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An easier way to administer granules out of a capsule to my 2 month old

My child has reflux that cuts off his breathing. He has tried many medications...and the one he is on now is Zoton 15mg. He recieves half a capsule in the morning and night. Could you tell me an easier way to administer these granules out of a capsule to my 2 month old. I have tried many ways and this adult medication is not friendly to get down his throat easily. I will mention no medication has elimated the breathing problem just eased it. He is always having trouble with trying to breath. The doctors told me he will grow out of it, but I know the vomiting will go,do you think the breathing problem will go at the same time.

Glend...
Answer: Hi, Thanks for contacting our organisation. It sounds like things have been very frightening for you! I’m glad that your doctor has been supportive as that can make a big difference to how you cope. It’s good too that you have found a medication that is helping (even though it is so difficult to administer). I don’t think any medication is easy to give to a young baby, but you’re right, many reflux medications that are designed for adults, are particularly difficult. Zoton is available in a suspension, so that is perhaps one option you have, if you haven’t already tried it. It is a pink coloured suspension, and depending on how much water the doctor wants you to add, it is given as either a liquid or a gel. Just be aware that if your bub has any food sensitivities, it may not be a good option because of the colouring. If the suspension isn’t suitable, then there are several different ways you can try- though I’m sure you have thought of some of these already. A lot of it is trial and error as you have been doing I’m sure and parents often find something that works for them (to some degree anyway). As I’m sure you are aware, it is important not to crush the granules inside the capsule as this reduces its effectiveness- though of course that makes it even harder to administer. What are you doing at the moment to give it to him? The manufacturer (Wyeth) say to administer it with e.g. apple juice (orange juice or tomato juice) or apple sauce or strained pears though I’m not sure if that is appropriate in a 2 month old. Have you spoken to your doctor about that? Wyeth do say to use only the liquids/foods they recommend as no others have been tested for effectiveness, so I don’t know if water will be effective enough to use. If you are using apple juice/sauce or pears with no problem, and your doctor is happy for you to continue, then that is of course fine. (if not, then perhaps Nexium would be worth trying, if you haven’t tried it already of course). Some families find even at 2 months they can get their child to take medication off a spoon. If you open the capsule out onto a small amount of the juice or puree and offer it straight off the spoon, it might work. Other parents open the capsule and add juice to a syringe and shake very gently to dissolve it (as much as it does dissolve). Because the granules tend to get stuck, some open the end of the syringe a little wider, and other families use syringes with larger openings e.g. 10 ml syringe, or the Nurofen or Panadol syringes or even a medicine dropper. I know it sounds weird, but it can also help to explain to your bub what you want him to do, and that it will help him feel better (and of course offer lots of praise once it’s gone). (- any granules that are spat out or fall out, just try to put back as best you can) Some families try using a very small amount of liquid so the amount is small and isn’t as runny. Others have tried using a Medicator (medicine cup with a bottle top, available from some chemists)- and mix the Zoton in it with apple juice- making sure the opening is big enough for the granules to come out. Your doctor or pharmacist may have some other ideas as well, but hopefully something in there gives you an idea of what else you can try. When you say he is always having trouble trying to breathe- what do you mean by that? If you are ever concerned about your child’s breathing, please seek urgent medical attention. A lot of refluxers do have breathing difficulties, and they can range from wheezing, to having croup, coughing, getting chest infections, choking, gagging etc. It depends on what is exactly happening with your child, but as I said, please seek medical attention if you are ever worried. My son used to choke a lot with his reflux, and also gag and splutter, and I wonder if that is what you are referring to when you say it cuts off his breathing? If so, it may help to know that his choking and spluttering etc is a thing of the past (though very scary when it was happening at the time). He does still have asthma though, so it just depends on the breathing problem, what it is exactly and whether it is directly related to his reflux, or if it is some other issue. I’m certainly no doctor so can’t advise you on that, and can only go by my own experience. There are some medications (e.g. Erythromycin at low doses, Motilium) that can help food etc go through the gut quicker, and they are sometimes used to treat reflux children. Has your doctor ever suggested using any of those, to see if that helps with his breathing? Something else I found that helped a little with my son’s choking, was to give him a small spoon of thickened milk after a breastfeed. Thickened feeds are often only effective in reducing the amount of vomiting, but I did notice that while it didn’t stop him from choking, it did seem to reduce it. Thickened feeds or using thickeners are not always the answer for every refluxer and can sometimes make them more unsettled or even constipated, but that may be something else to discuss with your doctor as well. I hope that information helps and I hope you find something that helps him feel better soon Glenda
Answered: 22 Feb 2008