Feeding advice w/ my 1 month old?

Question

My son is one month old. He is currently on his 5th formula in that one month period because he will projectile vomit anywhere from immediately after he's done eating to 2 hours later. He has been on Similac Advance, Enfamil LIPIL w/ Iron, Enfamil w/ Iron, Enfamil A.R., and is currently on Enfamil Gentlease. The current one has made it a little less frequent, but nothing has helped completely. Ped. isn't sure what's going on, and says that we will try something else if it's still happening at his 2 mon. check-up but says that my son isn't gaining weight like he should (one pound since Dec. 10) Could something else be wrong other than it just being the wrong formula? I have tried keeping him up right and still after he eats, not moving him around a whole lot, not laying him on his tummy for tummy time until right before next feeding, pretty much anything I could think of. (He will vomit out of his mouth and nose and it flies about 2 feet out from his body!) Please help me!

I don't think he's lactose intolerant, he was great on Similac Advance (the hospital started him on that), but we have WIC and they currently only cover Enfamil without a dr's prescription and you have to try ALL of the 5 or 6 that they cover before they will let you get a prescription from your doctor so we had to switch him.

Answer 1

Call the doc tomorrow and ask if it’s possible that he has acid reflux. Here are some symptoms of this

ALSO IF THIS DOC WILL NOT DO ANYTHING NOW PLEASE GET ANOTHER DOC WAITING A MONTH IS WAYYYYY TO LONG FOR THIS IT NEEDS TO BE NOW!!!!!!!!!!!!!!!!!!!!!

Gas
Tummy Rolls
Projectile vomiting
Excessive spitting-up
Screaming and/or crying during and after feedings
Painful and excessive gas
Arching of the back
Legs stay drawn up
Inconsolable
Turns head to the left frequently

These are just some symptoms you can also go to http://infantreflux.org for more info.

Also watch laying him down at night or while sleeping as they can easily choke and spit ups can also come out of the nose as well....

Additional info I have

Parents and other caregivers soon become familiar with the habits and schedules of the newborns in their care. Feeding and sleeping become activities of great significance – for the baby and for the caregiver whose life often seems to revolve around that of the infant.

For experienced caregivers – such as parents with several previous children or day care providers with years of practice – taking care of babies can become almost instinctive. Those who know the infant best “just know” what’s normal or if something is wrong. But what if a baby doesn’t follow the normal patterns, or has a feeding or sleeping problem that just won’t go away? And what if the caregiver is a new parent or babysitter who isn’t able to draw on years of experience to determine what’s “normal”?

Some of the most distressing problems of newborns revolve around their feeding behaviors. Each baby is different, but there are certain norms that allow even inexperienced caregivers to judge if development is proceeding in a way that’s consistent with future good health.

Most babies spit up on occasion; in fact, most infants usually vomit two or more times a day. This facet of infancy is perfectly normal, and healthy babies show little distress when they spit up. But sometimes a newborn baby vomits several times a day, often an hour or more after a meal. He or she shows symptoms such as pain when spitting up, irritability, and inconsolable crying. If your newborn is showing all or some of these symptoms, you might want to speak to your pediatrician about checking for Gastroesophageal Reflux, or GER.

Reflux most commonly occurs when the ring of muscle that joins the stomach to the esophagus does not function properly. This muscle, the lower esophageal sphincter, or LES, usually opens very briefly for swallowing or vomiting, and then closes again. But in reflux cases, the muscle stays relaxed and food and stomach acids can flow back into the esophagus.

Realizing that there was very little information available regarding GER in newborns, Sudarshan Rao Jadcherla, MD, FRCP (I), DCH, Assistant Professor of Pediatrics at the Medical College of Wisconsin’s Division of Neonatal-Perinatal Medicine, has set out to help people understand the complexities of reflux episodes in newborns. Dr. Jadcherla’s goal is to improve the feeding and growth of newborns with GER, while continuing to research methods of diagnosis and treatment.

A baby who spits up without a struggle, has continued good weight gain and has no accompanying cardiac or respiratory symptoms most likely is experiencing simple physical reflux, with no long-term consequences. Dr. Jadcherla refers to these babies as “Happy Spitters,” and says that these patients usually outgrow their reflux problems without any complications. “In the first six months of life, spitting up is common,” says Dr. Jadcherla. “It is a social nuisance for parents, but it is completely normal.”

“Scrawny Screamers,” on the other hand, show symptoms such as irritability, excessive fussiness, swallowing difficulties and poor weight gain. They seem to have painful regurgitation instead of the effortless spitting up that is typical of newborns. Many also exhibit poor feeding and sucking skills. They sometimes have breathing problems as well, stemming from fluids such as milk or acid being sucked into their lungs during reflux episodes. These are the babies that should be tested for GER.

There are other causes for an infant’s frequent regurgitation that first need to be ruled out. A physician will typically begin testing for GER with a Barium Swallow X-ray, or Fluoroscopy. The baby swallows a liquid that is easily visible by X-ray and highlights any obstructions in the esophagus or stomach. Once obstructions are ruled out, further testing for reflux can take place.

