Acid Reflux in Premature Infant

Dear Ask The Doctor: My daughter is 4 years old. She was born 7 weeks premature and has had problems with food since birth. Our Doctor believes it is caused by allergies and has had her on a strict diet for the entire time. However, there has been no sine of improvement. My personal feeling is that this could be acid reflux, but the truth is this feeling is based on similar cases I've researched online, so there is no evidence. Unfortunately my daughters doctor doesn't seem to agree and is determined to stick with this dietary regime. A little history: Born 7 weeks premature. She suffered with colic for the first year. Had allergies to certin foods (chicken, chocolate, various) but these seem to have cleared up over time. Weight gain has not really been a problem as we have essentially have had to force her to keep eating. We still have to feed her baby formula (which she seems to hate with passion!) and food which has been blended into a type of porridge or soup (she will not eat otherwise, or when she does it will take 2-3 hours). We are desperate for help and dont know which way to turn. The stress level is very high and we see no solution on the horizon. We are also very concerned that this will cause some developmental issues. Please help.

Dear Jon: Sickness in child can often be more stressful than sickness experienced by oneself.  Cases like this often require multiple opinions and a trial and error approach to treatment.

With kids, we often like to limit the period of trial and error to prevent physical, mental and social development delays.  You do not mention if your daughter has reached the same development milestones as her peers. If she has, this is very reassuring and the fact she is gaining weight is a further reassurance.

The possibility that you and your doctor are both correct has to be considered. Acid reflux is a debated topic amongst pediatricians but is known to be more common in premature infants.  Treatment is also debated and some doctors prefer to let the child "grow out of it".

The only medication I am familiar with that is approved for use in children is ranitidine suspension and prevacid wafer granules.

When frustration levels are high, it can be benificial to try two approaches at the same time in the hopes of faster results.