Vomiting in 6 week old

x3violins

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My 6-week-old daughter has had feeding issues since she was born. When she was born she wouldn't eat at all, not by breast, bottle, or syringe. She ended up in the NICU for 3 days on IV fluids and antibiotics and needed to have her stomach pumped before she finally started to eat. She didn't give hunger cues at all for the first maybe week and a half to two weeks and we had to just feed her on a schedule to make sure she ate. The nurses at that time recommended 65 ml every 3 hours as a feeding goal. She was on Similac Sensitive formula and breast milk at the time.

Since then she's been transitioned entirely over to bottle-fed breast milk, has started giving hunger cues, and worked her way up to 90-100 ml-ish of breast milk per feeding every 3-4 hours. In this time she also developed intermittent gas issues and issues with excessive spit-ups. Both problems have been intermittent. She can go a few days without any problems at all and then have a day where she's screaming with gas pain all day, then be fine for another day or two and then vomit up every meal for four meals in a row and then be fine again and it just keeps happening like that at seemingly random intervals.

I tried eliminating dairy for a few days since that's the most common intolerance in babies and that didn't help. She actually got worse in that time.

She's been on famotidine for a while and that doesn't seem to be helping either.

The last two days have been particularly bad. Her vomiting issues have gotten markedly worse and over the last few days she has been spitting up at least 6-8 times during and after every meal. She has had at least 4 episodes of projectile vomit where it comes out her nose and she's screaming in pain. She writhes around and cries inconsolably around feeding times and seems more upset after she eats than before.

She's seen her pediatrician and been to the ER. Her pediatrician sent her for barium x-rays to see what's going on and they found nothing. We were just told that her stomach is probably just too small and we're probably feeding her too much.

We've made a conscious effort to practice pace feeding. We were already practicing the technique for the most part, like keeping her as upright as possible during feedings, using the slowest nipple, and holding the bottle mostly horizontally so milk isn't just running down her throat. We just exaggerated these things and then would take the bottle from her and make her take breaks, to drag out the feedings. All this seemed to accomplish was to piss her off. One feeding this afternoon I only gave her 20 ml, took the bottle and she started crying and then barfed it all up. That was less than an ounce so clearly not too high of a volume. I really don't think that's the root of the issue.

An ER nurse told me to keep a food diary to try to identify any patterns with what I eat vs when she gets an upset stomach, but I haven't been logging it long enough to identify any patterns yet.

Her pediatrician has recommended adding rice cereal to her milk to thicken it and keep it down. I had a pediatric nurse tell me that that's a choking hazard and I shouldn't do that. My daughter's pediatrician is old and apparently this is antiquated advice?

Should we try the rice cereal? Is that safe? Has anyone else dealt with anything like this? Is there anything else we can try?

Sorry this is so long. I wanted to make sure I included all the information. Kudos to anyone who reads this whole thing!
 
I'm sorry you're having such a tough time with the little one. Have you considered giving a rice-based formula instead of breastmilk? Soy and lactose molecules are very similar and breast milk is loaded with lactose, she might have an intolerance for the moment. I have given both my children, Novarice from Novalac and they both stopped cramping. I don't know if it's available in your country but it's worth a try considering she's in so much pain. :(
 

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