacid dose.
I need your help–I’m so so so conflicted about things!
Currently my son is on Prilosec and I’m so sad about it, but I also don’t want to see him in discomfort. He is a breastfed baby and when I’m away he gets a bottle of pumped milk. He is a happy boy now at 5 months old, but was very unhappy from about 2 weeks-15 weeks. He was getting zantac for awhile and that was working for him, but then it didn’t. We are very anti meds but it was to the point where he wasn’t growing because he wouldn’t eat. It was a major problem and actually still is–he is at the 2nd percentile.
Now he still cries when he breastfeeds, but does not show any other symptoms. It is pretty bad when he eats from me. He’s on a lower prilosec dose so I wonder if it even makes a difference in his reflux. We give him probiotics, vitamin D and I am dairy free. I’d love to get some other ideas of how we could get him off of medication! Thanks for your information!
Hi Rachael, this is a common scenario, that the medicine works initially then fails. This is because – as the post here says – it buffers digestion more and more, to the point where appetite fades and discomfort increases; then the poor growth pattern ensues! So in the long run, these medicines don’t solve the problem and end up creating new ones. If you’d like help with how to back track out of this, you can set up an appointment anytime. It takes time and to start, assessing where this has landed your son’s digestion and GI environment. Click the appointment tab above to get started.
Thank yuh very much for this useful article. I have a question that I hope you could answer. My 6 week old starting having a lot of gas and tummy discomfort at 4 weeks of age, to the point where he would not sleep at night crying in pain (his stomach would get rock hard) and would be very fussy during the day constantly trying to push out gas (he would pass 11 gas in an hour and have 8 poops a day). He will also sound very congested all the time and nasally and will present with projectile vomiting every other day once or twice a day but didn’t seem to be in discomfort when that happened. He was born early term at 37 weeks at 6 lbs 7 oz and has been gaining weight steadily and is now 9 lbs 9 10 oz. He is a great eater and up until 4 weeks of age he took 3-4 oz every 3-4 hours but then, when the discomfort started, he started feeding more often (1-2 hours) and taking less ounces per feeding (2-21/2 ounces). I should also mention that he takes exclusively breast milk but through bottle since he had trouble latching since birth (shallow) for which we are currently working with a lactation specialist in order to see if he will drink directly form the breast at some point in the near future. Besides this gas/colic issue he is a happy baby. I took him to his pediatrician due to the discomfort at 4 weeks and, after trying with Mommy’s bliss gripe water, mylicon and probiotics drops for a week without any results, she diagnosed him reflux to my surprise and prescribed Zantac. I had the little one on this nasty thing for only a couple of days because it made him miserable: he got constipated and his gas problem increased considerably, he started crying in pain during the day also and choking more during and after feedings. Called the pediatrician and she encouraged me to keep him on the Zantac but I am not budging. I am currently giving my child only the probiotics (Herbert brand with L. Reuteris strand) My questions are: What are your thoughts on mastic gum for Infants? What can I do for this gas/pain problem since a lot of approaches failed already? I am worry sick that he can’t sleep due to pain and seems miserable all the time so any recommendations would be appreciated. Thank you so much!’
Hi Sofia, what you describe for your baby’s initial symptoms (at 6 weeks) sounds like a milk protein intolerance – this can happen even with breastfed babies. This will create gas, colic, and feeding difficulties. Meanwhile, check if he has a tongue tie (the lactation consultant probably already has, but make sure) for latching issues. The probiotics may not be much use if the issue protein intolerance, tongue tie, or gut biome issues (which often need more direct correction). Mastic gum may also not do much good either, and wouldn’t be my first choice here. Now that you’ve tried so many things, I’d suggest doing some work up to get to the bottom of this, with a functional stool test, to review what is going on with that gut microbiome. This will help sort whether the issue is protein reaction, biome-related, reflux, SIBO or what. If you’d like help with that I invite you to schedule an appointment here and we can get started anytime.
Hi Judy, I just ran into your article and coincidentally I recently purchased the Klaire Infant Probiotic for my 3 month old son (he just turned 3 months three days ago. He has been on formula since 2 months and that is when his silent reflux got worse. What would be your recommendation on dosage for his age? Do I give him the dosage at one feeding or throughout multiple feedings (I would put it in his milk after heating it up to room temperature/lukewarm)? Also, how many days do you think it could take before seeing a difference/deciding if it actually is helping? Thanks so much!
