My almost 5 month old son's been on the Prevacid 15mg/day and Carafate 2mls before 4 feedings a day since last Friday. For the first two days he was a totally different baby...laughing all the time, smiling when he woke from naps, etc. But since Monday afternoon he's reverted to his old self...crying (and he screams more than cries...it's eardrum shattering!) most of the day, won't play on his own, waking up crying. Last night he woke up 6 or 7 times, and was screaming for half of them. Plus, he's not nursing well at all. He used to pull away crying sometimes, but now he'll nurse about half as much on one side, pull off screaming, and refuse to go back on or take the other side. I have been hospitalized and put on the most powerful antibiotics for severe mastitis already (temp of 104), and get plugged ducts about every other day as it is...this is only making it much worse.
Does this mean the meds aren't working? Why was he so good the first two days? We started him on solids per the pedi's advice (to get him to sleep better) almost a month ago, and have only tried the single-grain cereals, peaches and apples. He only likes oatmeal cereal and the fruits, and since he's been so fussy, we haven't introduced anything new since the first two weeks. His bowl movements have gone from 5-6 a day, big one in the morning, to sometimes every other day and blowing out his diaper.
Any advice? I called the GI doc, but didn't get an answer.
Thanks! I love having people to ask about this stuff 'cause I'm clueless, but I think things should be so much better...

I am going to put this thread over into the BF forum so that you can get some responses from there. It sure does sound pain related to me. Prevacid can cause some gastro issues and it can take up to 2 weeks for it to settle down so you may be in for a rough ride until his system adjusts. It worked within about 4 days for us the second time around and by the end of 10 days it was clearly our saviour for feeds. I hope it is the same for you.

Any chance the antibiotics have changed your milk? Sorry, I am not so sure on this as I never was on antibiotics while BF but I wonder if you are um, not as "tasty" now? Someone else with more experience in that will hopefully come along. It may just be your needing to pump some and get some of what remains out of your system. Ouch on the clogged ducts, etc. Man, I admire you for plodding along with all that. I had mastitis and a clogged duct and thought I was going to lose my mind. It will get better.

Hi,
I have been nursing for 13 months (working on self-weaning now) but I have never taken antibiotics while breastfeeding so I cannot offer any thoughts on that. My son did that screaming/pulling off/refusing until we got him under control with the Prevacid (about 4 months old). Leigh mentioned it can cause gastro issues, which is true. My son had green, runny, smelly poops...but that subsided w/in a few weeks. Prevacid really has been a miracle for us.
I imagine you're having the problem with clogged ducts/mastitis due to him not emptying you fully each feed, is that possible? If so...I would strongly recommend pumping whenever you have the spare time (as if!):rolleyes: I [thankfully] have never dealt with mastitis, and I MAY have dealt with one minor, clogged duct but nothing worth seeking medical advice. I commend you for going through all of that! :shock:
My guess is that he's still having discomfort, but I'm not sure what kind of effects mastitis/clogged ducts is supposed to have for the baby.
Have you been to www.kellymom.com (http://www.kellymom.com) ? That is a breastfeeding site that has LOADS of information there, if you haven't yet, I would definitely check it out.

I, too, know that Prevacid takes a little time to work, so I'd give it a little more time. Also, I have dealt with mastitis (that lovely 104 fever), though I wasn't hospitalized, just given nice, strong antibiotics, 800 mg of ibuprofen, and sleep aids, because mine spiked in the middle of the night. You need to pump as much as possible, especially if your son isn't nursing as much as he should. If he only takes half a feed from one breast, you should empty it the rest of the way, then empty the other. If you don't keep your breasts as empty as possible, you'll get more plugged ducts, which will lead to more bouts of mastitis. I would pump until he is taking feeds better, then you stop the extra pumping and just nurse him. Once the Prevacid kicks in, I bet he'll be eating just fine.

