In responce toLeibovich Hain's case
This sure sounds like and acts like reflux to me.
Baby has reflux its there to be seen. Question is is it causing aspiration or bronchospasm, it sounds like it is. Cisapride is useful to increase Gi muscle tone but ideally one should get an upper Gi with small bowel follow through to rule out malrotation. Dose should be about 1.1 mg/kg/day divided q6 hrs. Zantac or other H2 blocker may be helpful.
I dont personally se the piont of a pH probe we know there is reflux.
A labeled milk scan may be helpful to look for aspiration.
Change to formula? Are you sure this is a pediatrician?
A pH probe with pneumogram or with event monitor might help document reflux if it occurs without visalbe reflux and with choking/gaging.
Cisapride may take a few days to be effective.
I presently have a refluxing breastfed pt who isnt gaining wieght since 4 weeks inspite of adequate materal milk. Radiologic studies are normal as is ammonia level and metabolic screen. Ill send the entie case after her GI consult.