Follow the label instructions for the product. I often adjust for my clients based on individual presentation, but since you’ve already purchased this and I don’t know any details, using the manufacturer’s instructions is reasonable. Always prudent to start low and work up to dose. You may see changes immediately but lasting improvements usually take about 2-3 weeks to evolve. If reflux worsens with this product then it doesn’t mean it’s a bad product but it may indicate other problems need attention. This is what I trouble shoot for babies, if you get stuck, and you can set up an appointment anytime.
Hi. My daughter is 14 weeks old. she was on 5mg Nexium and then had to go onto 10mg and now she’s using 10mg and Infant Gaviscon roughly two to three times per day. She’s been on the Nexium for 2 full months already and is going onto month three. When we reduced the Nexium her crying bouts and poor feeding started again. She still has times like this which I’ve seen are largely due to something I’ve eaten so diet is utterly important because I breastfeed exclusively. I’m actually not sure what to eat because only a few things seem to be OK. I want to wean her so her digestive tract can heal and learn to operate by itself but I don’t want her to be in pain and have side effects from reflux either. She has improved since adding the Gaviscon, it been almost 3 weeks now. She’s also using Iberogast which has aided greatly with tummy cramps and she no longer gets constipated. What do you advise? Can I start weening her. She’s been on Nexiam for silent reflux from 5 weeks old. They clinically diagnosed her. No probe. She’s so tiny as she’s only 14 weeks old now. I feel at such a loss. I will do the diet things, I’ve removed nuts, flactulance causing veggies, and most gluten and it’s helped already. But she still needs the Nexium and Gaviscon.
Hi Geraldine, I don’t advise unless a child is a client of mine and I have full history – if working with me is not an option for you (I do remote consults routinely including for clients in other locales and countries), then I would definitely ask the doctor prescribing the proton pump inhibitors and other drugs for your daughter to guide you more thoroughly on feeding and growth/gain. These drugs are changing your daughter’s ability to digest and absorb food and are not good long term solutions.
Thanks for taking the time to write this post and educate us. My son was prescribed Prevacid at 6 months old. Two years later we are weaning him off because of all the things I read about long term effects of PPI’s. It’s been a slow wean of 0.5 mL lower every Sunday. We only have two more weeks and he’ll be completely weaned. He’s a gtube kid and has always had some issues with vomiting and spit-ups so we were afraid to take him off. He’s been on probiotics (Pure Encapsulation) since he was one, as well as a whole food blenderized diet that contains no dairy, gluten, or sugar. We even did the raw cow’s milk formula Weston Price recommended from 8 months to 13 months. With those changes the vomiting and reflux have gotten better. Hopefully the gut is healing. Hopefully once the prevacid is completely removed the gut will do its job better. My son has started to show up on the growth chart over the last year. I wonder if there is anything else I could do to help heal his gut? to counteract the effects two years of using Prevacid?
Good work mom! Yes there is something you can and IMO must do: Prevacid profoundly changes gut biome and probiotics may not do the trick on their own. You might consider screening for fungal load with urine and stool tests. If this is still active (PPIs encourage fungal infections in GI tract, and possibly elsewhere) then leaky gut will persist and food allergies, reflux, and growth and feeding problems may also. Consider booking a single appointment so I can order that for you. This is a functional stool microbiology panel that assesses beneficial flora, fungal microbes, and detrimental non-pathogen bacteria as well. The urine test screens for fungal metabolites in urine. If positive, then a fungal UTI is a possibility. All can be addressed in a more targeted fashion with herbs, correct probiotics, and foods – some kids need prescription medicines for this piece but not all.
I have a 2 year old almost 3,his issues started when he was 14 months old with vomiting and his weight gain. He was 22 Olivé when he was 18 months, now he is 34 months and weights only 25lb. He is a really picky when it comes to food and he pretty much vomits 2 times a week. but since í complain a lot he was send to a gi clinic. They found something on his esophagus so they prescribe him reflux medicine for 8 weeks but after the first week his vomiting has increase now he vomits 4-5 times a week and lately 2 to 3 times a day. I stopped giving him the medicine after the 6th week. I don’t know what to do i am waiting for another endoscopy, they put him on that medicine so they can see if he has eoe.
What will you recomend?
I would not be able to recommend anything in this forum, but do indeed provide detailed and individualized care for toddlers in this situation. Your son has failed already with consult and invasive diagnostics from a GI doctor; he needs high level expert nutrition care, which you wouldn’t want to pluck for free off a website – it wouldn’t serve you or him. I invite you to make an appointment at my calendar here, and to book a three visit series (this saves you $75).
