2 month child seems sick

[sherwin73]

My daughter is 2 months old today.  In the past week, she started sneezing and dry coughing sporadically.  She has gotten really difficult to feed and doesn't eat much, but seems to be hungry.  The past few days, she only wants breastfeed, but that gaves her diarrhea.  She doesn't sleep well as before and seem to have more gas in her stomach than usual.  It's also harder to burb her after feeding.  She doesn't play as much as before.  Her weight is 10 lbs which is about where she was 2 weeks ago.

Probably due to her bad eating habits, she doesn't relieve herself as much.  It's been 6 hours since her last changing and she still hasn't peeped.

My 6 year old son has gotten a bad cough for about 1 week and he's still a little sick now.  He's on antibiotic.  Our daughter saw her doctor today for her vaccination and he didn't think she is sick.  We also took her in a week ago and he said the same thing.  Unfortunately, she doesn't cough during these visits.

We'll be getting a blood test Monday and setup an appointment with a gastroenterologist(3 weeks from now).

Please gave me some suggestions on what could be wrong or things we can try.  Here's a list of what we've already tried.  We've already switch to latose free formula.  Today, we got some hypoallergenic formula, but hasn't tried it yet.

We really feel that something is wrong with her, but don't have any idea what we can do.  We live in the San Jose, California which is known for its bad allergy season, in case that may be related.

Thanks You,
Sherwin

[Kevin Pho, MD]

Hello - thanks for asking your question.

There are a variety of diseases that can lead to feeding refusal in infants.  You state that these symptoms for 1-2 weeks.  A viral syndrome can simply account for these symptoms but if the symptoms persists then here are conditions that you may want to be aware about when you visit the gastroenterologist.

- gastroesophageal reflux: children with this condition will usually spit up a lot, which can lead to esophagitis and pain when swallowing, causing irritability.
- oral motor dysfunction: can lead to aspiration and recurrent pneumonia, especially in children that cough or gag when eating.
- food aversion disorders: this usually occurs in children with a chronic medical problem, who may have been hospitilized at a young age, requiring help breathing with a ventilator, intravenous nutrition or tube feedings.
- neuromuscular disorders: such as cerebral palsy can cause trouble swallowing.
- obstruction: delayed gastric emptying or other gastrointestinal obstruction
- achalasia: an uncommon condition, especially in younger children, in which the muscles of the esophagus do not work properly, so that foods do not move through the esophagus to the stomach normally.

If the infant is growing and developing normally and has good weight gain, then it is not unreasonable to wait a month or two and continue to try and feed small amounts.  If not, then the referral to a pediatric gastroenterologist would be a reasonable next step.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[ozark]

if her nose is stuffed she may not be able to breathe and suck at the same time and therefore has decreased intake....does she suck then pull away fromthe bottle?

[sherwin73]

My wife notice a very nice article in a recent American Parent magazine.  It talked about reflux.  I research the subject more and my daughter appears to have many of the symtons related to reflux.  We now feed her in an upright position and keep her in that position for 1/2 hour+ after the feeding.  We've also changed her to a hypoallergenic formula.
  We notice results right away and she seem much healthier now and does not cry nearly as much.
  This link was very helpful to me: http://www.colichelp.com/forums/showthread.php?s=7290c67790790ca404c46c14dfba86b6&threadid=797

  I was disappointed that her pediatrician did not gave us any information on reflux or colic after we described her symtons on multiple occasions, in-person visit and phone.  When pushed, he eventually recommended that we see a gastroenterologist, but still did not suggest what the cause could be.

Thank you for your responses, they were very helpful.

Regards,
Sherwin