Not drinking much, losing weight, getting worried

[lilac83]

I'm getting really worried about M. She's had continual GI issues. I switched her from milk-based formula to soy to try to help her reflux. This has seemed to help but she's not drinking much, she's not napping and just not happy in general. I'm not sure what to do for her. Last week she weighed a bit over 9 pounds. She should be nearing 10 now but she's back down to just 9. Any ideas on how to increase her intake? This has been her feeding pattern over the last week :

2:30am - 2-3oz
6:00am - 2-3 oz
9:30 - 3-4 oz
1:30 - 3 oz
4:30 - 2-3 oz
7:30 - 3oz

Daily total of 15-19 oz. She should be having 18-27 oz.

[Sam-n-Max's Mommy]

(((Hugs))), Robin.  Do you think she has a milk protein intolerance and that is why you switched to soy? If so, many kids that have an intolerance to milk protein also have it to soy.  Sometimes reflux is a symptom of an intolerance or sometimes they are independent of one another.  Is she medicated? 

In your feeding schedule, I see that there are a few feedings where she goes more than 3 hours -- does she refuse the bottle and then you just try again? My DS2 has bad reflux that we are still trying to get under control, and many times he just won't want to eat when you'd expect him to (ie he could take in a few oz at 5:30am and you'd expect that by 9:30am he'd be starving, but then again only take a few oz in). 

[lilac83]

Thanks Nicole.

I'm not sure what's going on to be honest. The constant spitting up and vomitting has stopped since switching to soy. The doctor suggested soy as a solution to the spitting up, so in that sense it has worked. She may very well be mpi but so far seems to tolerate soy. However, much like you described with your ds, she just isn't hungry when I think she would be starving. Or she will scream for a bottle, drink the first oz like she's starving, then stop. She does go longer than 3 hours quite frequently. I will continue to offer her the bottle throughout the hour but most of the time once she initially says she's done she will refuse anymore. But then she won't nap but won't be awake and happy either.

Most of what I've read says 3-4 oz every 3-4 hours for her age and weight. Even if she was consistently doing just 3 every 3 hours I would be happy but now today she's gone from 12:30 pm to almost 5:30 pm with just 1 oz. And she probably won't make up for it later either.

[TB9]

What does the soy formula taste like compared to her previous formula?  DD2 had a bit of an adjustment period when she switched formulas because the old one was sweeter.  It took 1-2 weeks for her to get used to it and start taking more.

What kind of bottles are you using?   It took us a long time to find a bottle for dd2...apparently she doesnt like to work for her food    so any vented bottles that are supposed to reduce spitup didnt go over well.  You could also try a faster nipple, dd2 would just quit even if she was still hungry if it was too slow, then shed be cranky and not sleep

[lilac83]

As far as medication goes, I never picked up her prescription. I'm sort of kicking myself over that now since she's just spent the last 1.5 hours crying, spitting up and not wanting to eat. Can a formula work really good for an entire week and then just stop working? Because seriously, if it can, I'm going to the store tomorrow morning first thing and getting her the hypoallergenic formula and her prescription.

I never tasted either formula, lol! Perhaps I will make myself a 1/2 oz of each and see . She seems to be drinking the soy ok though, no funny faces or absolute refusal. I've been using either the Playtex drop-in bottles or Gerber bottles, both with slow flow nipples, and she seems to be liking those. She sucks easily and quickly but not so fast that it's running down her chin. It generally takes her about 15 minutes to drink 3 oz. I had been using the Avent bottles and those I could tell she didn't like. She would have milk running down her chin and would come up gagging and coughing, even with the newborn nipples.

She drank 15 1/2 oz today total. She's definitely not lethargic and she's having wet diapers. Am I being paranoid about all of this? For some reason my mommy radar is on high alert with her.

