Omeprazole queries

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Permalink Reply by Jenny B on February 9, 2012 at 22:51

I dissolved half a tablet in 5 mls water, as directed by my doc. There might be a better way though, as this wasn't the bestcwaycto dissolve the tablet! 
I might be wrong but unthought omeprazole was an acid suppressant? I find it funny that you went to them with suspected cmpi and you've come out with that. But I'm not very experienced so maybe that's right! Hope it works!

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Permalink Reply by Nicola on February 9, 2012 at 23:24

Hi my lo was perscribed omeprazole in tablet and we dissolve in 5 mi
Ls of water and used a syringe. Omeprazole to my understanding is for acid and coats the throat and tummy. We were also prescribed donprridone which is meant to help sickness as it pushes everything through quicker. 

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Permalink Reply by Jenny Rawling on February 10, 2012 at 8:14

Hmm. A few thoughts...

I don't think you can use Carobel and Gaviscon together - def check with a pharmacist on that one.

Omeprazole is mainly an acid suppressant, it acts on proton pumps to reduce the volume of acid produced. It may have some effect on the lower oesophageal sphincter to physically reduce reflux, but that's a minor effect so it's mainly to reduce pain, not vomiting. It will take a while to kick in, but probably within a week you'll have an idea if it's working or not.

The easiest way to give it is to put however many half tablets (half tablet = 5mg) directly into the barrel of an orange nurofen syringe and draw up some lukewarm water to dissolve the tablet then squirt in. You'll eb left with some of the little balls in the syringe so just resuspend them and repeat.

Did he improve on the hydrolysed formula compared to whatever he was on before? Does the paed not think CMPI is a factor? I guess you do need to challenge at some point to confirm if it's an issue or not but can understand your reluctance to do that if you think it's helping!

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Permalink Reply by laura taylor on February 10, 2012 at 11:31

The Carobel is to replace the Gaviscon but he did warn some babies don't get on with Carobel in which case to alternate feeds between Carobel and Gaviscon.

Idiot of a GP made no mention of CMPI in the referral letter.  I did bring it up at the consultation but he wanted to see if the Omeprazole would make a difference before exploring that.  Which may be why he has made the follow up appointment so close??

The partially hydrolysed formula was introduced at the same time as the gaviscon so if nothing else it will show us if it was the gaviscon or the formula that made a difference.  His hydrolysed formula runs out today so I will move him onto normal formula over the weekend before we start omeprazole to see what happens.  Dr didn't think partially hydrolysed formulas would have any impact on a cmpi baby - he thinks it just a bit of a marketing ploy!!!!

When he said he was going to give Omeprazole I immediately said to him isn't that a proton pump inhibitor at which point he asked if I had a medical background! ha ha  He said that sometimes babies are vomiting because there is acid on the oesophagus and vomiting is the body's way of shifting it.  Which is a new one I haven't heard before.

I'll let you know how we get on!

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Permalink Reply by Sara B on February 11, 2012 at 20:08

Hi Laura
that all sounds a bit bizarre to me. If you suspect cmpi it is going to be very difficult to sort out what is going on with them throwing so much in to the mix at once. My daughter is CMPI, on a big enough dose of omeprazole she can tolerate some milk, so the omeprazole can to some extent mask cmpi. i was told that omeprazole shrinks the stomach a little, so this can have an effect on vomiting. I found when my daughter got to a dose of omeprazole that controled the acid the vomiting did reduce massively. My son is on a huge dose of omeprazole as well as a cocktail of anti histimines and still vomits more than my daughter ever did... They are all different. If he goes down hill after changing the milk before starting the omeprazole I would go back and use this as proof of the cmpi. You may find if you can get him on to neocate he doesn't need acid supression.
Best wishes. Xx

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Permalink Reply by Sara B on February 11, 2012 at 20:12

PS, i have had the medical background comment... It always makes me chuckle inwardly. It is as if they think unless you are medical you have no brain and cannot possibly understand. When I tell them i am a farmer they look even more shocked that i'm not chewing straw! It's good though, they know you will keep questioning them until you get what you baby needs.

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Permalink Reply by laura taylor on February 11, 2012 at 21:51

Sadly, it was as I suspected and this morning Harry started arching his back and writhing 3 oz into his bottle of C&G formula.  He gave up after 5oz which is unlike him first thing - he usually takes a full 6oz.  He then projectile vomited about 2 oz right back at me.  Same with his 11am feed after which I switched back to the partially hydrolysed formula thinking I should maybe wait until we have the carobel and omeprazole before switching formulas.  He's been whingeing and crying for most of today which I had put down to really bad teething but at bath time realised he is covered in eczema all over his tummy and back and is red raw under his armpits with it.  I've emailed the doctor's secretary to set out what has happened and to ask if he still thinks I should move him onto a normal formula.  I just feel so bad that I knew this would happen and I still did it and now my little boy is suffering.  I just don't understand why the doctors won't listen to me or believe me and instead just think I'm some sort of neurotic first time mum who wants a perfect baby rather than a sicky one! 

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Permalink Reply by Jenny Rawling on February 11, 2012 at 22:31

That must be horrible for you both, but try to see it as a confirmation that he has a problem with cows milk. You needed to see the evidence of that to make the decision to stick with the hydrolysed formula in the long term. Hope it all settles down again quickly for you.

When you say "partially hydrolysed" formula, which one are you using? The group of formulas including Pepti and Nutramigen 1 would be ok for the majority of CMPI babies (something like 70-80%). A lot of the babies on the board need the more hypoallergenic amino-acid formulas like Neocate or Nutramigen AA but that's probably because they tend to represent the more severe end of the spectrum. I've never come across a doctor saying the hydrolysed formulas don't work, usually they are desperate not to prescribe the AA ones because they are expensive and pushing the Pepti!

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Permalink Reply by laura taylor on February 12, 2012 at 9:49

He's on Aptamil Comfort which is just 40% hydrolysed.  Given that he is much better on that than normal I suspect he would be fine on Pepti.

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Permalink Reply by laura taylor on February 12, 2012 at 22:43

Paediatrician has emailed back today to say keep him on the Aptamil Comfort with Gaviscon and that he can see him on Thursday instead of the following Monday.

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Permalink Reply by Pippa on February 13, 2012 at 19:19

Hi
I may be wrong but I thought you couldn't use gaviscon with comfort milk as it is already thickened so would be almost impossible to drink??

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Permalink Reply by laura taylor on February 13, 2012 at 20:00

the GP prescribed it when he knew he was on comfort formula.  We just had to go up a teat size so he was on size 3 teats from 8 weeks old.  I find that if you dissolve the gaviscon in freshly boiled water then add the milk the teats don't get as clogged up.  The gaviscon doesn't seem to really thicken it to be honest unless it starts to get cold.

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