Tips for making Babywise and reflux work together. You can still enjoy the benefits of Babywise with a reflux baby and get great sleep.
Reflux is not easy on anyone. Baby is of course in pain and discomfort. Babies with reflux typically do not sleep very well, and certainly don’t sleep as well as they would without the reflux. This makes it harder on mom in many ways. Mom is emotionally and mentally worried about her baby’s comfort and health. Mom is also more exhausted physically because she isn’t getting as much rest since baby can’t sleep as well.
Post Contents
Babywise and Reflux Reality
Can you do Babywise if your baby has reflux? YES! Babywise and reflux can go hand in hand. A baby with reflux will most likely be slower to reach sleep milestones than she would if she didn’t have reflux. Using Babywise, however, will help your reflux baby sleep leaps and bounds better than she would otherwise.
Kaitlyn, my second child, had reflux. I did Babywise with her since birth. She was not sleeping as well as I hoped she would and as I felt she could if not for the reflux. I went searching for help online and left feeling pretty good about our situation. While other mothers were sleeping all night holding there reflux babies sitting in a lazy boy, I was wondering how to get her to sleep longer than 8:30 PM-5:30 AM in her crib.
I think there are great benefits to doing Babywise with a reflux baby. I think it helps their acid regulate.
While sleep with a reflux Babywise baby is much better than it would be without Babywise, there are challenges just because of the reflux. You have the likelihood that the baby can wake more often due to the heartburn. It will pass, but it is something to be aware of if you are having problems with early waking from naps or waking in the night.
Sleep training can be difficult. Having your baby cry it out while they are in pain isn’t really going to accomplish anything, especially when you take into account the crying aggravating the reflux. I highly recommend using the Four S’s for sleep training any baby, but especially a reflux baby. This is a no-cry sleep solution.
Something that can help is to burp your baby frequently and efficiently during feeding and throughout waketime. Give burping another go right before nap or bedtime. I also love gripe water for soothing pain (affiliate link). I would use it before every nap. I always gave only 1/4 of the recommended dosage, but you might need to use more if your baby has a lot of discomfort.
Despite these possible challenges, you can successfully do Babywise even if your baby has reflux. There is an excellent chance sleep milestones will happen later than they would without the reflux interfering, but in your moments of frustration, just remember it could be worse.
Tips for Making Babywise and Reflux Work Together
Here are some standard tips for reflux:
- Avoid caffeine. I went off chocolate altogether when Kaitlyn was about a month old, and that made a huge difference. I don’t drink caffeine in any way, but people I have talked to who drank coffee and cut that out saw a HUGE difference. Every so often I would be at a reunion or party and forgot my chocolate strike (honestly, I forgot, but my mind probably blocked it out on purpose! Yum, chocolate) and eat a piece of chocolate cake or something and I would see a change (for the worse) the next day in Kaitlyn.
- I have heard to avoid citrus, including tomatoes, so that includes all sauces and soups made of tomatoes. Citrus didn’t seem to affect Kaitlyn, though.
- Think back to when you were pregnant and got heartburn (if you did). Think of the types of food that gave you heartburn. Spicy, etc. That will do it to your baby.
- I personally think the reflux is better to have more frequent meals in the day that are smaller rather than a few large meals. So I kept Kaitlyn on the 3 hour schedule (sometimes we did 3.5 sometimes 2.5) until she was almost 7 months old.
- I do think a schedule is good for the reflux. There are definitely more factors to consider while doing Babywise though. Like if they are having pain during a nap and that is what wakes them, or is it one of the many other possible things that affect all babies? You have to weed that out.
- Some moms find that their baby with reflux will reach the “milestones” later. The milestones I am referring to are sleeping through the night, sleeping 10-12 hours at night, or moving to a 4 hour schedule. Other moms see no difference. Just be aware that it is a possibility.
- You can put your baby to sleep on an incline. I had Kaitlyn in a bassinet that we inclined the mattress by putting foam we purchased at a fabric store under it. My husband simply cut it at an angle. In the crib, I bought a mattress incliner from Babies R Us. She would slide down it and I am sure it caused her to wake more often, but at least she wasn’t having her esophogus burned! I stopped the incline somewhere around 15 weeks. Many people go longer.
- Nurse your baby if it is a possibility at all. I know it is hard for many women, especially when you factor in the foods you have to cut out of your diet. It is so worth it for your baby. Breast milk changes with the baby. The calories in an ounce of milk increase as the baby gets older. Formula doesn’t do that, so you would have to give the baby more formula to get more calories, but that can aggravate their tummies. Breast milk is also easier on the digestive system. Here is an example from my life to illustrate this point. When Kaitlyn is 6.5 months old, I didn’t even use a burp rag to burp her at home. She still spit up every so often, but rarely. At church every week I give her a bottle with formula. This is so I can stay and listen to talks, lessons, etc. and also so she can maintain her familiarity with bottles and so she will be okay with eating formula if need be. Now here is the interesting part. Every week at church after her bottle, my baby went from not needing a burp rag to needing a BLANKET to cover my lap or else I would be soaking wet before long. So I went from no burp rag, to blanket just from a bottle/formula. You read that formula is not as gentle on the stomach so reflux babies will spit up more if they eat it. I have found this to be true.
- Some advice I got from a fellow Babywise mom who had a daughter with reflux was to not let the reflux become an excuse for you. Yes, you want to be sure you are attending to baby’s needs, but don’t be too quick to attribute all problems to the reflux. If you do, you may be ignoring the real problems.
- Check out Babycenter.com and look up reflux and nursing–you will find all sorts of information. You will also find a bunch of people who at 6 months are still up every two hours at night and who hold their child for all naps and sleep in recliners with the baby at night. They are frazzled, I feel bad for them. They have accepted that it is just really hard with reflux. But it doesn’t have to be that way. You will feel much better about any difficulties you experience with your reflux after checking this out.
Reflux is no reason to not follow the Babywise plan. Babywise and reflux can work together beautifully. You might need to make some adjustments for your baby, but that is true for all moms. You will likely find life with your baby with reflux much easier doing PDF (parent directed feeding) than moms who do otherwise.
If you are having trouble getting your reflux Babywise baby to sleep, read my post on How To Get Your Reflux Baby to Sleep.
Sympathy for Reflux
When I am pregnant, I get really bad heartburn. I remember with Brayden it got so bad in my third trimester that I just couldn’t sleep at night. I am not really a person who likes to take medicine, so Mylanta is as far as I go. It just didn’t help.
