Author Topic: Silent reflux: anyone got experience of instant carobel vs aptimel anti reflux f  (Read 12478 times)

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Offline Clairehv

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Hi
dD2 is almost 6 weeks old now and I suspect has silent reflux.
Unlike dd1 who Gaviscon worked for straight away we have persevered with that but I stopped after a week due to constipation.

Yesterday we were prescribed carobel powder.

I have been using the tommee tippee comfort anti reflux bottles (similar to Dr Browns)
Does anyone know if you can use the powder with them?

The dose says 1 scoop per 60 ml formula however I did this and changed to size 2 teats and DD couldn't get any milk.

After making up 3 bottles we succeeded in getting some milk in but it was 1 scoop in 150ml.

So the prescription is clearly free compared to purchasing the anti reflux formula but just wondered if the formula would do the same job
Or do I need size 3 teats.

Anyone who has any experience it would be great to hear

Thanks
Claire




Offline Lolly

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If she is on a standard milk based formula then an anti reflux formula will do exactly the same as adding carobel to normal formula. You can potentially make it thicker than a reflux formula which may be necessary depending on how much she is refluxing. Emfamil AR is available on prescription - my two did well on that reflux formula.

The reflux formulas are easier to use as you are just mixing and feeding rather than faffing about with an extra addition. I'm not sure how the other reflux formulas work (they are more widely available than when my two were babies) but the Enfamil is a bit thicker in the bottle and thickens further in the stomach.

To my mind the carobel is better for babies on the hypoallergenic formulas as they tend to be thinner than normal formula.

I used Dr brown bottles with DS and we did need the fastest teat for the Enfamil, they also did a Y cut teat for thicker fluids, it looks like TT don't do that type, just a fast flow. With DD we used the Avent bottles and needed to use the 6+ month variflow teat with the Enfamil.

HTH!

Laura


Offline Clairehv

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Hi Laura,
Think it is trial and error isn't it.
Before switching anything again I probably need to give the powder for a week and see if things improve.
We had more success today with 1 scoop in a 5oz milk feed using size 2 teats.
She does take a long time to feed though even with a bottle and over the prolonged time 45-60 mins the formula became too think.
I have some size 3 teats arriving tomorrow as boots had none in today.

A friend used the Aptamil anti reflux and it was the only thing that worked for them but I have read you have to wait 7 mins from making it up to feeding whereas adding the powder to normal Aptamil is 3-4 mins. Have also only just opened a new box so will keep going with it.

And everyone says baby number two is easy!!!! What a myth 😉😉
Claire




Offline Lolly

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How are things going now?

Laura


Offline Clairehv

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Hi Laura,
Thanks for the message.
We didn't get on with the carobel, tried size 2 and 3 teats and dd2 so slow at feeding that it just became too thick to the point I was using 1/2 scoop in 150ml so it probably wasn't doing anything.

We went back to gp but as she is now gaining weight since I stopped breastfeeding then they won't refer.
We are back trialling gaviscon, so far better than last time and no constiPation yet.
Symptoms seem to be somewhat better but I am just keeping her upright most of the time as well.

How are you? X
Claire




Offline Lindsay27

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If you don't have any any success with the gaviscon the doctor can also prescribe Ranitidine (Zantac) or Prevacid.



Offline Lolly

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If you don't have any any success with the gaviscon the doctor can also prescribe Ranitidine (Zantac) or Prevacid.

Some Drs in the Uk may prescribe ranitidine (mine wouldn't ::)) but they need to refer to a paediatrician for a PPI. Some will prescribe it under the paeds instructions while waiting for an appointment.

We went back to gp but as she is now gaining weight since I stopped breastfeeding then they won't refer.

A lot of Drs will say this, if you think she is in pain though or her symptoms worsen again (fingers crossed they don't!) push for a referral. Mine were the happiest, chunkiest babies around but they were in pain and definitely needed the meds.

I'm glad you are seeing some improvement though!

Laura


Offline Lindsay27

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Geez! Here our family doctor can prescribe both!



Offline Clairehv

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Hi
I have continued with the gaviscon after seeing my GP on Friday and we have a follow up on Friday.
He is happy to prescribe ranitidine if no improvement and if the gaviscon causes constipation. Having had to give laculose today and given that DD just woke at 3.20 am but instead of feeding just strained for 30 mins until had a poo then I think I would be keen to make the switch.

