Appt with Dr. Alonso (GI)

Dr. Alonso was still pretty perplexed by Lydia today. She thinks that we do need to try some things to get the reflux in check, but she feels that reflux is not her main problem. She thinks that there is also something neurological causing her so many difficulties, and I'm beginning to agree with that. Not only does she have a poor suck, but she has an inconsistent poor suck. I've been playing the trial and error game trying to find the right nipple with the right amount of oatmeal with the right formula. At her first feeding this morning, she took 3 oz of formula with 1 tsp of oatmeal with a #3 faster flow nipple. It was a challenge for her, but she got it down. For her second feeding, I tried exactly the same combination, and she couldn't get a drop out...seemingly sucking profusely. Dr. Alonso suggested that maybe she is more tired at certain times of the day...I will begin keeping a better log of her feedings to watch for that. A couple of people have suggested the possibility of a cleft palate...Dr. Alonso checked for that and didn't see it to be an issue...she said, unless it was farther back in her mouth where she couldn't see. I will look into this further with the next few doctors/therapists that we see.

Dr. Alonso did suggest a few things for reducing the reflux. She switched the Nexium to powder instead of the capsule that we were doing, and switched it to the evening instead of the morning. We will also begin using Enfamil AR (anti-reflux...already has cereal in the formula). She said to start with no oatmeal in the formula and see how she does. Then if she seems to need it, gradually add oatmeal to a maximum of 1/2 tsp per ounce. She wants to see her again the week after Thanksgiving...her appt is Nov 28 at 8:45. Dr. Alonso is most concerned with her weight gain. Lydia gained 7 oz. in 10 days according to her scale...not as much as she would like to see. I am going to take her to Dr. Wood's office tomorrow for a weight check to be sure that she hasn't lost since Friday with all of the tribulations over the weekend. She was 8 12.5 on Alonso's scale today, and 8 13.5 on Wood's scale on Friday. If she does not consistently gain enough weight, Dr. Alonso will find more ways to add calories to her intake. She suggested adding vegetable oil to add 7 calories. She doesn't want to do that yet, but it is a possibility depending on her weight gain.