One night in my last pregnancyI had heartburn really bad. As I got in bed to go to sleep, it was painful for me. I tried laying on each side, but to no avail. It hurt. My husband offered to rub my back because that helps relax me to fall asleep. I can still lay on my tummy for short periods, so I lay on my tummy. Immediately my heartburn was relieved.
As I lay there trying to fall asleep, I had even more sympathy, and moving into empathy, for those little babies with reflux. It is hard to sleep if your esophagus is burning.
I know that many parents who have babies with reflux get discouraged because their little one takes longer to be able to sleep long for naps, sleep through the night, and move to a 4 hour schedule. Kaitlyn certainly took longer than average to sleep through the night and to move to a 4 hour schedule (she had reflux).
Take heart and have patience. Your baby will get there when it becomes possible. Have sympathy and know your little one is in pain. Do research to find out what you can do to help ease that pain. Try different things; remedies are different for every baby. Your baby will get there and you aren’t a failure if it takes extra time.
Reader Reflux Advice:
- John and Amanda said…
I had to comment on this one! My baby had (and still does at 6 months) severe reflux issues as well as extreme fussiness/colic issues. We saw the doctor at 5 weeks old and started Zantac and it helped take the burn away, but not the constant spitting (I’m talking 1 – 2 ounces at a time). For me, I slept my baby swaddled and in his car seat. I know it sounds silly, but it worked for us! We also used Gripe Water a lot although I don’t know how much it really worked because he still spit a lot. It wasn’t until he was 4 months old that he became a “happy spitter.” My advice to BW Moms with Reflux Babies: Babywise was a little more difficult to follow with a fussy/colicky/reflux baby, but it can be done. Things may look different in your routine with a reflux baby, but if you stick with it he/she will get there eventually! - nessa said…
hi, I’m a mother of a 5 1/2 reflux baby named Garrett and i have followed babywise since he was born. There are a few things I wanted to share that helped my child with this issue, without taking medicine. I found that with his reflux cutting things out of my diet helped dramatically. I eliminate caffeine (including chocolate to my dismay) dairy, citrus, and minimized gas forming foods (broccoli, onions, etc). I even tested the food items by eating them one time in the week and found that he would have episodes of reflux for a few days after (especially to chocolate). I noticed after a few days of eliminating these items that his symptoms dramatically improved. Another item that helped was purchasing a wedge pillow from arpillow.com The pillow makes a huge difference. I wanted to let other reflux mom’s know about the pillow because i’ve seen it work for my lo. He slept through the night after purchasing this pillow. When he doesn’t sleep on it, he arches more after a few days and has more acid pain. (I’ve experimented) Another comment I wanted to make is at the dreamfeed. I held him up for 30-45 mins after feeding him, before putting him to bed. Another difficulty I found was giving him TUMMY TIME. Because laying on his stomach caused him to spit up more! So I started giving him tummy time when he awoke early from a nap, right before feeding him. In the beginning it only lasted about 5-10 mins. Depending on his hunger level. Then later around 4 1/2 months he started to enjoy it, and at 5 months became a rolly polly. There are ways naturally to help comfort our LO through reflux. AND yes they do need routine!
Plowmanators said…
nessa, thanks for all of your tips! It is good to have a variety of tips. I couldn’t agree more about the caffeine. - usmcfamily04 said…
Great post! I, too, suffered from HORRIBLE heartburn during pregnancy…I was taking the daily acid reducer and eating tums like nobody’s business! On top of that, my son had/has reflux…so he is still in the swing…but we are getting ready to transition to the crib after the holiday season (get through one stressor at a time!). - Shelia said…
My reflux was somewhat “tolerable” while pregnant. But watching my baby girl experience it has been miserable. The Zantac doesn’t work well. She took it for three months to no availe. But the Prevacid is a gift from above! I immediately saw a change in her… though she’s still at times reluctant to eat and only weighs 17 lbs at nearly 14 months of age. The best advice I have is to get a referral to a Pediatric GI doctor if it continues very long. It turns out my daughter has a slight milk protein allergy that will just take a while for her body to “grow out of”. That was something that even shocked my pediatrician (who never even thought of the possibility). And… Get a good swing! - Lorri said…
Hey I can feel your pain, I had really bad reflux with Scooter too!!Try eating an apple whenever you feel the heartburn coming on. It doesn’t work for all but it did for me-and I mean worked as in it COMPLETELY got rid of any discomfort. I ate close to 6-7 apples a day because no matter what I ate, I seemed to get heartburn.For babies with reflux-our doctor told us we had a bad case baby. We had him on prevacid and would have to stay up with him for an hour after eating-and when he was first born and on a 2 hour schedule, believe me, no fun. Even with the prevacid he still complained-so we ended up giving up the prevacid since it wasn’t doing any good and tried to work through it with him.I can say the reflux improved at 4 months and now by 6 months he is doing great!There are lots of things to try with a baby who has reflux-you can try them all, but sometimes you just have to tough it up. I can give the advice that when someone asks when it will get better-I can honestly say 6 months is a magical transition!
Christie said…
I agree with Lorri, there is something about that 6 month transition that helps with the baby’s reflux so much! I think it is because they are sitting up on their own by then. Something that helped when I was nursing her, was for me to drink two cups of chamomile tea a day, it helped calm her stomach. It worked better than Zantac (which she was on for one week, and made her act funny, so I took her off of it!).