My son took nexium 10mg per day from 8 months to help with what we thought was reflux. Each 6 weeks we tried to wean him off but it was really hard and we continued the drug, being told if was safe. At 12 months, he started reacting to foods he previously was fine with and then at 14 minths he lost a lot of weight, became anxious and cranky, and struggled with food. I wanted him off nexium and a probe proved he had no reflux. So I took him off immediately. He now has fructose and lactose mslabsorption with bacteria in his tummy. Previously he ate fruits with little problem. After getting him off nexium, he improved but our health professionals wanted to give him more fats and he couldn’t take it. His behaviour changes when he eats and he had episodes when he just wobbles and falls over. He copes so much better when his foods are mashed. After being advised to stop breastfeeding at 15 months and going onto neocate things are just not right with my boy. When he eats whole foods he turns into an anxious child. It breaks my heart and I am trying to get my happy boy back again. I am now using probiotics which have helped, using magnesium baths, and seeking the advise of naturopaths whom are working with me to restore his tummy to better health. Is there any advise you could give me to improve his health now or have we done the permanent damage to my son? Can damage like this be reversed? I wish I could go back to breastfeeding as he was more settled too. My mum and I have been in tears thinking of how he is now compared to when he was younger. Unfortunately, I seem to be the only person who thinks nexium has done this – all others in the medical fields disagree with me. I live in australia and would really like your advise. Thankyou.
Hi Tania, please see my updated blog above – first / last paragraph. Would be happy to help.
My 4 mo is exclusively breast fed and suffering from reflux. his weight gain has begun to taper off and has had green watery/ mucusy stools for three weeks. previous stool cultures have only shown pus cells but the latest one shows heavy Ecoli growth.
He has been taking half ampule of enterogemina on and off for the last 2 weeks but has recently been prescribed an antibiotic (cefuroxime)for 10 days to stave off the eColi. He is really not feeding well and I suspect this could be due to a tongue tie. His reflux is much better when fed from a bottle.
we recently started solids to see if the reflux would get better but it hasn’t helped. I’m afraid now that the doc will insist on reflux medication and I really don’t want to give it to him.
The Enterogermina (bacillus clausii) hasnt really helped. shall I try a different probiotic. do you agree with the treatment plan?
If the treatment plan hasn’t worked, then it’s time for a new plan. I can’t advise in this forum, but would be happy to investigate with you if you’d like to set up an appointment. Looking at more detail with functional stool microbiology is one of your options when working with me, as well as specifying best next steps on feeding and gain.
Hi judy. My 13 months old baby is having frequent vomiting n motion issue since 1—2 months. She is pre term baby so having gas n colic problem from the beginning n used to vomit frequently than i started himalaya bonnisan which helps a lot and she is on Nan HA from the beginning. But from 1-2 months she is getting hyper acidity suddenly – suddenly, she do projectile vomiting even vomit at the first spoon of meal n sour smell comes from her vomit n farting. N her vomit is hot water type. I realized she is allergic to parle g biscuit so i avoid it which shows improvement but she is continue of bonissan syrup which is herbal n no side effects.
Earlier in dec doc prescribed nexium 10mg sachet once daily n babyfen drop thrice daily for 7 days she gets better but after few days of stopping the medicine she again started same problem i was giving babyfen on n off but now from 3 days her vomit is sever like dec so this time doc gave gaviscon infant once daily n bonissan twice. She used to eat everything which is dirty coz of tat also its repeated as doc said.
My elder son also started same vomiting issue from 10 months of age which converted into Chronic acidity n sensitivity which resolved slowly slowly over the period of time by continued of jr. Lanzol 15mg. For almost a year than on n off untill he become 4yr. We got his treatment when he was almost 2 yr.
Now similar thing is happening vd my lo so im worried wgat is effecting her digestive system. What can be done to make her overcome from this.
Hi Pooja, set up an appointment and we can get started troubleshooting! I think the “chronic acidity” is a red herring. Unless a pH probe was placed in your baby’s stomach, that can’t be known for certain. The stomach is supposed to be extremely acidic to digest food. When food sits/refluxes, often the problem is that the stomach is not acid enough. Hence the sour vomit. This will still be quite acidic, but not acid enough to effectively initiate digestion. Though they can give temporary relief, reflux medicines will exacerbate this problem over time and cause weakening digestion.
My baby is 2 and half month , dr.Described him nexuim for 10 days then change to zantac ,i didnt give him zantac but he is not getting better, he has reflux and swallow what goes up , am not sure what to do , they told me its better to use medicine because it hurts him and he has cough during the day and not happy after feeding, any help ?
