Thanks everyone for you help. I feel bad always asking questions but I am still new at this and don't have much advice to offer anyone yet.

How many ounces at a time or per day does you child get and how much do they weigh?
Miranda was eating about 20oz or so before we started Neocate between nursing and supplementing with Alimentum. Of course this was an estimate but I have a low milk supply so I kind of know at this point how much milk I have every couple of hours.
Yesterday I could only get 15oz in her which doesn't seem like enough but I know if I tried shoving more in her it would only come back up like this morning.

What is the result of using Neocate supposed to be? I mean if the spitting up doesn't go away and they still spit up hours after feeds then why not use breastmilk or another formula? Maybe I am missing something.
We started the Neocate because Miranda was spitting up anywhere up to 3 hours after eating and the doctor said MSPI so she wasn't digesting and it was coming back up. If this isn't going to stop why am I spending $40 on a can of formula and giving up BFing (elimination diet still wasn't helping the delayed spit up)?

This is kind of just a bottle feeding question....how do I know if I should switch to stage 2 nipples? She's almost 3 months old and seems to get somewhat frustrated taking her bottles with the stage 1's. It also seems to be taking forever. I mean I see her sucking but it takes a lot of sucks to get a swallow.

Thanks!!

According to our ped and it's been true in our experience, hypoallergenic formulas can actually increase spitting/puking because they're so much thinner than regular formula.

My 11mo daughter still uses Avent stage 2 nipples. Stage 2 in that brand is for 1 month or older. She drinks about 20oz a day and weighs 17 pounds. She's never taken more than this consistently and takes in in 4oz feeds.

Try a faster flow nipple with your daughter. If it turns out to be too fast, it's a small investment to find out and she'll likely be able to use them anyway as she gets older.

Thanks!
I guess I just don't understand what the purpose is then if they spit up even more? Aren't we trying to keep food in them? She's still refluxing although she doesn't seem to be in much pain with it.

I found a stage 2 nipple in my Dr. Browns set so I'm going to try that with her next feed.

This is all very frustrating but I'm sure everyone already knows that.

The uses of Neocate vary. For Evan, it's increase his spit up and refluxing, but there is no pain w/ it and his relfux meds work, so the Neocate is working. If you weren't having pain issues before, I'd question moving to Neocate. Evan is also allergic to many other things I never realized till I went on the total elimination diet and now that he's weaned, he's getting better. I just talked to his GI nurse today and the DR wants Evan to get in 28ozs a day, he's not on any solids. He took in 23 yesterday and doesn't seem to even want to take that today. She said I needed to keep an eating log for him and have him weighed next week to see if he's still gaining. If he is, then the intake won't be quite as important. He's almost 18.5#.

Well we started more because of the DGE which GI feels is due to MSPI but I found that even with cutting that out of my diet it wasn't helping. I just didn't have the energy for a TED right now. I know that might seem lame but mentailly I am just drained right now and decided to try Neocate instead of the TED while I pump.
So what I still don't understand then is if DGE is because they can't digest what they are allergic to and this is hypoallergenic why isn't her stomach emptying after 2-3 hours? We've done the barium test and they said structurally everything was normal. (bangs head against the wall)

She can have DGE without having a problem with milk or soy. Sometimes with DGE they will recommend neocate because it is digested faster than another formula. Neocate and ALimentum both made Alexys puking worse, because like Lesley said it is thinner. If you did an elimination diet, and it didnt make a difference...and you are using Neocate and it didnt make a difference....then it is prob not MSPI. Which in that case breastmilk would be best, because it is digested so rapidly....and you wouldnt have to do a TED. What other symptoms of MSPI did she have? Puking alone is not an indication of it, as many refluxers puke and can handle milk or soy.

Lauren was put on Neocate because of MSPI. She could not tolerate the milk at all, made her gassy, she'd arch her back, scream, all other classic symptoms of reflux. Then we switched to soy, this took most of the screaming and pain away, but she still spit up. Then we tried hypoallergenic (nutramigen) and it decreased the spit up slightly and all the pain went away. The GI said to switch to Neocate b/c it is totally comprised of amino acids and there was nothing in it that she could be allergic to. The Neocate in conjunction with the Zantac has made a world of difference. Let me tell you though, it took us a good 3 weeks to see the difference. I never knew it would take that long to see a difference, but you can definitely tell now. Actually, I just did a load of her laundry for about 3 days, and only washed about 10 bibs. We used to go through about 20 bibs a day, no joke.

One last thought, Lauren had the barium swallow done also and her results came back normal. She spits up hours after eating and does not have DGE. The GI explains it as uncomplicated GER "happy spitter".

Maybe I don't give things long enough, that could be part of the problem. I did the elimination diet and while her "chunky" spit ups seemed to decrease she was still spitting up way after she ate. Breastmilk is supposed to digest in 2 hours so 3 hours later she shouldn't be having spit up but she was.
Our GI had suggested Neocate at our last appointment I didn't want to do. 1) the expense and 2) I really don't want to stop nursing.
After another week of spitting up and NOW green diarrhea I had enough and decided to do the 2 week Neocate trial just to see if its actually MSPI or something else.
In the meantime I am pumping and freezing my milk in case it turns out not to be MSPI.
I am going to talk to him about thickening it though. As soon as she burps up it comes. Its kind of mucousy looking sometimes too, is that normal?

Hi Connor is on Neocate and still spits up hours after but he is a happy spitter. It does tend to look mucosy I think it is just the Neocate! I would definately ask about thickening it might really help with the spitting up. We use 1 tablespoon per 2oz of formula. Just to warn you in case you already haven't had it happen poop on Neocate is dark green and sticky almost like there first poops in the hospital and this is comepletely normal. When I first changed one of Connor's diapers after switching to Neocate it scared me.Does she have any other problems with milk based formulas? Connor was put on the Neocate due to MSPI it didn't cut down on the spitting up but it definately got rid of the horrible gas pains and loose poops the milk based and soy were causing.

The GI said to switch to Neocate b/c it is totally comprised of amino acids and there was nothing in it that she could be allergic to.

Just to correct this, children can be allergic to Neocate. Generally it's a corn issue, but some just don't tolerate it well, while elecare is tolerated. Who knows why?