Brief Answer:
There is no need to be worried about weight

Detailed Answer:
Namasthe
Welcome to Healthcare-Magic
Greetings of the day

Dear XXXX

Being a parent myself I understand your concern and apprehension. Let me assure will take care of things . At the end of discussion you will be relieved of all the concerns.

As a rough guide I would like to mention you the following. Baby doubles its birth weight by 5 months and tripples its birth weight by 1 year of age. So his approximate expected weight at end of 1 year is 7.8kg ( 2.6*3= 7.8kg). He is presently 7.6 kg, so I don't consider it to be of any concern. Being a Pediatric Surgeon I come across several kids and their parents. Weight issue is a very common concern. In majority of cases it requires reassurance and understanding that its perfectly normal, no 2 kids can be the same and also their growth and development varies.

Reflux is not of much concern if he is occasional vomiting. It would be because of many reasons
1. Improper burping
2. Feeding through bottle feeds
3. Wrong feeding technique: Feeding in sleeping position
4. Giving too much of liquid feeds
5. Jolting or moving baby too much after feeds

Taking care of following minor adjustements will help
1. Feed the baby is sitting position
2. Use watti and spoon to feed
3. Burp well after feeds
4. Use semi solid feeds: I will suggest you one nutritive feeding which you can try
5. Adding gastric motility promiting drug like Domperidone will help

One recipe which the kid will like is as below

Ingredients needed: Ghee( 2 spoons), Whole wheat flour ( 2 spoons) , Pista( 50 gms), Cardomom ( 6 in number), Almonds( 50 gms), Khajur( Dried dates 50 gms), water/milk

In a pan pour 2 spoons of ghee, heat it, add 2 spoons of wheat flour (Atta), cook it till golden brown on low flame till its slightly golden in color. Add 2 Cups of water or Milk and keep stirring it continuously making a thin water paste( same like sira consistency). To this add powdered mixture of rest of ingredients grinded in mixer ( pista, almond, khajur, cardomom , remember to ground it well , also remove the peel over the cardomom and add only seeds).
Supplement baby breakfast with this recipe, and also can be consumed at night when baby is hungry. In this way his quota for milk will also be fulfilled.


Coming to undescended testis: If the testis is not palpable in the groin it will require laparoscopy
Ideally the baby is to operated at 10 to 12 months of age. As its not an emergency Surgery it is important to correct anaemia especially if the hemoglobin is below 10gm%. Hematinics and multivitmain are indicated.
Eosinophil is 14 % which is definitely high, if the Absolute Eosinophil count is more than 500, I treat it in my clinical practice with 21 days course of Diethyl Carbamazine(DEC). You can discuss it with your Pediatrician/Surgeon.


In case you require any further assistance, will be glad assist you.


Take Care

Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Pediatric Surgeon

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Brief Answer:
Wait till CBC normalizes

Detailed Answer:
Namasthe
Good evening
Dear XXXX

Absolute eosinophil count of 2086 is quite significant. It will require treatment with DEC. Laparoscopy is a planned surgery atleast the counts(Complete blood count-CBC) should be normal. Ideally Surgery is to be done at earliest, but there is definitely no harm to wait until Complete blood count normalizes.
I had given you a semisolid recipe , try it the vomiting should reduce. You sais he vomited thrice yesterday. was it just a small regurgitation or he vomited more than 50% of what he consumed. Apart from Lanzol, I had advised you Domperidone, it will increase stomach motility and prevent reflux.
Vomiting may have some contributory factor in weight, but seeing the weight I would definitely not be worried about the weight as I had previously explained to you.

Try the above suggestions mentioned in my 1st response , I am quite sure the reflux should regress over next couple of weeks.

Do take Care

Regards
Dr Deepak

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Brief Answer:
Better to wait till CBC normalizes

Detailed Answer:
Namasthe
Greetings
Vomiting has no relationship to the counts.
2. Many children have improvement in symptoms Of reflux over period of time. Many will have no reflux by the age of 18 months. Diet modification, right feeding technique is all that is required.

3. Coming to urgency of surgery. I don't consider it to be emergency surgery. At least the Hemoglobin should be minimum of 10 gm % before one considers a planned surgery. Increased eosinophil count causes airway hyperactivity which may cause prolonged bronchospasm intra operatively while Anaesthesia is given. I always prefer to wait till CBC normalizes

4. Laparoscopy will have no after effects After the surgery so don't be worried about it

I have no links in Pune . I would suggest to try with Pediatric Surgeon In KEM hospital Pune who may practicing outside.

Do get back to me if you need any further assistance, will be glad to assist you.

Take care
Best Regards
Dr Deepak

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