Weaning Down Or Titrating Up

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Weaning down or titrating up when using a compound formulation with a PPI can be super helpful in minimizing the transition of medications.  Your doctor may have prescribed a medication like a proton pump inhibitor and typically when you start treatment it's helpful to start off slowly and introduce more of the medication each day. This will help minimize the effect of Acid Battle and easing into the treatment is best.

As you know, it's extremely important that you work with you doctor on any medications being used and this is just an example of what a weaning program looks like.

Say your doctor recommended a dose of 4mL (12mg) per dose.

  • Day 1: Dose 1mL per dose.
  • Day 2: Dose 2mL per dose.
  • Day 3: Dose 3mL per dose.
  • Day 4: Dose 4mL per dose.

By day four the desired dosage and the issue of refluxing due to CO2 will be minimized.

Weaning Down From a PPI

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It's hard to know exactly when to stop treatment for infant GERD and we all know that just stopping doesn't give the best outcome. Working a infant GERD specialty doctor helps but typically babies outgrow reflux at 12 to 18 months of age. This is when most babies start sitting up, walking and eating solid foods and the esophageal sphincter muscle is more developed.

All babies are different, and we have worked with some babies that just require a little more time to wean. That's ok!
This plan will help you figure out if "now" is a good time.

You can start weaning one dose (usually the mid-day dose is the best one to start with) and if you see reflux symptoms creeping back, you know it's not time. Then you simply titrate the mid-day dose back up and continue with the treatment until your baby's time to wean comes. It will be here sooner than you think. Hang in there.

Here's an example fo what your doctor may suggest to wean your child. 

  • Step 1: Reduce the middle-day dose down until you get to 2.5mL for that dose. Then just stop that mid-day dose.
  • Step 2: Reduce the morning dose down until you get to 2.5mL for that dose. Then just stop the morning dose.
  • Step 3: Reduce the evening dose down until you get to 2.5mL for that dose. Then just stop the evening dose.
  • Step 4: CELEBRATE! Your child is now GERD free.

If your doctor is on board they can recommend the use of an antacid in between doses to assist with any mild and sporadic acid reflux episodes.

It's a good idea to track reflux symptoms. Now is a great time to use the infant reflux diary.

All of these instructions should be done with the guidance of your doctor or if you need to consult with a doctor connect with one that specializes in infant acid reflux here!