Kristin said…
But I also think that people should not be too discouraged if it does not clear up at 6 months because for others it doesn’t get better until 9 months or 12 months. - Kara and Chris said…
Our child was diagnosed with reflux at 2 months. He was immediately put on zantac and enfamil nutramagin. We saw about 70% improvement. We elevated his bed with phone books and held him for 30min. after each feeding. Most of the terrible symptoms went away but he still had constant hiccups and refused to nap more than 20 min. at a time. We still haven’t managed the STTN, he is 14 wks this Sunday, but I feel we are getting really close. Two weeks ago he seemed to go downhill fast! I was at wits end watching him suffer like this. That evening a friend of mine told me her child had reflux and lactose issues. I asked her how she figured out the lactose part. She said it carried a few more symptoms than reflux such as, infant acne that doesn’t clear up (this should really start to disappear after 2 months) constant bloated tummy, constant diarrhea like stools (they should start to get harder after 2 months if baby is not breastfed)and a stage of bluish poop for about a week. My child exhibited all these signs. I rushed to get some soy formula figuring it couldn’t get any worse and after 2 bottles he was 100% better, no more zantac either! I wish my dr. would have caught this or at least pointed me in this direction. This was a lifesaver for us. - Jessica Babcock said…
My son has reflux and it took us weeks to get the diagnosis. in the mean time he was screaming thru every feeding no matter what we tried. my husband and I had to take turns feeding him and help each other by watching close for each other’s frustration building. the honest truth is that there were times, especially in the middle of the night that both of us had to put him down and pace the room just to calm ourselves down. Your mind knows that something is very wrong and he’s not screaming to irritate you, but with sleep deprovation and the feeling that nothing or no one is helping its easy to lose your cool. I wanted to share this because i think its more common to feel this way that many want to admit. its important to recognise that you need help and find ways to cope that protect the baby as well as yourself. my son is now on zantac and everything has changed for the better! - Rachel Stella said…
I wanted to mention that although I’m not a big fan of drugs, I think some situations like reflux call for them if they can’t be remedied by other ways like inclining the mattress etc. I try to always think of things from my baby’s perspective…if I was in pain, which was bad enough that I couldn’t even sleep or eat, I’d want something to help me out right?
Reader Reflux Questions
- Jordan & Nikki said…
A week & a half ago, my near 4 month old was diagnosed with acid reflux. I’m not sure what took me so long to figure it out…regardless, the hardest thing is that the medication isn’t yet fine-tuned & she is still highly bothered at least 2x/day. It kills me to see her so upset – and then the spit up comes & she is as happy as a lark. At our follow-up Dr. visit, we should be able to adjust the medication, but until then, with the early nap wakings (i.e. less than an hour into the nap, clearly due to the reflux), should I just start the cycle anew? I guess I just feel frustrated that attempts at a schedule can be pushed aside due to reflux at any time. Is that normal?
Jordan & Nikki said…
Aside from needing validation of my frustrations, I do have specific questions. She sleeps from 6 pm – 6 am, with a dreamfeed around 10. She wakes as happy as a lark…I can’t complain. During the day, she is able to fall asleep on her own, unless the reflux is acting up or she is overtired from it acting up. She does wake up in the middle of the night… she isn’t hungry but I don’t want to make her CIO to learn to go back to sleep, as it may aggravate the problem. She doesn’t take a pacifier, so if I start to nurse her, she immediately goes to sleep. Any suggestions on how to wean her from that dependency? Or should I just appreciate that she is doing so well, considering the occasional pain?
Plowmanators said…
Nikki,I am glad you found it. I think if the NICU nurses hadn’t pointed it out in Kaitlyn, I never would have noticed. I think I would start the cycle new, but give her about 20 minutes before feeding her if she will so you can be closer to the right interval. Eating too often can aggravate reflux. Though some need smaller amounts more often :).I do think you should be happy she does as well as she does, but I also think it is something you can work through. Once the meds are in place and working well, then I would give it about a week and then start to work on the night stuff. See this post for ideas on breaking it gently: 5-6 AM “Night Wakings” I found that Kaitlyn was a little slower in reaching some of the big milestones because of the reflux, so if your daughter is the same way, keep that in mind (I mean STTN and 4 hour schedule). - mkk23 said…
Hi there,Thank you so much for this blog! It has made this process so much easier. 🙂 I know that you have mentioned that Kaitlyn had reflux, how did you know or the nurses know that she had it? What are the signs of a reflux baby? My 6 week old spits up a lot but I don’t know how much is too much. We start our day at 7am and right now, it is 2:30pm… he has spit up about 12 times already. He definitely has had gas problems since birth – meaning he has always had a difficult time letting the gas/burps out. It has improved in the last week. Any advice would be greatly appreciated.
Plowmanators said…
You are welcome! I am glad it has helped. Kaitlyn had silent reflux, meaning she didn’t spit up. What happened was she would spit up, then swallow it back down. She did her best to hold it in; it would even often come out her nose because she was trying so hard to keep it down. There are a lot of signs of reflux. I would google it and see what you find. It is also known as GERD. Some babies just spit up a lot.
RELATED POSTS
Reader Reflux Questions
Kjackson said: plowmanators, I got your comment and I regret to say!!, that the zantac was awful. It worked for the first 2 doses (when I posted the comment about it), and then it made her 5 times more irritable. She developed this new screeching cry Id never heard and she seemed much more irritated when trying to go to the bathroom. She didnt go for a couple days. I took her off the zantac and she went like over 10 times after the meds were out of her system. It makes me sad because it really helped for a short bit. I am going to take her back to the dr tomorrow to get her something else. It just stinks because she wont eat more than 3 minbutes of food every hour right now. I am having to feed her hourly and her schedule is just completely gone. I am going to have to start compoletely over. It is also harder to assist her in sleeping and shes been waking up every 2 hours, as where a couple weeks ago she was sleeping for 5 hrs and then another 4. Waking up once. Now its like 4 times nightly (her reflux started acting up around 5 weeks, shes now 7). Shes gradualy gotten worse. I just feel sorry for the poor thing and I want my sleep back!!
Has anyone had this experience with Zantac?? Also, does anyone have meds to recommend that helped?
I will let you know how things go after tomorrow.
BabywiseMom said: KJackson, Zantac doesn’t work for most, and for those it does work for, it doesn’t work for long. A PPI blocker is better. I hope you got a better med.
GoBucksKB said:
My son is 8.5 weeks old and has silent reflux. He takes Prevacid (suspension), but after a week and a half, hasn’t experienced any real miracles. He is formula-fed (Good Start) and has been growing at a steady clip. He takes in about 32 oz a day over the course of 7 feedings. We are on a 3 hr schedule, starting at 6:30. We DF at 12:30 am and he is “good to go” until morning. His night sleep is pretty peaceful until the early morning hours. He has a lot of gas and grunts then. Our main problem is daytime sleep. We are recovering slightly from the fact that it worsened when we started Prevacid, but he will still scootch around a lot, cry with the paci in and wake 3-8 times in a 90 +/- “nap”. Perhaps I am being selfish with him wanting to have good naps, but I also think it is good for development, too! Can you tell me how you applied some CIO strategies to your reflux baby?
Also, a huge thanks for your blog. You are a very on-top-of-it mommy! You can pray for my jealousy of you!
