Monday, December 8, 2008


Yesterday Noah put a goldfish cracker in his mouth. Of course he took it out again without even attempting to chew or swallow it, but for a few seconds he had real food in his mouth. I never thought I'd see that happen!Of course only a few short hours later he was hysterical because someone tried to give him a wrapped candy cane. We'll get there someday. I hope.
Our feeding team is inspired to try new things so we've made some changes. Noah's Prevacid has been doubled from 15mg to 30mg and he now takes it in the morning instead of at night. The big difference that we've noticed so far is that now he throws up all over his bed each evening instead of his high chair or carseat in the morning. Anyone know why he might feel the need to vomit an entire meal approximately 12 hours after a dose of Prevacid?

We're also sampling EO 28 Splash in an effort to try Noah off of dairy. Thus far I've noticed a distinct lack of couching, retching, gagging, and congestion in my house. Lots of grimacing over the flavor, though, and a major increase in avoidance behaviors at meals. About the same amount of refluxing - that never changes. We still have 2 more flavors to try before the official test, so hopefully he'll fall in love with one of them.

If the increased Prevacid and/or the lack of dairy don't solve all of Noah's feeding issues, or next step will be to try Periactin. After that we may or may not try Neurontin. If that doesn't work I imagine they'll try to come up with this or that in an effort to look like they're doing something, but the fact that they've recently started to refering to "if" Noah eats real food as opposed to "when" makes me think there probably isn't a lot left to try. Not that it matters to me, really. I mean, pureeing food isn't all that much trouble. Id'd be nice if he'd feed himself, but we're actually making progress with that, so I don't imagine it'll be too many years. That'll be a day to celebrate!


abby said...

Can you guys split the PPI dose between morning and evening? That seems to work to keep Hallie's reflux at bay.

And does Noah have issues with motility like Hallie does? I think I remember he had a problem related to his ilium but I'm way too lazy to research this on your blog. I wonder if anything can be done to strengthen the tone (does that ever happen? I suspect tone is a big part of our issue too) to make things move through Noah more effectively.

Anyway, I understand your concerns and share them. Hallie can eat some solids--just not enough and not effectively enough to actually take in the calories she needs to grow. Maybe her oral tone issues will get easier to deal with over time, but between allergies and motility issues, I'm not sure we'll ever solve this thing.

Anonymous said...

"Anyone know why he might feel the need to vomit an entire meal approximately 12 hours after a dose of Prevacid?"

Because Prevacid is metabolized much faster in children than adults. Not all GI's/peds seem to understand that. My son is about Noah's age and used to barf the bed full regularly, until we fired the first GI and found one who put him on a higher dose and split it into 2 doses. The research at suggests 3 doses per day, but 2 seems to work well enough for my son. The 30mg solutabs are pretty easy to crack in half.


Emily said...

Thanks! I actually asked my feeding therapist the same thing this morning and she said to split it in 2 doses too. Once we're out of the 30 mg solutabs they'll rewrite the prescription for 2 15 mg ones. Thanks for the info!

The Microblogologist said...

Glad the split dose is working for him. I am not sure if this is how it works for everyone or just me but as far as I know PPIs do not stop/prevent reflux, they just make it "safe". I am on 40mg prilosec (I was on prevacid before and they are about the same for me, nexium was horrid), I have to take other meds to lessen the reflux (reglan until I couldn't afford being a zombie anymore and now dicyclomine, but that is for IBS so probably not for him assuming it can be given to a child). Not sure how helpful any of this is given I am an adult with different issues causing my GERD/GI issues but who knows where one will be able to get a useful tidbit, I know I learn a lot from Abby's blog among others starring kids with GI issues. I pray your adorable little man grows out of this and soon!


Anonymous said...

Hi. I'm new to your blog. My former 25 weeker has simialr-sounding feeding issues. I think he's a bit older than your son. Anyway, I wanted to mention that periactin greatly decreases puking for us. Also, we tried all of the EO28 flavors as well as Elecare Vanilla with NO success (DS has multiple food allergies in addition to being a preemie). He puked daily until we got allergy testing done and switched him to rice milk and pureed solids. I don't know if any of this helps you, but I thought it would be worth a try. Good luck! Your doing a great job!!