Judy and Sara took the words out of my mouth re: emptying your breasts to help alleviate/eradicate the mastitis. :-)

I am still b'feeding my 17 month old GERDling and remember very well some rough patches. :-( I wonder, also, about the antibiotics affecting your milk. When B was smaller, we both suffered from a nasty thrush infection that we passed back and forth for a few months. When I was medicated for this, she went on a hunger strike and refused to b'feed. My OB told me that the meds often make b'milk taste bitter. I'm sure you're on something totally different, but I wonder if that might be part of the problem.

I am totally with Sara--the kellymom website is an awesome treasure trove of information re: b'feeding. We're always here to chat, so feel free to vent whenever--this is tough to deal with alone!!

Do let us know how things go this week! :-)

Glad to hear I was not out in left field about the milk being less tasty with antibiotics. Pumping then would help with that too.

Lots of great advice here! Thanks ladies.:wink:

Thanks for the advice and encouragement. It's really nice to know there are others who've gone through this, as all of my friends have perfect babies. Theirs have all slept through the night early, and almost never cry...so I feel like an outcast, and like I should keep my screaming child away from their happy children, so he doesn't affect them.
The plugged ducts keep recurring (a few days ago my whole right side was plugged, and most of my left...he barely got anything to eat for a few feeds), but the mastitis was a while back. I think it was when he as about 10 weeks old. I was on the IV antibiotics for 4 days, and then on oral for another 10, but I'm sure they've flushed out of my system by now.
I do pump most of the time when he doesn't eat, or only eats a little, but I can't evacuate the milk like he can, and then I get engorged much faster (which leads to more plugs). Several times when I tried to pump to get extra milk, I got a plugged duct right afterwards...so I think pumping has been counterproductive sometimes. When I'm super engorged though, I do pump to relieve the pressure.
Take tonight for example:
He ate at 3pm, and then again at 6:30 for his "bedtime" feeding (he is going longer between feedings now too, after changing meds), but barely nursed at all. He didn't even empty one side. Then I fed him about 2 tbsp of oatmeal cereal with breastmilk, and peaches mixed in, and he ate 3/4 of it. He has eaten 4 tbsp of cereal before. I put him to bed at 8, and he screamed for 20 minutes before falling asleep (we've been to the sleep clinic too, and they want us to do sleep training with him; gradual extinction, where we check on him after 1, then 2, then 3 minutes, etc. until he falls asleep), but then he woke up at 9 screaming bloody murder. His diaper was clean, so I fed him again, waking him up between sides so he'd eat both (he's a sleep eater), and he conked right out. I don't understand why he didn't want to eat earlier though, it'd been a long time!
The GI nurse said that his pulling away and not wanting to eat is probably a learned behavior, because he knows eating makes him hurt, but why would he start doing it way more often now that he's on this med, when he didn't do it all that much before? He used to eat full meals, most of the time.
You are all probably right though, that I need to give it more time. I just don't know how long to wait...I knew he should've been on Prevacid, and even asked for it when he was 5 weeks old, but I didn't insist, and he's screamed most all day every day for his life so far. I don't want to just sit back and let him keep screaming and hurting, if I can help it this time. Or, is this as good as it gets? Do some babies actually scream most of the time, without any medical reason? Are your babies considered good babies now that their on medications? Do you get to enjoy them, and do they seem happy? I just don't know what to think anymore, and I know he'll eventually grow out of this, as everyone tells me, but I'd really like to be able to enjoy my baby, and have him enjoy life, NOW! He's been so bad that my husband and I debate having any more kids...we don't want to risk having another one like he is...he's so hard to handle all day every day. Reflux stinks, and makes life horrible!!!