PS What are your thoughts on the paci? We used it with success with our first son. It was a way to soothe him before (and during) bedtime and it also was cue to him that it was “time”. With 2nd son, I’ve used it b/c that is what I know and the additional SIDS “protection” (don’t tell, but he sleeps on his belly) and b/c I heard that it creates “juices” that help calm the reflux. Having said that, I am forever putting it back in. Don’t know whether his wakings are a result of the reflux or losing the paci. I guess I know the answer- it is up to us, but if you want to weigh in on this, I am all ears (uh, eyes).
BabywiseMom said:
GoBucks, Are you sure he has a large enough dose? Prevacid is based on weight, so be sure of that. Is suspension the liquid? I have read that doesn’t work as well (though that is what my daughter took). You have to have a really good pharmacist who can do it right. You can get pills that you disolve in breastmilk and then suck up in a syringe.
My daughter did well with CIO, but I never did it during a nap. See this post:
Waking Early From Naps/Won’t Fall Asleep For Naps
Until his meds are worked out, I would be cautious about CIO with him.
Honestly, I am not a paci fan. I think it quickly becomes over-used and abused by parents. If you are aware and careful, you can make sure you don’t let it become a problem. Most parents don’t do that. I prefer a soothing method the child controls because then it will only be used when really needed rather than when the parent thinks it might be needed.
S&K Nielsen said:
I am so impressed with this blog and have spent many hours finding new information! So THANK YOU!
My 6-week-old was diagnosed with reflux about 2 weeks ago. He is now on Zantac and a hypo-allergenic formula (he had a food allergy to normal formula and couldn’t nurse because he was tongue-tied.) He sleeps pretty good during the night from about 10:00 to 4:00 or 5:00 with a few times in there that he needs a little “comfort”. Our trouble is during the day. He really struggles with naptime. He falls asleep really easily about 1 hour after his awake time. Unfortunately, he struggles to stay asleep. I can pinpoint the time (around 25 minutes into his nap) that he starts fidgeting and by 30 minutes he has woken himself up. If by chance he gets passed the 30-45 minute mark, I can tell that he still struggles with his light/deep sleep transition each time after that as he grunts, groans and moves around during that time interval.
I am very curious as to whether this is a reflux issue or a sleep issue. Could it be his stomach that is bothering him during this time? Zantac seems to be helping…he used to cry during his feedings, but no longer does that and seems very content during his wake time and the first part of his nap. He just can’t seem to get through the sleep cycle very well. Any suggestions on how I can weed out the cause of his naptime struggles? Any suggestions would be greatly appreciated!
Thanks again!
Go Bucks said: s&k nielsen- that is exactly what my son does! I have no advice yet, but wanted you to know that you aren’t alone. My son cannot make it (usually) past that 30 minute mark in anything- the swing, carseat, carrier, crib. Can’t wait to hear the response!
BabywiseMom said:
S & K Nielsen, It could be either. It might be reflux, it might be sleep. There is no way to know for sure at this point, which is one thing that makes reflux hard.
Sleeping propped up usually helps with discomfort. I would suggest you look through troubleshooting naps post and if all of those issues are resolved, I would assume it is a reflux issue: Naps: Troubleshooting
Taylor’s Mommy said: I also want to be another to say thank you for your blog! My daughter is 13 weeks and has silent reflux. I am sort of at a loss because my pediatrician has dismissed it, saying she is gaining weight so well that she is fine. There are days where is it hardly noticeable. Then days where she can’t soothe herself for a nap and I have to rock her to sleep and then lay her in her crib. She is also not STTN. I don’t want to push anything, but her 4AM feeding, leaves her not hungry for her 7AM feeding, then starving for her 10AM feeding (sometimes becomes 9:30). The last week we have let her cry it out and the fourth night she slept on her own, but then has woken up each night after that (we’ve done if for 8 nights). We have given her a pacifier to avoid feeding her, then we let her cry 15 minutes back to sleep another night which worked. But nothing seems to get her to STTN on her own. Anyways I don’t know if this is due to her reflux and whether or not we should push for medication. I am really worried to give such a small baby medication. So my question is should I just start feeding her in the night again and wait until she naturally starts sleeping through the night (just in case it is due to her reflux)? AND are there horrible side effects to the medication?
BabywiseMom said: Kaitlyn also had silent reflux. One of my best friends had a baby with reflux a year before Kaitlyn was born, and she really encouraged me to push for the meds. My doctor wasn’t going to do it, but he is the type to listen to the parent and their thoughts. So we did prevacid. We didn’t see any negative side effects.
The problem with silent reflux is that it comes up, burns the esophogus, then baby swallows it back down, which burns it again. When it comes out, it is actually better for the esophogus.
A woman who lives close to me had a 19 year old son at the time of Kaitlyn’s birth. I remember her telling me to watch the reflux. When her son was a baby, he also had silent reflux, but they didn’t treat because it “wasn’t a problem.” He has ended up having to have regular visits to the doctor to open up his throat due to scar tissue. He almost choked to death in elementary before they realized he needed these treatments. Because of this, he couldn’t leave the country to serve his mission because he needed to be close to doctors who could do this.
I am not trying to present scare tactics to you, just let you know that there are real reasons for meds with silent reflux. I remember researching it when Kaitlyn was first born and reading one woman’s recommendation that if the doctor wouldn’t do meds (and many don’t believe there is a reason for it with silent reflux), get a new doctor.
I would recommend you look into it and express your feelings with your doctor.
As far as the night, I wouldn’t do CIO with her having reflux. She could easily be crying and/or waking because of pain. I would personally just feed her until you either get her on meds or her reflux is gone and she does it on her own.
John and Andrea said: I have a 4 month old baby boy who was just diagnosed with reflux. We’ve been doing babywise since birth and have great success with naps during the day but night time we are still getting up 1-2 times. We are on a 2.5 – 3 hr schedule and the dr. recommended that I go off all dairy for 5 days before I start meds. She also recommended feeding him less milk every 2 hours. Any suggestions on how that would look with babywise?
BabywiseMom said:
If you fed every two hours, you would have to have a short waketime followed by a short nap.
Honestly, I find feeding every two hours unnecessary at that age. Obviously you are with him and know what is best for him–and that goes both ways. You know better than the doctor if two hours is a good thing or not. If you don’t find it necessary, I would do 2.5 hour schedule. It will be easier to fit in the E/W/S cycle that way.
Autumn Castillo said:
I am a first time mom and your blog has been a blessing in helping to implement BW.
