I saw a 2.5 month old baby today who for the past month has reflux post
feeds and between feeds, either white milk like or clear. No
AM pre-feed reflux and no fussiness or wheezing with reflux. Weight gain is
25 grams per day in past 14 days.
I've talked to mom the past few days b/c of brownish more explosive stools
and increased gassiness with odor. No history of other foods
or formula, was briefly on multivitamin with Fl (I didn't do that).
Baby was colicy big time in past but is improving. Mom has eliminated cow's
milk from her diet.
Exam remarkable for a heart murmur suspect innocent vs VSD.
Small amt of stool in rectum was heme negative yellow/brown color.
At breast baby arches and pulls away early in feed.
My thoughts are resolving
1.gastroenteritis tx continue breastfeeding
2. benign reflux tx with gravity
3. overactive let down tx express before feeds and/or feed reclining.
4. refer peds cards
I also told this mom I think not only did her bay have a GI bug but if she
had done as friends suggested and put him on soy formula he'd
be in the hospital with an IV. I told her she can ask her soy pushing
friends what they think of the lack of nucleic acids, the
phytoestrones and aluminum in soy and of course ifs terrible taste.
Any other ideas?
-Rob