Further tests may include:

24-hour ph-Probe Study. A thin tube is inserted into the baby’s esophagus, with the tip of the tube just above the stomach. This flexible tube connects to a monitor which shows the amount of acid in the esophagus, as well as how often the acid levels rise. If a baby has high acid levels for most of the 24 hours, he or she might be diagnosed with GER.
Scintigrahy, or Milk Scan. The baby is fed liquid mixed with a radio-labeled powder, which is then detected by a scanner. Repeated scans show both the normal emptying of the baby’s stomach and reflux episodes. It also shows whether or not food is being aspirated into the baby’s lungs, which can lead to respiratory problems.
Endoscopy. A flexible endoscope is inserted through the baby’s mouth, allowing for examination of the sphincters and checking for obstructions or ulcers in the area. With an endoscope, the health care provider can also take biopsies of the esophagus, the stomach, and the top of the small intestine if needed. These samples are checked for signs of other digestive problems that would rule out GER. Testing is also done for Barrett’s Esophagus, which is an abnormal cell growth in the lining of the esophagus.
Manometry. A manometer measures the pressure inside the esophagus by means of a thin tube with tiny openings at locations throughout the tube. The openings sense pressure as the baby swallows and the esophagus contracts; the results are transmitted to a computer and shown on graph paper. This process allows the health care provider to determine whether the esophageal pressure is normal or abnormal.


If an infant is diagnosed with GER, his or her health care provider usually starts treatment conservatively, by removing the factors that contribute to the reflux. For instance, infants who are held at a 30-degree angle while eating – the most natural angle for a baby being bottle- or breast-fed – have fewer reflux episodes than babies laid flat. Breast-fed infants have shorter reflux episodes than those who drink formula, and dietary changes can make a difference as well. For bottle-fed babies, adding ingredients such as cereal, carob flour or sodium alginate to the bottle sometimes helps, but in some instances might lead to constipation or coughing. For many infants, being fed smaller portions on a more frequent basis can help reduce reflux.
If dietary changes don’t work, prescription drugs exist for the treatment of neonatal GER, but their side effects in newborns are not well documented. The classes of medications prescribed to treat GER are prokinetics, which help food move through the system normally; H2 blockers, which reduce the amount of acid the stomach produces; and proton pump inhibitors, which limit the amount of acid output from the stomach.

Surgery is a last resort in treating GER. In a typical procedure, the surgeon wraps the fundus (the base of the esophagus) around the lower esophageal sphincter, which can help reduce the backwards flow to the esophagus. Results, however, are unpredictable, and some patients may actually experience a worsening of symptoms after surgery. A new baby can bring joy to parents, family members and caregivers. But as any new parent can tell you, it’s sometimes difficult to determine what’s typical and what’s not in a newborn’s behavior. Knowing some of the signs and symptoms that indicate a reflux problem can help. Dr. Jadcherla reminds parents and caregivers that the vast majority of newborns with GER simply outgrow their problem. And even in cases where further testing and treatment are necessary, it’s reassuring to know that infants can remain happy and healthy.

Hope this little bit of info helps

Answer 2

First of all, you may want to consider getting another doctor's opinion...a baby not gaining weight normally and projectile vomiting like that shouldn't wait a month to be seen again.
Second, my son had issues with formula too, and the one that we got that did wonders for him was Good Start. He is two years old now. It was so difficult, we tried a bunch of formulas as well, and with my daughter who is seven months old, I am breast-feeding her but I make her cereal with good start formula. She has had no problems with it.
There is a condition he could have where there is a flap in his esophagus that isn't closing properly and that could be why he is projectile vomiting so much. IF this is the case, there is a reletively simple surgical procedure the docs can do to fix it. I would not wait until next month to figure this out...try good start for a couple days, and if it doesn't help, make an appointment with another pediatrician...
Good luck to you...and congratulations on your new son!

Answer 3

I had the sammmmmmmme problem with my 2 month old try enfamil prosobee..it did wonders, its soy based also so his poop stinks worse..my son projectile vomitedalso..but after 3 or so days he stopped..the gentlease worked for a little while too.

Answer 4

sounds like GERD, reflux. does he appear to be in discomfort, pain. does he turn red and arch his back. i had to request the test, because my son was gaining weight so they didnt think it was that. the test consisted of me feeding him this icky white stuff while they watched exactly what his digestive system was doin with xray. sure enough, he had it. he was on 2 types of med. took one twice a day and the other 4 times. but the good news, most babies "grow" out of it once they start sitting up and eating solids. my son took the medicine from 1 1/2 to 6 months. his belly was still a little sensitive to some things for a little while. no food bothers him anymore.

i wouldnt even wait for his next checkup. i would call in the morning and insist that he be tested for reflux immediately. if that is what is wrong, i assure you it is very painful for him.

Answer 5

it could be a medical problem but probably not maybe he needs a lactose free based milk or maybe you should try breastfeeding it's never to late to start to build it back up i have four kids and i nursed them all and they spit alot less then other babies that was on formula because the mother milk breaks down in their tummies better i really hope you find your answer and your baby starts to feel better and you what don't worry if he is gaining his proper weight then your doing something right.
---angie

Answer 6

It doesn't sound like you have tried any soy formulas and you son may be lactose intolerant so try a soy based and see how that works. Good Luck

Answer 7

Demand the prescription for wic to cover the formula that your baby can handle....what the heck is wrong with some systems for cryin' out loud....Obviously the doctor is aware he isn't gaining weight like he should, so DUH to the doctor!! Uh, what more does he need to give the prescription to you, ugh!!!!

Answer 8

You need to see another doctor, that is not normal. My daughter spit up here and there but never threw up like that. Watch your child closely when he is sleeping as well until you get this problem taken care of.

Answer 9

My sisters kid did this. He had to be put on a soy based formula.