My son Aiden is 12 weeks old and recently has been diagnosed with reflux. He was born 3 weeks early at 5 pounds and started spitting up around 3 weeks old. Prior to being diagnosed, naptime was horrible! Aiden could CIO for the entire supposed naptime. He would get so worked up and we couldn’t figure out why he couldn’t fall alseep. We tried everything (swing, shushing, paci, burping) and nothing would work short of us picking him up and holding him.
One day after he only slept for 45 minutes the entire day, I picked him up, laid him on my chest and laid down. He burped, passed gas and then fell asleep right away! I then moved him off my chest and he continued sleeping for 2 hours!!
Since then, we now put him down for his naps and wait 10 minutes. He starts crying and we then turn him over to his stomach. We then leave him there for 10 minutes until we are sure he is alseep and we turn him back over. Doing so, he sleeps for 1.5 hours for naps.
We want him to be able to self- soothe but we also don’t want him in pain and missing out on important sleep. We know that CIO aggravates his reflux. We are hopeful that this will pass as he gets older and bigger.
Question 1: Do you have any suggestions for self-soothing to sleep for our situation?
Question 2: His schedule is 7, 10, 1, 4, 7, 10 with 1.5 hour waketime and 1.5 hour naps between each feeding. After being put down he sleeps until 3:30am for another feeding. We have never had to awaken him for a DF as he awakes on his own. Does this mean that he is not ready to drop the 3:30am feeding? Is he sleeping too long during the day?
Thank you very much for your support!
BabywiseMom said:
Autumn, I would suggest you get The Baby Whisperer Solves All Your Problems. She has methods for self-soothing without CIO.
I don’t think he is sleeping too long in the day. Be patient with that night feeding. I think reflux babies need it longer than others.
Autumn said:
Thank you for your comment.
I am happy to say that Aiden dropped his night feeding and has been sleeping 11-12 hours a night since 13 weeks.
He is currently on Prevacid for his reflux and we are praying for healing and strengthening of his little stomach muscles.
In regards to putting him down, we noticed that he was able to sleep but that he would flail his arms and keep himself awake. We discovered the SwaddleMe and Aiden CIO for maybe 5 minutes and sleeps peacefully for 1.5 hours.
Parenting has its surprises……and great rewards!
BabywiseMom said: I am glad to hear things are going well Autumn!
Stephanie said:
Hi. I have found encouragement in your Blog. I never read babywise, but have gotten advice from those who have. With my first son, I scheduled during the day and it made nights a piece of cake by the time he was 2 months old. He STTN by 3 months (12 hours). However, I have a four month old that is bringing me to tears almost everyday. I am doing my best to keep him on schedule despite having severe reflux.
He was one week early and delivered via c-section due to a uterine infection. He was in the NICU for one week on strong antibiotics…he was a fighter and got to come home one week after birth.
I fought hard to breastfeed…and despite huge issues (he wasn’t allowed to eat for 2 days due to conditions at birth and was only allowed to nurse ever so often because of his breathing.)we succeeded. He nurses great now and all our latching issues were over by 2 months. I am giving him zantac (I was told that was all he could have until 6 months). I can’t see a huge difference, but he is definitely not worse. Also, he does not cry anymore with the spitting up (more like projectile vomiting!)He is a really happy baby.
However…I am not a really happy momma right now because he wakes up constantly through the night. His eat/play/sleep schedule is every 3 to 3.5 hours right now. He seems to do pretty well for naps… usually a one hour nap in the morning, a 1.5/2 hour nap in the mid-day and a 1 hour nap in early after noon. I do have him elevated. He usually goes to bed at 7:30 and wakes around midnight. I have been feeding him then. (I felt like he needed an extra feeding because he wasn’t gaining as much weight as he should due to the excessive spitting up). After midnight, he will sleep another 2 hours and wake up. I just keep going in and putting a passy in his mouth because I don’t want him to cry to much and make his reflux worse plus he has a 2 year old brother in the same room. (the 2 year old does well with some fussing but I don’t think he’s going to get great sleep if the CIO goes on for an hour or so.)Sometimes Graham (my 4month old) Then from 3:00 am on…its every hour. I don’t feed him until 6:00, but it’s like he just keep getting woke up.
The frustrating thing is that at 2 months, he was sleeping 6-7 hours,eating, and then sleeping another 4. When his reflux starting getting worse, so did his sleep. What should I do? Should I just let him CIO? It’s been two months of chaos at night. I’m exhausted. Like I said, he’s doing great during the day with feeding and naptime. And yes, he’s putting himself to sleep for naptimes. HELP!
-Stephanie
BabywiseMom said:
Stephanie, the first thing I would do is try go get his meds right. You said reflux got worse and then sleep did. Has he had his dosage increased ever? It is weight based, so as he gets older he will need his dosage increased.
Also, many find that zantac works initially but then loses effectiveness. I would talk to your doctor about alternatives so you can find something that works for him.
I would also try to think about what is different about night and naps. Is the room colder at night? Since naps are good, I would think that there is something about night that is rousing him. It might be the brother in the room, in which case some white noise in the room might help block each other out.
You might also want to consider seeing if he can sleep well without the incline once meds are right. I think the incline is good and necessary, but I think it is best to take it away as soon as you can because they slide down it and just have a hard time getting comfortable sleeping that way.
LEM said:
My 5 week old was recently diagnosed with reflux. I believe it to be a mild case though because her sleep is bot affected too much and she has already slept 7 hours at night twice. She cries at almost every feeding though and is miserable through her short wake time. We just started Prevacid, 1/2 tablet once a day. My question is how did you give Kaitlyn her meds and still follow the eat, wake, sleep cycle? I was told I have to give them 30 prior to eating. I chose to give it to my daughter before her last feeding of the day since I’d rather ruin the last nap of the day. At this age I may be able to get her to fall back asleep but I know this will be difficult as she becomes more alert. If I can’t get her go back to sleep then she will be awake for 30 min, then eat for 30, which will then be all her waketime messing up the cycle.
Here is my schedule: feed at 630,930,1230,330,630 then dreamfeed at 10. She usually wakes around 3 or 4 am although she has slept through untill 6am twice! After our 630 pm feeding I give a bath a 7pm then bed at 730. She has 45-60 min of waketime. So right now I have to give her meds at 6pm but she won’t always fall back asleep leaving her with 1.5 hours of waketime. I am curious how you did this with Kaitlyn and what suggestions you have for me. Thanks!