Best option is to set up an appointment so I can advise and assist. I’m not able to do that in this venue, but would be happy to help if you like.
such great info and so happy i stumbled into your site,my 4 month old had stomach acid and thrush. He was prescribed anti acid and antifungal . I am not sure if thrush is completely gone.Just a little white patch in his mouth but he is starting to develop eczema.He is exclusively breastfed and im wondering if a probiotic would help since his stools have been watery since he was born
Yes the right probiotic could help – choosing these correctly for each situation can make or break success here. He may also need gentle tools to clear the fungal infection more directly. This may mean using an oral prescription medicine like Nystatin or Diflucan, or non-prescription anti-fungal herbal drops. The thrush and eczema should clear quickly once you have the right combination. For detailed guidance, I’m happy to do that, and you can set up an appointment anytime via my calendar here.
My baby had thrush and now has eczema. She has painful regurgitation of breast milk after every feed. At times it is very think when it comes back up.
Ive found it gives great relief when I give my little one some grass fed ghee. I just use a very little and it solves the problem.
I just took my 2 year old off Prevacid. Looking for tips for getting his stomach acid back in balance. He’s having trouble eating and throwing up once a day. He can’t seem to drink milk anymore either.
He needs a bridge piece to link him from being dependent on Prevacid to dialing up his own digestive capacity. This can work with a weaning process while other natural support tools are brought in gradually. Assessing gut biome and food sensitivities can help too. Best for me to help one on one in an appointment, if the suggestions in this article haven’t done the trick. If that’s out of reach, have a look at my book Special Needs Kids Go Pharm Free for more details and ideas.
Please i need some help
My baby is having reflux problems and now i am using hipp anti reflux but is all gasy and poop is exploding and painly eventhoug the througing has stoped. Should i continue with this milk or stop it??
If you can’t breast feed, it’s a good idea to try Hipp formula, but if it hasn’t settled things down fairly fast, then it’s likely you’ll need to consider a hydrolyzed formula. There are many versions and brands of these. Some have more whey than casein, and vice versa (these are the proteins in the formula). Babies vary with respect to which ones they tolerate better. Formulas also vary with what types of carbohydrate is in them, and this changes tolerance too. Some have lactose (like breast milk), some have corn syrup (YUCK). You might start with a product like Gerber Gentle, which is partly hydrolyzed whey protein (no casein) and mostly lactose for the carbs, with just a little maltodextrin (this comes from corn or beets but is easier to digest than straight up sugar or syrup from either vegetable). I would skip soy formula altogether. There is in my opinion no good reason to go there. If even hydrolyzed formulas fail, you can try goat milk source or even camel milk, though both need to be altered into a formula and can’t be used as a straight replacement for other formulas.
THis is very helpful, sadly my 15 month old has been on these medications since birth. I want to take him off them. He has a condition called laryngomalacia. Have you heard of it? The issue is that reflux can make his condition worse. I ordered your book, and hopefully will get some insights into how to go about it. Thank you!
Hi Katherine, I’m not familiar with laryngomalacia as I’ve not had kids in my practice with this condition, but I would be sure to ask your doctor if it is still necessary to stay on the reflux medicine. Long term use is known to diminish absorption of many nutrients including minerals. This may make it harder for your son’s larynx to structurally normalize itself in the long run. Now that he is older, perhaps a weaning plan can begin off the medicine – I ask your doc about this, and consider getting a couple opinions.
Hi! My son also has laryngomalacia and is on a high dose of Zantac and eats the Nutramigen. He’s 3 months right now and his weight is good.. he is slowly becoming a better eater. Last month he went on an antibiotic to help with inflammation so I am thinking adding a probiotic to his diet will help. Let me know if you have any tips!
Hi Nicole, I encourage weaning off the PPI as soon as possible, to preserve and protect digestive function. Begin lowering the dose with your doctor’s guidance. This may not work without further intervention for correcting the gut biome environment, but worth a try to start right away. Probiotics alone may not repair the shifts in his biome and may make him feel worse. A quick improvement may be seen if you ask for a course of Nystatin to clear the fungal species encouraged by using a PPI and antibiotics.
Thank.you this all makes sense. What have you heard of giving infants grass fed ghee and what would be the dose? Could l sprinkle these probotics directly onto my nipples when feeding? Thanks!
Grass fed ghee would be great for infants – stir a melted half teaspoon into any soft food if you are introducing solids. More at one time may be hard to digest until a little older. Yes, you can dust nipple with probiotic prior to feeding, it’s easy. If your baby is under four months or so and you are breastfeeding, enjoy plenty of ghee and other healthy organic fats yourself, to replenish for your own milk supply – no need to give this food to baby just yet.