Lindsey do you have experience with ranitidine? How do you give to a bottle fed baby?  Would I need the formula thickened as well?

X
Claire




Offline Lolly

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Ranitidine is a syrup so you give it by syringe. Ask for a 1ml syringe as they are the easiest to use. It's dosed by weight and the weight range for under 6 months is 1-3mg per kg x 2 per day, sometimes they will prescribe x3 per day. For over 6 months it's 2-4mg per kg but some Drs will go to this for younger babies. The syrup is usually 150mg per kg so the dose will be very small which is why you need the 1ml syringe.

It tastes disgusting - it's bitter mint, but babies get used to it really quickly. We found the best way was to lie them on the floor swaddled (or just arms swaddled to keep them  out of the way!) and then get the syringe into the mouth as far to one side as possible. You will need to get it in in tiny bits to start so she doesn't get enough in her mouth to spit back out. Getting the syringe to one side and as far in as you can helps to bypass the taste buds. After a couple of weeks both of mine were willingly sucking down :-X :-X

It can take a couple of weeks to work and they tend to start at the lowest dose so it may be that she needs more before it works rather than it not working. It's very weight sensitive so she will need regular reviews as she grows. Both of mine needed the full 4mg per kg for it to be effective. Ranitidine starts to deteriorate after it's been open for 4 weeks, so keep an eye on how long you have had it as you may notice symptoms returning.

You will probably still need the thickener or a reflux formula as all the ranitidine does it reduce the acid, it doesn't stop the reflux action. Ranitidine is a histamine antagonist, when you chew, you release histamine which triggers the acid cells in the stomach to produce acid. Ranitidine reduces the amount of histamine the body produces so it reduces the amount of acid produced, it doesn't stop it a PPI drug like omeprazole will do that.

My health visitor told me it was ok to add a bit extra water to formula if they were constipated - not a lot, but for example if you are making a 5oz bottle you fill the bottle to just over the 5oz mark and then add the amount of powder for a 5oz bottle. That little bit extra in each bottle can help. Check with your Dr or HV though!

HTH!

Laura


Offline Lindsay27

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My DD was on raniditine and we success with it.  We've now weaned off if it as since she's started solids things have really improved, but that said her reflux was mild to begin with.  I just gave it directly from a syringe 1 x per day and I didn't thicken her formula.  Her dose at the time was 1.6mls and I think she was roughly 12lbs at the time it was prescribed.



Offline Clairehv

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Thank you both so much.

Laura and Lindsay.
It is definitely the acid regurgitation that is the problem rather than vomit as we do not get a vomit incidence everyday.
Ayda was 10lb 13 last week and as she is definitely a comfort feeder I am sure is well over 11lb now. Will get her weighed tomorrow ahead of the appt on Friday.

Can I ask do your LOs now nap in the day? I need to have some hope that I can break free from the sling

Xx
Claire




Offline Lolly

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Haha! I wish!! Mine are well past that now unfortunately for me!  ;D

They did nap though, pretty well really, especially DD although she was a high a time baby so dropped naps ahead of schedule. She was sleeping through before 9 months, my DS didn't but he was worse than her. I had a wedge under their mattress which helped and DD also had a sleep positioner thing that proped her up a bit more.

You will get there!

Laura


Offline Clairehv

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Any tips on how to start trying to get naps in the cot?
Thanks x
Claire




Offline Lolly

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Have you got the cot elevate? If not, that's the first thing to do then I would pick a nap and work on that first. We used sh/pat although the pat bit was more of a rub or a bum pat. The first nap is often a good one to start with.

How old is she now?

Laura


Offline Clairehv

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Hi
she will be 9 weeks on Monday and has not successfully napped in moses/cot or pram for over 6 weeks.
Wanted to try this week but with having to get dd1 to preschool then I haven't been able to persevere with the cot. on Monday I tried the pram thinking if she could sleep on the walk I would then keep going after drop off however she woke after 20 mins and didn't go back off leading to a hysterical OT feed at 10 am.
 A couple of naps this week have been in the car but she wAkes as soon as car stops and doesn't transfer well.
So I have fallen back to the sling just to get her some sleep.
The last 3 nights I have had OT meltdowns after bath and refusal of bottle. She'll scream for 30mins fall asleep in arms then wake 20 mins and want milk.
Have oh just got her settled at 9.30pm. She was out of bath at 6.10!

X
Claire