[TB9]

The nurser bottles are what dd2 likes best too   I would stick with the slow flow nipple because the med flow is good for dd2 at 5.5months 

It is possible that she id soy intolerant as well.  With dd2 it took a couple week for us to start seeing the results of her lactose intolerance.  Go with your gut, if you think something is up and she may have a soy intolerance then try her on hypoallergenic formula.  Is she showing the same signs of intolerance as before when she was on milk based formula?

[Lolly]

Or she will scream for a bottle, drink the first oz like she's starving, then stop. 

That's pretty classic uncontrolled reflux behaviour - both mine did this until we got them on meds and reflux formula in our case (no MSPI). My two would go for hours on one or 2 oz of formula and just not show hungry signs.

I would get the meds started and switch to the hypoallergenic formula. It could be that she is reacting to the soy, but it's taken a week for the soy proteins to get into her system and to start reacting - it also takes a while for the milk proteins to leave her system. What meds did you get prescribed and at what dose?

I think the soy formula is quite sweet (one of the issues with it!) so she may not be objecting to the taste.

Laura

[lilac83]

Ok, dh is not onboard with the hypoallergenic formula. He said he would take her to an allergist before putting her on that. So I picked up her mere. She gets 1 ml of ranitidine twice per day. I'm not going to use the soy anymore either since in the last 48 hours she has drastically declined. I hope this works, she's miserable.

[TB9]

So what type of formula are you going to use?  Honestly around here an appointment with an allergist could take months, and I dont know that they would do much more than ask you to switch her to the hypoallergenic formula to see if she improves    I know when we were going through it with dd2 it felt like a lot of trial and error, but we knew that was basicallywhat a doctor would have us do in order to figure out what was causing the reflux.  If the formula she is on is causing the reflux then you *may* see improvement with some of the reflux symptoms with the meds, but you wont see improvement with any intestinal issues

[Lolly]

That's a good dose of ranitidine - if she is 9lbs then that dose is the full4 mg per kg. I am a bit surprised they started on that dose, Drs usually start at 1 or 2 mg per kg and then increase if it doesn't work or stops working quickly.

Which formula are you going to be using now if you aren't going to try the hypoallergenic one? What are her stools like - do you see any mucous in them?

The thing with MSPI is that it isn't an allergy, it's an intolerance which babies generally grow out of, mostly by 1 year. They aren't able to test for intollerances in babies, it's a case of removing what they are reacting to and seeing if the symptoms go away. I have heard that any form of allergy testing isn't reliable on babies and infants either, so seeing an allergist probably wouldn't be of much benefit.

Laura

[lilac83]

I put her back on the gentle formula. There is no mucus or blood in her poop. She has been constipated but I had blamed a lot of that on the barium. Im glad her med dose is good!

[TB9]

Yay no mucus!  Just keep an eye out for any signs that she isnt tolerating the formula   Hopefully you see improvement with the meds.

[MasynSpencerElliotte]

The thing with MSPI is that it isn't an allergy, it's an intolerance which babies generally grow out of, mostly by 1 year. They aren't able to test for intollerances in babies, it's a case of removing what they are reacting to and seeing if the symptoms go away. I have heard that any form of allergy testing isn't reliable on babies and infants either, so seeing an allergist probably wouldn't be of much benefit.

I agree...our allergist did testing when Spencer was 1 and it showed nothing on skin prick or blood tests, but he considered her allergic/intolerant based on reactions alone.

Fingers crossed the meds do the trick!

[lilac83]

All she has done all day is cry. She has slept a total of 30 minutes all day and it's 1:20 pm. Sorry, just need to vent somewhere because I am nearing my breaking point with her today. I don't know if she's in pain, has gas, is just massively ot, no clue. I have no idea how we went from being relatively ok to this. Is this just how reflux is? Am I missing something? She doesn't have a fever and isn't inconsolable so I don't think she's sick.

On a positive note, she drank her first 3 oz bottle in 24 hours earlier!

[TB9]

Glad she ate a decent bottle.  It could be a gs that shes having a tough time with because of the reflux