I also wanted to mention that from 730 when I put her down untill dreamfeed she cannot settle herself. She will cry from the second I put her down. Her paci calms her but she will cry every 10 min when it falls out. Maybe the reflux maybe witching hour? I’m not sure but I’ve thought about waking her at 6 pm, give meds, give bath, feed at 630, then put straight to bed at 7. But this seems to go against everything I know about bw!
BabywiseMom said:
LEM,
I was actually never told to administer the prevacid 30 minutes before eating, so I always did half of the does in the morning after breakfast and half in the evening before bed.
Many moms do the 30 minute thing, though, and some even say the baby goes right back to sleep. You kind of administer it like you would a dreamfeed.
You should also see the post “Eat/Wake/Sleep cycle”. You can feed a baby up to 30 minutes after waking and be okay.
I think your giving it to her in the evening to be a smart choice, except for some reason I am remembering giving in the night to be the worst time of day to give it since acid production is reduced in the evening…again, I did give it to Kaitlyn in the evening.
I think there is a good chance you are having witching hour in the evening. If that is the case, then it is the perfect time to do meds.
I would probably go with your plan and see how she does. If her reflux bothers her, I would stop and try something else (a different time of day). If it works, then great!
Natalie said:
I am not sure how this works, and when I will see a response…does the response get emailed to me??
anyway, my question is this. My 2nd child, a son, is 4 weeks old this saturday and has reflux. We are trying some “Homeopathic” meds first before going with a prescription. we are going to see the doc. on monday for more advice….
My question however, as a babywise mom, is, the sleeping elevated approach… Is my son going to become depandant on that? I am so diligent on wanting to do babywise, i think i stress myself out on how perfect i try and make everything. So needless to say, i am freaking out that everything i have worked for so far up to this week is going to get messed up with the reflux.
Should I not let him sleep elevated? will he never be able to sleep regularly again if I let him do it for now?
or can i let him sleep elevated for every nap and night time sleep, until the reflux goes away??
will it ruin my babywise attempts?
BabywiseMom said:
Natalie, the response is emailed if you check the “email follow-up comments” box.
No, he won’t become dependent on that. He will prefer to sleep flat–it isn’t the most comfortable to sleep up like that.
It won’t ruin babywise. It is important to do what you can to help him be comfortable–even if that would mean sleeping in the swing for a few months. You want to avoid long-term damage to the esophagus. My middle child had reflux and was/is awesome so far as BW is concerned, so it can be done.
Cat said: Hi my name is Catherine just found your blog,my son has horrible acid reflux its a hard thing to deal with, My dr is a big advocate of babywise and i was able to use some of the babywise tips but cio went by the wayside due to my son choking on his reflux during cio during naptime we had to rush him to the emeregency room. I am trying to get my blog going and want to reach out to reflux moms and get tips from moms who have been there so it was good to find your blog on such various topics. My blog is titled as we go along,if you want to visit.
Babywise Mom said: Cat, you might find this website helpful: http://refluxrebels.com/. The founder is a babywise mom.
Rachel said: Hi Val!It is so interesting that you are having reflux issues posted today. We are having issues w/our 16 month old on medication & I have been dying to ask you about it. She has been on Prevacid since she was 2 weeks old and it has helped her ENORMOUSLY. She was definitely slower to reach milestones (didn’t sleep 8 hours/night consistently until 13 weeks and didn’t sleep 12 hours until 6 months). But for a long time I thought we had “figured out” the reflux thing, but now I am wondering- will she ever be ready to stop taking the medicine?First, I have read that keeping your child on prevacid longer than a year is not healthy. There are some side effects that can happen (wont go into detail- not trying to scare ppl). My dr seems to agree. He suggested weaning her off a quarter of a pill at a time, but for the last two weeks on 3/4 of a pill, she seems to be eating less and less and her sleep seems more and more disrupted. (I also wonder though, if we are hitting a wonder weeks time frame?)My question is- what age did you wean Kaitlynn from the prevacid? Was it a difficult process? If anyone else has experience with this I would love to know what ages you weaned your child from meds also? I’m just not sure if I should be worrying that DD isn’t ready to come off it yet. The dr. mentioned that we might need to see a specialist soon if she is not getting better as she gets older. So I would love to hear what some of the “norms” are out there. Thank you so much!Trying not to worry, Rachel
BabywiseMom said: Rachel, I weaned her when she was 12 months old. I don’t have experience taking it past a year old at all. Good luck with it! If you would like, I can post this as a “help a reader out” post.
Marysol R. said: Glad you are featuring this today. IDEA for every mother trying to convince a doctor. We took quick videos on our phone of a bad feeding episode and showed that to our doctor. She immediately said “Ok, now I can be sure.”
Ashley said: Rachel – I am just weaning my son (13 months today) off of Prevacid. He started with zantac when he was 6 weeks old, the switched to prevacid a few months later when it wasn’t working. Around 9 months we had to increase his dosage to a half a pill twice daily as his reflux got worst. To wean him, I started by only giving 1/2 a pill once daily for 2 weeks, then every other day for two weeks, then stopped. I tried this at 11 months and his reflux came back, but now he seems fine. He seems to be having a lot of the same side effects as your LO too — eating next to nothing, disturbances in sleep, and all around crankiness. I thought it was just teething, but it’s been going on for nearly 2 weeks now. I don’t know what the side effects of being on the medication for too long are, but my Dr. felt strongly that the medication was pretty harmless and if it was working to stick with it. She even called a pediatric gastro while we were there at his 12month visit to ask his opinion on if he thought it would be wise to keep him on the medication longer. He thought there was no problem or risk with doing so (although I decided to try weaning again just cause I was sick of dealing with the meds).HTH! Ashley
Rachel said: Coming back to leave an update! It seems my sweet little girl is just taking her time to wean off the meds. She needs about two weeks (or 3) on each smaller dose before we can move on. The first one seems to be rough- interrupted sleep and more fussiness in the day, but by the second week she seems much more normal. We are currently in the middle of week #2 of 1/2 a pill. (I will probably keep her on this dose for 3 weeks). We are taking it slow and steady though and things seem to be going better. Thanks to everybody who left a comment for me so far!-Rachel
Ashley said: Rachel – I am just weaning my son (13 months today) off of Prevacid. He started with zantac when he was 6 weeks old, the switched to prevacid a few months later when it wasn’t working. Around 9 months we had to increase his dosage to a half a pill twice daily as his reflux got worst. To wean him, I started by only giving 1/2 a pill once daily for 2 weeks, then every other day for two weeks, then stopped. I tried this at 11 months and his reflux came back, but now he seems fine. He seems to be having a lot of the same side effects as your LO too — eating next to nothing, disturbances in sleep, and all around crankiness. I thought it was just teething, but it’s been going on for nearly 2 weeks now. I don’t know what the side effects of being on the medication for too long are, but my Dr. felt strongly that the medication was pretty harmless and if it was working to stick with it. She even called a pediatric gastro while we were there at his 12month visit to ask his opinion on if he thought it would be wise to keep him on the medication longer. He thought there was no problem or risk with doing so (although I decided to try weaning again just cause I was sick of dealing with the meds).HTH!Ashley
The Hunts said: Forgot to mention above–I also talked with a lactation consultant about the reflux, and she said that sometimes with breastfed babies, if you have a very strong letdown, the force of the spray at first can actually cause reflux. The baby gasps and drinks so much milk so quickly and then it can come back up. So she suggested getting in a position where baby is on top, so that gravity will help slow things down, or to unlatch baby when you feel the letdown until the spray is not as forceful, or to pump for just a couple of minutes before a feeding.
