H2 Blockers and Infant Acid Reflux

H2 blockers and your baby's acid reflux. How they help, how long and why they seem to stop working.

Here's how they can help your baby's reflux. They block the messengers that tell the stomach to begin production of acid. These messages or signals. These signals are delivered by the messenger hormones called histamine (type 2). Histamine communicates with the cell by attaching to contact points located on the cell surface called receptors. They work by occupying the receptors so that histamine cannot bind and communicate to the parietal cell to activate it to start producing acid.

Acid is produced by the parietal cells located in the stomach lining. These cells don't secrete acid until they receive the signal from Histamine type 2 to begin production. (THIS IS WHY YOU MUST SPACE THE DOSE OF  A PPI FROM ANY H2 BLOCKER DOSE)

The H2 blocker works by occupying the receptors so that histamine cannot bind and communicate to the parietal cell to start producing acid. However; they only block one of three different signals that the parietal cell receives telling it to produce acid, so the signal can still get through.

Some examples of what is available on the market today are:

H2 Blockers are GREAT for sporadic or mild reflux. But for more moderate to severe reflux they may not be the best choice. Here's why.

The human (and baby) body will build a tolerance to H2 blockers. So you will likely notice it’s depleting effectiveness over time. In fact they stop working in about 7 to 14 days. This is called tachyphylaxis (or tolerance). Here's information about that study.  So even if the H2 blocker provides some relief initially, the infant often rapidly develops tolerance and becomes ineffective. Increasing the dose of the blocker will not help.

Another consideration is that histamine 2 blockers contain alcohol and alcohol is a mucosal irritant and may cause frequent diarrhea. 

Administering & Dosing H2 Blockers:

H2 blockers come in different dosage forms including tablets, capsules, liquids, and effervescent tablets. They are available in over the counter (OTC) and by prescription (RX) form.

This is a suggestion or option and by no means are we instructing you to dose your baby this way. Please do your research and proceed with what you feel comfortable doing for treating your baby’s acid reflux.

Crush a 75mg Zantac® or ranitidine tablet. Mix with 10mL of Mylanta Cherry Supreme or if unavailable you can use any generic brand as long as it doesn’t contain aluminum. Read the ingredients. RiteAid, Walmart, CVS, Target, and other retail chains carry generic brands.

You can dose 1ml up to 5 times a day even if you have a new born.

Please keep an eye out for very loose stools. If indicated you may have to lessen the dose.

Normal recommendations are to take them about one hour before eating. That gives the drug time to be absorbed into the bloodstream and reach the parietal cells before histamine can (which would trigger acid production).

Zantac Oral Dosing Information in PDF

The Contraindications:

Contraindications are WHAT NOT TO DO

You should not take with any of the following medications:

  • PPI drugs: They prevent PPIs from working if they are taken too closely in dosing times. For this reason they should not be given within four hours of giving any PPI drugs. Read this important message about spacing PPI's and H2 blockers!
    An in depth look: PPI Drugs work by directing inactivating the acid producing pumps in the parietal cells, but they can only have this effect if the pumps are actively secreting acid. Because an they will prevent the activation of pumps, they can actually inhibit the ability of a PPI medication to have its effect when they are given at the same time or together. However, giving PPI drugs in the morning and at mid-day and then an H2 blocker at bedtime can allow these two classes of medications to work together (since they are not in the bloodstream or body at the same time.
  • Sucralfate: Because sucralfate requires to be converted to its active form. By neutralizing acid in the stomach, the blockers inhibit this conversion. If sulcrafate is not converted to its active state, it will not adhere to and protect damaged areas.

In Conclusion:

They only inhibit one stimulus of acid production. For example, H2 won't block production stimulated by the nervous system (stress-induced acid production).

Much of the contents of this page came from the archived version of the Marci-kids.com website.

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