Since Matthew is formula fed, would we not being see true LPI symptoms in him
Matthew is on formula, so this would mean that he is getting protein all the time. When you are breastfeeding you breakdown the protein for your baby so that they do not have to process it, but formula does not do this. It is believe that the symptoms only appear if the persons system is being "overtaxed" by protein. That being said, it is possible that Matthew has a relatively good tolerance of protein and so he's not being overtaxed.
If we look at how we calculated James protein requirements for a day then it would be said that Matthew can have around 11grams of protein a day. Currently he gets about 13 grams per day. I have read of some cases where the tolerance is about 3 times higher then what James' diet was at. In reality this means the person is barely protein intolerant, they just can't binge on steak. So if Matthew had a high tolerance then we may not be taxing his system, and therefore we would not be seeing symptoms at this time.
When James was diagnosed we also had the girls tested for LPI. They had no symptoms so why was this done? It is possible that you can have a high tolerance and not have obvious symptoms but because your body isn't able to process the protein well it taxes the kidneys and in the end does severe damage. There are cases of LPI where the person was not diagnosed until older ages (I recall two, one at age 6 and the other at age 9), but to be fair they did have some symptoms, it just wasn't all tied together until later.
All this being said, the doctors are still "quite confident" that you would still be able to detect in the urine if a person has LPI even if their system is not being overtaxied. Not knowing enough about LPI the test is not a guarantee, only DNA testing can finalize the question.
With that being said, what I did before Matthew's test was to increase the amount of protein he was receiving. To do this I concentrated his formula for about 4 bottles. I have no idea whether this will make a difference on the results or if we reached a level where his system was taxed, but I figured a short term high calorie diet wasn't going to hurt and might just make me feel a bit more confident in the test results.
Two things happened yesterday that increased our concern. A couple hours after the 4th bottle Matthew threw up (a lot), and an hour later again threw up (a little). Matthew's afternoon BM was thinner then normal. I would not classify it as diarrhea, but it was definitely thinner. To add to that today Matthew had four BM when he's almost always has two a day. Three of these were thinner, and one had mucas in it. (He also did throw up today, but I'm quite sure that was caused by coughing/gagging).
Now to be fair, this could be concidence. It could be because of the additional protein. It could be because of the concentrated formula, for not only was there additional protein but additional everything. So this doesn't spell LPI, it just adds another thing to the list. The other thing is that when you concetrate formula you should end up getting thicker stools (or constipation), altho I'm not sure that would happen in just a few bottles. So the thinner stools doesn't fall in line, but at the same time can be from any of the additional ingredients in the formula. So the whole process just confused us more instead of helped us ... or maybe it helped us ... I'm not sure -time will tell.
So in reality there are no true obvious signs of LPI (the fact that he is growing so well goes strongly against LPI). The symtpoms that we see that are similar to James could be related to many, many illness, or could even just be minor viruses, sensitive stomach, etc. Only time will tell so for the time being we keep busy and try not to focus and think about it too much ... so to the ladies I visited today ... thanks for keeping me busy I had an enjoyable day:)
Thank you all for your e-mails, comments and prayers. We pray the answer will come soon.