How is his stooling?

Dr. Mian finally responded today. Good thing we had already started the prune juice!

Hi Stephanie,

This could be a sign of reflux, the symptoms of which can go up and down with other illnesses, feeds, etc. His Zegerid and Reglan seem to be at a good dose. If his symptoms continue we can increase his Reglan slightly if needed.

The other thought I had was about his solid feeds. Did you start these yet? Many times, we see constipation symptoms develop after starting solids (esp rice cereal). The symtpoms you described seem to be more consistent with constipation. How is his stooling?

He can be given 1 oz of prune juice a day to help keep his stools soft. If this doesn't help, 5 ml of Lactulose can be give once to twice daily for the same purpose. If he is having normal stools and has ongoing symptoms conissitent with GERD, then we can consider increasing his Reglan or Zegerid if needed.

Thanks!

Dr. Mian

I decided that we would use prune juice if needed and hold off on the med increase for now. I really want him off the reglan. I wonder if the rice cereal on 12/29 set off these chain of events?