You will not get any arguement from anyone here. Reflux DOES stink and it indeed can be horrible. All of us have been in that boat more than once. Also I am in the same boat for friends with perfect kids who wonder what on earth I am doing wrong when I have had three kids with reflux issues (we were diagnosed only a little over a year ago for my youngest when all three have gone through it! Imagine how it must have looked to have a 3 year old puking up!) One thing I can assure you is that it DOES get better. Once we got the right meds it made our lives and those of our kids so very much improved. You will enjoy your child and you will have moments when you wonder if it is ever going to end. For the vast majority it does end and for some it continues on, but you are much more equipped to deal with it if you fall into that category.

Some of the behaviour is learned, even at such a young age. Iain was totally solids averted until he was diagnosed and put on meds at the age of 14 months. It took work with an OT and feeding skills psychologist to get him where he is today. He is still supplemented heavily, but intaking very well now. I do not think you need to get and OT yet but give the meds a chance to work. Keep in mind you have a young baby and they are a lot of work at the best of times reflux in the picture or not. Sometimes babies do scream for no apparent reason but it is often over stimulation for the cause. You will eventually figure things out and likely be able to put this chapter behind you. It is far too early to give up on any more family members right now. Give the meds a chance and see how you feel a year or so from now, do not put undo stress on yourself to determine whether or not to have more children as now is not the time for that consideration, ok?

As far as sleep goes, he is only 5 months old and his reflux must be under control for the sleeping to be good. Do not put undo pressure here either. If he is in pain and not managed well with his reflux you may have a losing battle on your hands until he is well managed. Once my guys were on the right track sleeping became a lot better. Do not dispair as it again does get better. 20 minutes of screaming does seem like an eternity but not to make you feel any worse I will tell you that I have had marathon screaming sessions of hours. It is different for each child.

I am wondering what can be done for the clogged ducts. Have you tried warm compresses? Can you hand express? Is the pump you have strong enough? Maybe renting one from the hospital for a month to get your supply really rocking would be good?

Hang in there. You are doing a great job and it will pay off in the end.

{{{hugs}}}

Big hugs to you. I was right in your shoes about 8 months ago. My son's reflux TOTALLY put off the thought of any more children (he is our first.) I swore that if i ever said I wanted another baby, someone should shoot me. Well...I should have been shot a few times this week. :shock:
It really does get better...with the right meds and time. It should NOT be screaming all the time. It has come to the point where I can sit back, smile, and watch my baby play and entertain himself, read books, smile, laugh, etc etc...
Re: the breastpump...they definitely cannot express like the natural suckle of a babe, BUT there are new pumps out on the market that are EXTREMELY close....they're electric and you can "set the pace/speed/suckle" to your own preference! VERY COOL gadgets. I'd get one but we're in the process of weaning.
If you would like to continue to breastfeed (and I do encourage this, especially for a GERDling), I recommend that if you do not have a high grade pump already, it may be a wise investment. You wouldn't want your supply to diminish before you and your son are ready.

I really just want to offer you lots of sympathy. Your son sounds exactly like my daughter so I know how you feel. Except that she's my second child....so I had a 20 month old wanting my attention at the same time. It took me a long time to realize that there were actually 2 issues going on with Hailey- one was the uncontrolled reflux, the other was a bad bout of colic. I had to hold her 24 hours a day or she would SCREAM all the time. It was awful. But the colic passed at 6 months or so, though the reflux is still here. But thiings became much better once all the awful screaming passed. I want to tell you that once his meds kick in, which can take up to 2 weeks, he'll probably be a different child. Please try to hang in there. I was wondering how you give the carafate and the prevacid and what form of prevacid are you giving? This can affect how well it works. Regarding the breastfeeding, my daughter went on a wicked nursing strike at 8 weeks and would never empty my breast. It was awful and caused terrible engorgement and blocked ducts. I used cold cabbage leaves for the engorgement and found it helped me for some reason. I really hope that things improve for you soon. I went through a phase when things were at their worst where I really felt that there was no form of birth control in the world that offered enough of a guarantee for me to ever have sex again! I was so scared of having another child like this. But things do get better when they start to feel better. I hope this happens for you soon.

Lori, Hailey's mom (born may 31 '05)