tummy specialist

We took Tyler to the pediatric gastrointestinal specialist this morning. We were referred to him because Tyler throws up all the time, and has had eating issues since birth. The visit didn't start well, but ended on a very positive note!

Chad took Tyler to the scale to do the standard height, weight and head circumference check. While in the exam room finishing up paperwork, I heard the nurse say his weight. I rushed out, as she repeated, "18 lbs. 15 oz." Tyler lost weight since his last doctor visit a couple weeks ago. I was initially very upset and concerned. He also hasn't grown in height (27 3/4") at all since his 6-month check. He's now in the 50% for both weight and height. I was very thankful that Chad came with us. He calmed me down and insisted that everything was okay. Tyler, of course, was just as happy as always and didn't seem to notice anything!

The doctor, dressed in a lime green Hawaiian shirt, came in a few minutes later and gave us a little more piece of mind. He asked about 10,000 questions, checked Tyler's tummy and took a sample of his poopy. He stopped several times to play with him and comment on his haircut (to which, I made a pouty face). The doctor said a lot, so here are the bullet points:

• Tyler's three-hour eating pattern is typical for a true breastfed baby, and we should not worry or try to change it. He is in a pattern of eating a certain [smaller] amount and is basically too old to change.
• Tyler most likely has "spitty baby syndrome," which means he has reflux or GERD. The majority of children (60-70%) outgrow this by 6 months. There are a small few (30%) who have a more severe case and do not outgrow it until 12-18 months. Tyler falls into this category.
  
• We were instructed to stop all nighttime feedings, which also includes the bedtime feeding. Due to Tyler's reflux, he needs to be fully upright for at least one hour after eating.
  
• Keep breastfeeding. If Tyler does have a lactose protein sensitivity issue, breastmilk is much better than formula. There is no compelling reason to wean at this time.
• We need to continue giving him Zantac twice daily and may even need to increase the dosage.
• He insisted that Tyler was a very healthy and happy child. The drop in weight was nothing to cause concern and can most likely be attributed to a leveling out of growth. Since all his measurements are in the exact 50% percentile, he said we should feel relieved, not the opposite.
• The doctor said there was a small chance Tyler has Pyloric Stenosis or Intestinal Malrotation (click links for explanations). He ordered a UGI just to make sure these problems didn't exist.

Immediately after the appointment, we went downstairs to the Plano Pediatric Imaging Center for the UGI. (On a sidenote, the building was great: pediatric specialists of all kinds, including sleep doctors and a surgery center.) The UGI was a little difficult for both Tyler and me. Chad was the brave one, comforting Tyler and encouraging me to stay calm. The doctors had to lay Tyler down on a magician-style board with his arms raised above his head. He was tightly secured down with five straps at every section of his head and body, so they could turn him in all directions. The nurse gave Tyler a bottle filled with a sweetened Barium, and the doctor watched the liquid travel through his stomach on an X-ray like machine. She took numerous pictures, and said she would have the final results by the end of the day. Her preliminary diagnosis looked good--no obvious signs of deformity, Pyloric Stenosis or Intestinal Malrotation! Thank God! She did, however, notice significant reflux. Instead of traveling down normally, the liquid he drank went down and then all the way back up to his throat. She said this could be causing all his issues.

Chad took a picture before Tyler's head and arms were fully secured. I'm not sure anyone wants to see it, but I thought I'd share anyways.



Tyler did okay. He cried a lot when they turned him in the many directions. He drank the bottle though, and finished up strong. He's pretty resilient. In fact, after the doctor was finished, he was laughing and smiling at her!

We'll know the final results by the end of the day. But it looks like our little guy just has a really bad case of reflux. We'll just continue giving medicine and make the adjustments mentioned above, and hopefully, he will outgrow the condition by 18 months.