I'm a speech pathology masters student and almost (I hope! Where are those test results?!) IBCLC. I did a speech rotation in a major pediatric hospital doing mostly feeding and swallowing disorders, and this is what I hope to continue doing when I graduate in May. 

I saw a LOT of kids with food sensitivities and unfortunately trialing them on a hypoallergenic formula is a fairly common intervention (more often these kids are on a standard formula already, but I did see a couple of breastfed babies that this was recommended for). However, Alimentum is a casein based formula - it's extremely broken down, but it's still milk protein based. We always put kids on Elecare if they truly needed gut rest - it's completely dairy and soy free (it's also VERY expensive and has to be ordered). Neocate is a similar option. I almost hate to say it because far too many breast fed babies get put on formula for these types of issues, but I have personally seen and heard of babies where this made a huge difference. However if the doctors insist on a gut rest trial, they at least need to be using the right formula.

Not sure if this baby really has reflux symptoms or if they just got thrown meds. But if it does look like possible GERD I would keep in mind that Zantac needs to be dosed properly (a lot of peds prescribe too little) and that proton pump inhibitors (Prilosec, Prevacid) are often more effective than H2 blockers (like Zantac). 

I'm also curious about how strict mom's elimination diet was? Sometimes moms just cut out milk, cheese and yogurt without reading labels (canned tuna usually contains casein, who would've known?). I would also consider that dairy and soy sensitivities are highly correlated; maybe mom should try a soy elimination too?

Hope some of that is at least food for thought. Please keep in mind that I'm still a student!

Adara Blake
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