Reflux in 1 month old
TLDR: 1 month old baby has silent reflux and really hard time passing gas and nothing seems to be helping. Mom's at her wits end holding fussy baby for 90% of the day😅
Looking for some additional advice. For context this is our second baby and he is a 180 from the first.
Baby was born at 8lb 11oz at 41 weeks. In the hospital we were using Similac 360 total care (blue) RTF. When we came home from the hospital, We were originally using Philip Avent Natural Response bottles with a slow flow nipple and we noticed he had problems with gas. He would be inconsolable, overnight especially. Week 2 we tried to switch him off of RTF and onto powder and that lasted for 1 week because we started noticing he would have silent reflux. This was waking him up, making him really fussy etc. We called our pediatrician after we noticed the reflux with the powder formula and they suggested switching to Total Comfort (purple can) we've been on that since. (baby is 5 weeks old) We had called a few days before his 1 month appt to let them know his reflux was still really bad and they have us a few cans of Similac Alimentum but we decided to wait until his appt to actually talk with his doctor. Also for context, he's been drinking 4 oz bottles since about 20 days old about 6-7 times a day. (Sometimes he'd only take 1 oz-3 oz)
We had our 1 month appt and baby weighted 11lbs 8 oz. When doctor came in, I mentioned how he has had really bad reflux and it seems to be getting worse. He immediately said it was because we were overfeeding him since he had gained so much weight in the last month. (mind you, with his silent reflux, he never actually spits up and we always follow his hunger cues) He mentioned we should cut back how many oz he's drinking at a time. When I asked if we should look at switching formulas or not, he said we should try this first.
We tried cutting back his formula to 3 oz and adding an extra feed to keep oz the same so he isnt hungry. (The pediatrician even daid that we should be feeding 2-2.5 oz per lb, so that would put us between 22-28 oz a day) We've been doing this for 2 days and his relux is almost worse and he's mad because he's hungry and not getting good sleep. Other symptoms be has along with the relux is really hard time passing gas, wheezing/congestion, baby acne that wont clear up, still has random "baby rash" (thats what pediatrician called it in the hospital which is just random red patches that pop up and go away within a day) and i have noticed with the last few dirty diapers his butt get immediately red. ( I've looked into cmpa and it's mentioned about mucus or blood in poop, but im not sure what to look for with that)
Should we bite the bullet and just start him on a hypoallergenic formula? (doctor didn't even mention testing for cmpa or next steps if cutting back oz didn't help the reflux)
For context, we are already doing the pace feeding, slow flow nipples, changed the bottle until we found one that he has a good latch on, burping every .5-1 oz, making sure to stir his formula to make sure there are as little bubbles as possible, keeping him upright for 30-45 mins after feeding, using gripe water/mylicon as needed (most of the bottles throughout the day needs some sort of intervention to help with the gas), and doing bicycle legs/tummy massage to help work out extra gas. His reflux seems to pick up about 1-2 hours after feed, but can be sooner if he gets laid down too soon or has too much pressure on his stomach right after feed.