Tuesday, October 05, 2010

Periactin & the Sit n' Spin

We had yet another follow up with our regular GI (the one from U of MD and not affiliated with Mt. Washington Pediatric Hospital Feeding Day Program) today to make sure that our very slow weaning of formula is not impacting the boys negatively.  We have been giving the boys only 500mls of formula per day, down from the approximately 700mls they used to get.  The decrease in formula through the pump is in hopes that they will be hungrier and want to eat and drink more by mouth.  This seems to have worked because up until a week and a half ago we saw some great consistency and improvement in the volume of foods and drinks they consumed by mouth.  The boys were regularly consuming about 3 to 4 ounces of purees and 5oz of milk or juice or water per meal.

But then about a week and a half ago it all tanked back down to fighting to get two ounces of puree and three of milk each meal.  They both started puking at night again, even puking three times in a row at the same time on Thursday night.  Good times.

The GI was expecting at this appointment to see that the boys would have lost some weight in the last 4 weeks but they actually have gained a little bit with Evan weighing 26lbs and Cameron weighing 29lbs.  This is good news because she feels that they boys need a little help with eating and we don't want to take away calories from their formula unless they're gaining tons of weight, which they are not.  To do this she's prescribing a medicine called Periactin (also called Cyproheptadine in the generic form).  Periactin is actually an antihistamine that when given in small doses has for our purposes a convenient side effect of causing hunger.  So it is another drug like Erythromaicine which is an antibiotic the boys were on that given in small doses increases stomach motility/digestion, this Periactin makes you want to eat.

There are side effects to this medication, but nothing really scary.  The most common problem with this medication is that over time the body begins to tolerate the small doses and suddenly without warning the medication stops having its desired effect.  So for this reason we will start giving the medicine two times a day for 4 weeks and then stop giving it for one week.  If this is too long a time frame and we see their appetite begin to wane again then another option is to give it five days a week (Mon - Fri) and none two days a week (Sat and Sun).  Also, this medication is an anti-histamine so the next issue is that it makes you very sleepy.  If this happens and it causes issues during the day/morning hours then we just drop the morning dosage or give it right before nap time (hallelujah!).  This is a side effect that a very sleep deprived Mommy and Daddy will like.  Lastly, and by far the most severe but also the most rare side effect, this medication has the tendency to decrease urine output.  Luckily the solution is to stop giving the Periactin and the problem stops within 24hrs. 

We'll be starting the Periactin tomorrow morning.  I hope this is the trick to get us to the next stage of eating.  I'm just as excited to try this medication if it means more uninterrupted sleep at night for all of us, as well as increased interest in eating by the boys. 

If you or your little one has been on Periactin, what was your experience like?

Now some pictures for you to oooh and aaah over.  ;-)


Annie and Jason said...

CUTE photos!

So I went back into the blog to read the details of when Jax was on that drug. It's hard to really say since he got the drug while in the hospital, then had the EGD procedure and then put on Zofran.
The GI doc had me stop Zofran to see if the ciphro was helping and his vomiting always came back, so it was the Zofran helping (which only helps for so long).
In my notes, Jax was tires on ciphro for the 1st few days until he acclimated to it. His vomits remained, but he never was upset by the drug. Reglan made him an angry baby, that's the only drug I remember making him crazy.
I wonder how ciphro would work now since Jax took it during a crazy time.
Keep us posted on how the boys do. Hang in there and I hope for another night of sleep for your house!!

Ann said...

they look alike although they are fratenal twins. :)