Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-06-14 Encounter: Spruce text message followed by in-person weight check visit CC: Infant with worsening symptoms since last visit — increased spitting up, crying, and poor napping, with concerns about formula supplementation and botulism risk. HPI: Macklin is an infant (age not specified) who has been worsening since a Thursday appointment, with the parent noting he was spitting up or crying the entire day on the day prior and did not take any naps despite previously being a solid napper. The family recently began supplementing breastfeeding with formula, and a grandparent fed him 4oz breast milk followed by 2oz formula approximately one hour later. The parent questioned whether the formula type was contributing to symptoms or whether overfeeding was the cause, and also asked about botulism risk. The family subsequently switched to Bobbi formula, which the parent reported as much better by June 18. Assessment: Dr. Hobbs assessed the infant's worsening symptoms in the context of formula supplementation initiation, advising flexibility with supplemental feeding patterns and suggesting the formula type or volume may have been contributing. He recommended switching to regular Bobbi formula and arranged a weight check visit to monitor progress. Plan: Dr. Hobbs advised that any pattern for supplemental feeds is acceptable and encouraged the family to experiment. He recommended starting with regular Bobbi formula (over the gentle version). A weight check visit was scheduled for June 19 at 9:30 AM to monitor Macklin's weight and overall progress. No prescriptions were sent. Key clinical quotes: "Any pattern for supplemental feeds is just fine. If he takes 4oz in one feed, I don't expect he will want more after that. Absolutely feel free to experiment" "I'd start with regular" "I'd love to see you. Does 930 work? How's the week gone?" Source: Spruce conversation t_2NMHFV8FSP800