Tamie said: Is this post still going? I just wanted to ask if the eat, wake, sleep pattern is still important with a reflux baby. My baby (not yet 1 month) seems to spit less if she falls asleep while breastfeeding as opposed to when I wake her up by changing her diaper after eating. Then she can spit and have hiccups for the next half hour. I really want to do babywise – but am wondering about this.
BabywiseMom said:
I followed eat/wake/sleep with my reflux baby. A hard thing about letting your baby fall asleep eating is you aren’t burping, which I would worry about for comfort of the baby. You also aren’t teaching the baby to fall asleep independently, which is vital to Babywise.
But if you feel like it is best for your baby to breastfeed to sleep right now, you can focus on feeding intervals and having enough wake time. Then when the reflux settles down, you can do eat/wake/sleep.
Hi,My 6 month old was diagonsed with GERD at 6 months of age. We've been on Zantac to Prevacid adn back to Zantac while continuing to play with the dosage to find the right amount for her. She's the happiest and most smiley baby ever, but sleep remains to be the primary issue.My firstborn also had GERD, but followed BW to the T and slept through the night at 6 weeks, so I'm at a bit of a loss as to what to do…if anything.While I can't seem to get her to establish an exact nap schedule during the day, I have been able to get her 2-3 hours of day time sleep. We're still on a 3 hour feeding schedule, which I'd love to extend, but I know that night sleep is supposed to come first.At night, I nurse at 7 pm and put her to bed. I do a DF between 10-11 and after that she wakes up anywhere between 2-3 times with waking at 7:30 am. The doctor has recommended feeding her when she wakes assuming that she wakes due to the reflux. She said that food will help push the acid back down. Since I fully nurse, this is beginning to get tiring after 6 months. When I do feed her at night, sometimes she wants a little food, other times she'll just use me as a pacifier. I've tried CIO several times, but it doesn't work for her. She'll cry for over an hour and not soothe herselve back to sleep at night. I'm not sure if I should just continue on as I am in hopes that one day she'll STTN or if there is something else I should try. I'll probably start her on solids this week and am wondering if that might help too. Do you have any suggestions for this tired mama?
Correction…she was diagnosed at 1 month of age with GERD.
Beth, that does sound tiring! I think solids have a good chance of working.I don't know if I would do feedings every time she wakes. Eating activates acid. I would try soothing her back to sleep with a pacifier or whatever works for her and see if she sleeps better that way.
HELP!my first son was diagnosed with reflux at 3 months, he had silent reflux like kaitlyn. He responded beautifully to prevacid and although he struggled with sleeping, it was due to severe food allergies we didn't know about until testing at 6 months. My newborn baby girl has been a different story. She is miserable. On day 4 she spit up yellow bile and cried. I immediately took her to dr and put her on prevacid. That weekend she had constant diarrhea, a full body rash, and continued to be miserable. After 5 days on prevacid we pulled her off it and kept the Zantac. We are on week 4 and are MISERABLE! I am pumping and we are doing 48 hours of nutramigen formula. After a week on the elimination diet and no change the dr wanted me to try this. She barely sleeps ever and I mean ever. Sometimes the morning after 7am and midafternoon are her best stretched. Nights are awful. Lots of screaming and spitting/vomiting. I know breast is best but it's a last ditch effort. She has the worst gas an most intense screaming I have ever heard. She was born at 37 weeks and was 6 lbs. Any and all advice would be so appreciated. I barely make 3-4 hrs total of sleep in a 24 hr period. And I just want to help my baby so badly.
Oh Courtney! That sounds so awful for your baby and you. Poor girl. First, have you tried giving her gas drops?Second, is there something else besides zantac she could have? I know there are other meds out there, and I know zantac is the weakest and doesn't work long-term. I would look into that. Third, it sounds like she has it really bad, and I don't have experience with that, so I will refer you to a reflux site that was created by a Babywise mom.http://refluxrebels.com/
I wanted to post a little about my baby girl with reflux in hopes of helping someone. The first 8 week were really really hard for us because we couldn't figure out what was wrong. At three week she was diagnosed with acid reflux and put on prevacid and it really helped as far as her pain but not the spitting up. That was fine because I can deal with spitting up and lots of laundry but there was still something up. The next thing we moved to was formula changes because I had to supplement a lot. We tried nutramagen which we thought was helping at first but then we realized it was making it worse. FINALLY at 8 weeks we found the right formula for her, she is lactose intollerant and the only formula with NO lactose is similac sensitive the orange can. She impoved dramatically from there and since we were no longer in survival mode we started her with just the schedule. She did great so one week later at 9 weeks we started the CIO and she did awesome it only took her 2 days maybe and it wasn't even every nap. I hope that gives hope to someone who wants to do babywise with their reflux baby. The schedule really helped give her time to spit up since the wake time was after eating. The inclined bed also really helped her and I had to adjust it so that she had something at her bum and on her sides so she didn't slide. We seem to be in a good groove now burping her half way through her bottle and at the end. We still deal with a lot of burp rags but she doesn't seem to mind spitting up at all. Also for wake time we simply put on a bib and wipe her face as it comes, and of course a lot of laundry :). She is now just a few days shy of 3 months old and doing great as far as her reflux, but she still is a normal baby with growth spurts and other little bumps in the road. she also just barely made it to 9.5hrs of sleep at night where she was at 7hs. from 8 weeks. Oh and I almost forgot gripe water(only the mommy's bliss brand) worked really well as far as helping her burp, it didn't eliminate any spit up but when she was younger it really helped. Now she does great at getting it all out on her own and doesn't really need it anymore. Hope it helped, and as always hang in there!
