What to do next?

I am at a loss as to both what is wrong with my little guy and what to try next to help him.

My older son had clear silent reflux. He was miserable for a few months and was helped unbelievably well by prilosec- like a different child overnight.

My new son, who is now 7 weeks, is much harder to figure out. He is equally unhappy- has to be held all day, only naps when held, wakes every hour or so at night, acts uncomfortable a lot- but it is not clear why.

He seems to mainly have gas and digestive issues- lots of writhing and straining for hours follwed by bms- and I can’t figure out if it is reflux or not. Unlike my older son, he has funky diapers. He is breastfed and periodically has had green diapers- sometimes very dark green. They are almost always at night- why would that be? He will have nice yellow diapers all day and have a very upset tummy at night followed by these green diapers, which last until mornign when they turn yellow again. His general discomfort is all day but he is much more miserable in the evening, which I know can be typical at this age. I did not think green poops were normal at all though for bf babies (my ped says they are).

I did the elimination diet for a week about 5 weeks ago. I have kept all dairy out, which I think has helped, but it is not really clear that it has helped much. I just figured it couldn’t hurt. I could not see an improvement otherwise with other foods out.

We did an upper GI. He refluxed a ton during it, but I understand most babies do so I am not sure it is a good test. I do hear him do the silent reflux swallow my older son did sometimes, but not often. He does not spit up much.

We tried zantac, and now prevacid. We started prevacid Tuesday and we had our first bloody diaper Tuesday night. He has since had one diaper with a bit of blood each night since- only once at night. I can’t figure out why it would only be 1x per day. If it was an allergy, wouldn’t it be more frequent? My ped did a hemocult wed that was negative, but I saw blood that night.

I am at a loss. We honestly don’t know if he has reflux, an allergy, both, or something else. Our sleep deprivation is making us desperate. He is clearly uncomfortable most of the day, but we have no idea why.

Does it sound like an allergy? Does he sound allergic to the dairy or aspertame in the prevacid? He is not any better on the prevacid, but it has only been 5 days so far. We are waiting to hear back from the ped GI to see if he wants to switch meds since we have bloody stools.

Is it possible I did not do the elimination diet long enough? I hate to treat this as reflux with meds if it is really an allergy I am missing.

The green poops make me feel like something other than reflux is going on. I do not think it is an oversupply issue, and again it is almost always only at night.

I feel like we are randomly guessing as to what is wrong and I feel aimless.

Any ideas?

Thanks!

Cathy