Weaning is described here on this page as both titrating up or titrating down from a proton pump inhibotor when using a compound suspension such as TummyCare Max® and a PPI. Here is an example of how to titrate up if you are just starting your I suspension.
If you are intending to give your baby TummyCare Max® and Prevacid®. The dosing recommendation as shown in the PPI dosing information chart indicates a 12mg per dose, three times a day. If you are making a 3mg per mL concentration (typical for Prevacid®) then this would be 4mL (12mg) per dose.
By day four your baby will be at the desired dosage and the issue of refluxing due to CO2 will be minimized. Why is this important? Titrating is so important because it will help minimize the effect of Acid Battle and easing into the treatment is best for babies belly.
Determining when to begin titrating down from a proton pump inhibitor can be a challenge. Although there is no real set time to begin titrating we here at Infant Acid Relux Solutions find the best time to wean off a proton pump inhibitor (PPI) is at one year of age. This is when most babies start sitting up, being upright and walking. The gravity will help to overcome the reflux. Also the sphincter between the stomach and esophagus (gastroesophageal sphincter) will be more mature and functional.
Suggested steps to titrate are: You can go down to 2.5mL of your suspension of TummyCare Max® and the PPI of your choice. Once that dose has been achieved there isn't enough buffer to overcome any potential acid being made in the stomach. So you can discontinue that dose.
For example, lets say you are giving three doses per day and you want to wean. Reduce the middle of the day dose down until you get to 2.5mL for that dose. Then just stop that midday dose. You may have to supplement with plain TummyCare Max® for a few days but then you will successfully be at 2 doses of the proton pump inhibitor and TummyCare Max® per day. TummyCare Max® is an excellent buffer product all by itself so it can be of great assistance to you during this process.
You can repeat those steps for each dose.
We recommend that you start with the afternoon dose. Then move to the evening dose and then the morning dose. Unless of course most of the reflux symptoms are displayed in the evening. Then you would reduce the morning dose then the evening dose.
If at anytime during the titrating process you find that your baby is displaying signs of reflux you simply replace the weaning down to titrating back up to the original dose.