Hi,

Im not sure if Im allowed to ask this on here or not, but I wonder whether my 6 month old DD is not on a big enough dose of ranitidine as while we have seen an improvement since starting her on it (a month ago), she is still uncomfortable and in pain during feeds. I have had her latch etc checked by a lactation consultant who agrees she appears to be in pain and suggested she have her meds reviewed.

She was last weighed a couple of weeks ago and was 7.2kg, and dr has put her on 2ml twice a day (she started on 1.5ml at 6.5kg). Does this sound right?

Hi Lulu,

Generally doses/weights aren't discussed because meds can be so individual and really up to medical professionals. But I can say that ranitidine can be very very weight sensitive and there is a dose/weight guide chart over on Crying Over Spilt Milk which you can check and even print and take to your doctor to discuss doses with them.

Hope that helps and your little one feels better soon.
Hugs

Thanks for your reply Eleanor- yes I thought that might be the case re asking about doses on here.
I did look for the dose/weight guide on COSM as I recall there being one but I couldnt find it which is why I posted on here. Do you happen to know which section it is under? I cant find it under the medication instruction sheets which is where I thought it would be.

My dr is a 'give the lowest dose possible' kind of person. Which is great for some meds but the current dose really dosent seem to be controlling it so it would be good to have some kind of guidelines to take back to discuss with him

Hi Lulu
Sorry it's taken a bit to get back to you - crazy busy round here atm!

I've looked for it too and can't find it either so I've pmed Roz to ask where it is. Once she either comes back here with it or lets me know I'll let you know!

Hi again,

I see Roz has commented on other posts since your reply, so im wondering if maybe she is not allowed to comment about the doseage?

I did ask our pharmacist if he could also check the dose for me and he said it was right for her weight so Im at bit of a loss with what to do....... things have been getting progressively worse, DD keeps making a really WEIRD noise when feeding, like a really loud gasping sound with every inward breath then a grunting kind of noise when breathing out while constantly squirming and thrashing around at the breast. Almost every feed is starting like that then ending with her screaming- total feed time is usually around 5-10 mins and she is feeding around every 2 hours.

Should I be asking to try omeprazole instead? Any ideas?

Hi Lulu,
Sorry to hear that things aren't going well for you.
I think that Eleanor is right re not being able to post specific doseages on this board.
However - I had a read back about what our girls were doing at this age (they were both put onto ranitidine as opposed to omeprozole like most others that we were in contact with), and they were on about the same dose.
So it may be worth taking her back to your GP to get checked out, just to make sure that there's nothing else going on (re the funny breathing noises when feeding).
The feeds ending in screaming don't sound nice at all - for you and her! And it may be worth asking if a change to omeprazole would help (we never put our girls onto it - so not experienced with this one). Maybe Roz can help out with some comment about changing to losec.

All the best!

Hi Lulu

Sorry I haven't replied earlier - I'm rather behind as have been very busy with holidays and then working. I've been answering a few emails that are new and then a few that are really old, and yours must have been lost in the middle! I would have got there eventually - well I just have.

The dosage chart has been made more difficult to find as the current policy by some prescribers is to not prescribe as it isn't indicated in most instances. Also we were finding that some members were changing their child's dose without discussing it with their health professional which of course is really dangerous. We didn't want to be forced to have to move it altogether.

I'll check the dose for you and PM you soon.

Also how is your daughter fed? Have you tried a dairy free diet?

Hi again

Thanks for your pm Roz, it was really helpful

So Im actually more confused than ever now...... Is it possible that the ranitidine dose might actually be contributing to the strange gasping noises she is making? .........

It was about the same time as starting the ranitidine that the weird noises started- a lactation consultant who observed her feed said that the noise and her behaviour was definatly not normal and suggested that maybe what was going on was that the ranitidine was controlling the pain a bit (as she had stopped screaming during feeds) but she was still obviously very uncomfortable so making this other noise and wriggling and thrashing about instead- she thought that maybe the ranitidine was only helping a bit, but not enough.
So I asked for the dose to be increased (which was to 2ml), but actually ever since I did that the noises became worse and in the last few days she has started screaming with every feed again which is why I thought the dose was still not high enough.
But now I am wondering if perhaps the noises became worse because the dose was too high? Then yesterday I actually forgot to give her her morning dose as we were in a bit of a rush then late morning I fed her and was really surprized that for the first time in AGES she was fairly calm and didnt make the odd noise once. I told DH to come and see how quiet she was and it was then we remembered we had forgotton to give her the morning dose.
Do you think it was just conincidence? Or do you think that it is possible the medicine is causing our current problems?

So Im not sure what to do, I wonder if I should trial not giving the medicine for a week or 2 and see what happens? I recall reading that if you stop the medicine you need to do it slowly is that right?
I am worried about stopping the medicine though as I dont want the reflux to go back to as bad as it was before

I hope all that made sense, I am trying to explain it in a bit of a sleep deprived blur.

Oh yeah, and in answer to your question Roz- DD is breastfed and we started a couple of solids a couple of weeks ago. I am on an 'almost' dairy free diet as I thought she was ok with me eating diary in small amounts as an ingredient. We have an nut, egg and sesame free house due to DS so I dont eat any of those although on a few occasions I have eaten products with egg as an ingredient and she has been absolutely awful afterwards so I do think egg is a problem for her. Other things that seem to make her worse that I have cut out are tomatoes, citrus, hot/spicy foods, fizzy drink.

Sorry, I haven't gotten back until now.

My main concern with overdosing on Ranitidine is breathing difficulties so it could have been that. When weaning Ranitidine they have usually just outgrown the dose. I guess in your case I would drop each dose to 1.5 ml twice a day for a few days, and then 1 ml twice a day, then drop one dose and then the other. There isn't a rebound acidity with Ranitidine so no need to wean slowly in my opinion - note the words "in my opinion". If reflux gets worse, you will at least notice the level of Ranitidine needed.

You have probably already worked this out as I'm so slow!

If reflux is still any issue, I would recommend a fully dairy free diet for two weeks as a trial.