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.
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. Need help with this? Contact me.
2) Change up the feeding routine. Milk and soy proteins are not what your baby was built to digest. So, if you’re using milk or soy formula, change it. This alone may ease “reflux” symptoms. Use a partly digested (“hydrolyzed”) formula instead. Some ideas here.
3) If you’re using milk protein formula, don’t switch to soy. It may be just as hard or harder than milk protein to digest. And soy. See step (1).
4) Switch to organic, GMO-free formula. GMO ingredients in conventional formula are potential trouble for your baby’s gut bacteria and gut health. 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.
5) Use probiotics, like Klaire Labs Infant Therbiotic. This blends a number of beneficial strains that babies need in their guts for good digestion and to reduce inflammation. Klaire does not sell directly to the public, but you can purchase here or call them directly at 1-888-488-2488, with my provider authorization code 825.
6) Use an herbal tincture designed for babies and toddlers, in a glycerite base, that supports digestion. My favorite is from Gaia Herbs.
7) 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.
8) 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!
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!
Thanks for stopping by! If you don’t see answers here to your baby’s situation and need more help, make an appointment to work with me – you can view options, fees, and access to my calendar here. I can’t answer treatment questions or give individual care advice in this forum, but look forward to working with you one on one.
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!
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.
Hi There!
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.
Hi
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.
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.
Hi Judy!
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.
Same happened with us. Finally we had gone through a lot. Advise is to try Homeopathic medicine
Hi,
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.
K
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.
Hi Judy!
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!
Hi Judy
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?
Hannah
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.
Hi Judy,
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.
Hi Judy
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 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.
Hi,
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?
Thank you
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.
Hello there,
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.
Hi,
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.
Need help.
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.
Hello
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.