Also I forgot to mention that her pacifier REALLY helped. I don't know where I read it but it helps them to keep the acid down better with all that sucking. She has always taken it and I would give it to her because I knew it made her feel better. I used to reinsert it durning naps but now that she is doing much better I only give it to her when I lay her down and she caught on really quick that she wasn't going to get it back in the middle of a nap.
Thanks for sharing your story Whitney. I am sure it will help many parents!
Could you just elaborate a bit more about your daughter's reflux during CIO? My daughter, 1.5 weeks old, started a rice starch milk-based formula to control her reflux and spitting up (though hers is silent too, she swallows it usually). It used to be so bad that it would wake her up early from naps, but now we do not have really have an issue with her reflux. However, when she gets upset and cries, the crying seems like it might be aggravating it, though of course I cannot really tell because she swallows anything that comes back up. I was curious whether your daughter showed signs of the reflux when she was crying, and if so, how you knew that it wasn't causing her pain (so you could let her keep crying)? I really want to try CIO because she's having some difficulty getting herself to go to sleep on her own, but I'm just nervous she will be in pain and I won't be able to tell.
Also, like so many others have commented, I love your blog and very much appreciate the time and effort you must put into it – it's wonderful encouragement just to be able to read about what you have done.
Erin, Thanks :)This is a hard thing with reflux. If I even thought she might be in pain, I moved her to a swing for naps instead of her crib. It is something you get to know pretty quickly. When meds were right, the reflux did not bother her. But you often have to adjust meds (the ones weight-specific). So I would suggest if you think she is in pain, you don't CIO that nap. Kaitlyn took some naps in the swing still even until about 7ish months old (I am sure the exact age is somewhere on the blog–I just don't remember exactly). It didn't ruin her at all, so don't worry about that.
Thank you for sharing these reflux in newborns remedies. My wife and I are really worried about our baby so we hope this works or we'll head to a doctor already.
Like others have said, your blog is very helpful. Thank you!! My 7 week old baby has severe reflux, and I was about to throw Babywise out! She is taking Prevacid, but I think she may need a higher dose because she still screams in pain often after meals. Ideally, I would love for her to sleep from 8:30pm-8:30am at some point. Right now, she will wake up at about 1:30 and 5:30 to eat.With Prevacid, she is supposed to take it 30 minutes before she eats. How does this work? How did you make it work? Do I give it to her at 8:30, feed her at 9. Depending on how she is feeding that day, she may be done at 9:15 or 9:30. Because I have to keep her sitting up for 30 minutes after she eats, she may not be able to go down for a nap until 10 (she is very fussy at this point)… She's not ready to stay up that long. Did you have any issues with that?Having her sit up for 30 minutes after eating has also made organized wake time really difficult… How did you make it work with Katelyn?Also, I have been trying to get my baby to sleep in her crib during naps. She sleeps in it without a problem at night, but for some reason struggles during the day. I am using the 4 S's, short/sweet sleep routine, and etc. I don't have a swing, so when she wakes early and all of my attempts at getting her to go back to sleep fail, I carry her in a MOBY wrap so that she has a decent amount of sleep before her next feeding. I have found that it is the only thing that will work. In fact, with really rocky/hard days, she spends a lot of the day in a MOBY wrap. I have been using it for a week. Before I discovered it, she would just inconsolably cry for hours.Would you recommend something besides carrying her in a wrap?
Thank you for this post encouraging flexibility when a baby has reflux. My sweet baby girl (now 6.5 weeks old) was having terrible trouble sleeping almost from the beginning, and I KNEW something was wrong. I'm a first-time mother, so I didn't have a clue that reflux was a possibility, I just knew that she couldn't sleep except on her tummy lying on my chest while I was semi-upright… so that's what I did for her for a few weeks. My BW friends kept stressing my need to sleep-train and let her CIO, but it just didn't feel right. I switched pediatricians, and the new doc diagnosed her immediately. With medication, she now sleeps in her crib in my room with no crying. And it turns out that smaller, more frequent feedings (every 2 hrs during the day) have helped her tremendously, even though my friends told me I was "doing it wrong." At night she sleeps well in two 5-hr stretches, which is perfectly fine by me; frankly, I'm not comfortable with trying to make her sleep 10-12 hrs given what I now know about reflux and frequent feeding.Anyway, I think Babywise gets such a bad rap because of adherents like my friends who can't allow flexibility based on individual babies' needs. (Indeed, the book is likely to blame here, as it's written in such absolute terms — doesn't admit the possibility that the 2.5-3 hr schedule just might not work for some newborns, or that sleep training isn't the solution for all ills.) Thanks for providing some much-needed balance! I'm so glad I followed my instincts with my daughter and refused to let her suffer so I could get more sleep. Now we're both sleeping well!
So my 3.5 month old had a tongue tie that I thought was the root of her feeding issues. I took her to a dr but she was no help at all. She gave me a prescription for reflux but was such a bad dr that I didn't dare give it to her. She is great at night. At least I just feed her and she goes right back to sleep. Sometimes though I think she is nursing to sleep. But during the day she is awful. We have never put her in the car seat without her screaming like a knife is in her. And it's the same screaming when I put her down to nap. I burp her for sometimes an hour after a feeding and still more burps and more screaming. Eventually she falls asleep as I'm still burping her. Sometimes she sleeps for 1.5. Other times it's just 45 min. I've taken dairy, eggs, citric fruits, chocolate, and tomatoes out of my diet with very little improvement. Do you think this is reflux? Should I get the prescription filled??
Yes I would try meds for sure! If you don't trust the doc, search doses online. You can also get a second opinion from another doctor, but I would definitely try the meds.
Thank you! I am picking it up today. I did find out that it is Zantac which I understand doesn't work as well. What med did you use on your baby girl?
We did Prevacid. I understand Zantac is a common first try med. I think it should help initially, but watch for symptoms to return. I think the problem with Zantac is that it loses effectiveness over time.