enzyme dosing for infant

M

momtocrazel

New member
hello,
so my 9 1/2 month is currently taking 2 caps Zenpep per feeding. i am guessing she is close to 17 lbs? (she was 16lbs as of 3/1.) we have clinic in about 2 weeks but i am thinking i might need to up her enzymes to 3 caps/feeding based on increase frequency of floating stools. based on CFF recommendations in article borowitz et al,2009, she should take no greater than 2500 lipase units/per kilo/per feed (not to exceed 19,000 units per feed for her weight). if i bump her to 3 caps that would be 15,000 units per feeding. however, since she still nurses 6-7x/day, she would exceed the max recommended daily dose of 77,000 units (10,000 units per kilo/day)as with 3 caps 6-7x/day she would be taking 90,000-105,000 units. sorry for all the math. i just want to know what others here are doing with their babies. at last clinic, i brought this up when they asked us to increase from 1 to 2 caps and they didn't seem too concerned about exceeding max daily dose. the article cited above set the max daily dose to decrease risk of fibrosing colonopathy and suggested that the infant gut could be more susceptible to this. but i guess absorption/wt gain trumps this concern? i know some will respond, "ask your cf doc" and i will but also want to hear personal thoughts and experiences. thanks so much.
 
M

momtocrazel

New member
hello,
so my 9 1/2 month is currently taking 2 caps Zenpep per feeding. i am guessing she is close to 17 lbs? (she was 16lbs as of 3/1.) we have clinic in about 2 weeks but i am thinking i might need to up her enzymes to 3 caps/feeding based on increase frequency of floating stools. based on CFF recommendations in article borowitz et al,2009, she should take no greater than 2500 lipase units/per kilo/per feed (not to exceed 19,000 units per feed for her weight). if i bump her to 3 caps that would be 15,000 units per feeding. however, since she still nurses 6-7x/day, she would exceed the max recommended daily dose of 77,000 units (10,000 units per kilo/day)as with 3 caps 6-7x/day she would be taking 90,000-105,000 units. sorry for all the math. i just want to know what others here are doing with their babies. at last clinic, i brought this up when they asked us to increase from 1 to 2 caps and they didn't seem too concerned about exceeding max daily dose. the article cited above set the max daily dose to decrease risk of fibrosing colonopathy and suggested that the infant gut could be more susceptible to this. but i guess absorption/wt gain trumps this concern? i know some will respond, "ask your cf doc" and i will but also want to hear personal thoughts and experiences. thanks so much.
 
M

momtocrazel

New member
hello,
<br />so my 9 1/2 month is currently taking 2 caps Zenpep per feeding. i am guessing she is close to 17 lbs? (she was 16lbs as of 3/1.) we have clinic in about 2 weeks but i am thinking i might need to up her enzymes to 3 caps/feeding based on increase frequency of floating stools. based on CFF recommendations in article borowitz et al,2009, she should take no greater than 2500 lipase units/per kilo/per feed (not to exceed 19,000 units per feed for her weight). if i bump her to 3 caps that would be 15,000 units per feeding. however, since she still nurses 6-7x/day, she would exceed the max recommended daily dose of 77,000 units (10,000 units per kilo/day)as with 3 caps 6-7x/day she would be taking 90,000-105,000 units. sorry for all the math. i just want to know what others here are doing with their babies. at last clinic, i brought this up when they asked us to increase from 1 to 2 caps and they didn't seem too concerned about exceeding max daily dose. the article cited above set the max daily dose to decrease risk of fibrosing colonopathy and suggested that the infant gut could be more susceptible to this. but i guess absorption/wt gain trumps this concern? i know some will respond, "ask your cf doc" and i will but also want to hear personal thoughts and experiences. thanks so much.
 
R

Ratatosk

Administrator
Staff member
It's been forever, since DS was a baby. He was on very high calorie formula, plus we added butter, oil, cream to his food. We were told, that based on output we could gradually increase his enzymes by half a capsule. However, you should still contact the clinic.

It's my understanding that too many enzymes that can lead to other issues means a really, really LOT of enzymes.
 
R

Ratatosk

Administrator
Staff member
It's been forever, since DS was a baby. He was on very high calorie formula, plus we added butter, oil, cream to his food. We were told, that based on output we could gradually increase his enzymes by half a capsule. However, you should still contact the clinic.

It's my understanding that too many enzymes that can lead to other issues means a really, really LOT of enzymes.
 
R

Ratatosk

Administrator
Staff member
It's been forever, since DS was a baby. He was on very high calorie formula, plus we added butter, oil, cream to his food. We were told, that based on output we could gradually increase his enzymes by half a capsule. However, you should still contact the clinic.
<br />
<br />It's my understanding that too many enzymes that can lead to other issues means a really, really LOT of enzymes.
 
S

sdelorenzo

Guest
What about 2.5 pills per feeding?
Sharon, mom of Sophia 9 and Jack, 7 both with cf, Grant, 2 and Paige, 6 months both without cf
 
S

sdelorenzo

Guest
What about 2.5 pills per feeding?
Sharon, mom of Sophia 9 and Jack, 7 both with cf, Grant, 2 and Paige, 6 months both without cf
 
S

sdelorenzo

Guest
What about 2.5 pills per feeding?
<br />Sharon, mom of Sophia 9 and Jack, 7 both with cf, Grant, 2 and Paige, 6 months both without cf
 
S

SadiesMom

New member
We are on creon, not zenpep, but our docs are very careful about not going over the recommended dosage. Maybe it's different with zenpep.

I would say before increasing enzymes, did they try adding an antacid? They added zantac to help with the absorption when we started having issues. Also, I'm not sure how you administer the enzymes, but we've found that giving them before, during, after (before/after, before/during) sometimes helps with the absorption as well.

I would check with your docs, and if those methods fail, start by increasing half an enzyme, which I know is a pain to measure out.

Anyways, good luck to you.
 
S

SadiesMom

New member
We are on creon, not zenpep, but our docs are very careful about not going over the recommended dosage. Maybe it's different with zenpep.

I would say before increasing enzymes, did they try adding an antacid? They added zantac to help with the absorption when we started having issues. Also, I'm not sure how you administer the enzymes, but we've found that giving them before, during, after (before/after, before/during) sometimes helps with the absorption as well.

I would check with your docs, and if those methods fail, start by increasing half an enzyme, which I know is a pain to measure out.

Anyways, good luck to you.
 
S

SadiesMom

New member
We are on creon, not zenpep, but our docs are very careful about not going over the recommended dosage. Maybe it's different with zenpep.
<br />
<br />I would say before increasing enzymes, did they try adding an antacid? They added zantac to help with the absorption when we started having issues. Also, I'm not sure how you administer the enzymes, but we've found that giving them before, during, after (before/after, before/during) sometimes helps with the absorption as well.
<br />
<br />I would check with your docs, and if those methods fail, start by increasing half an enzyme, which I know is a pain to measure out.
<br />
<br />Anyways, good luck to you.
 
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