Silent reflux - help!

[Ojtx]

Has anyone ever not found the cause to their little one’s silent reflux?
We have tried everything. TT divided, feeding positions, bottles, teats, changing formula (diary & non diary) but her silent reflux seems to persist.
She’s 14 weeks now & Dr is reluctant to medicate her as she has stayed at 50th centile.
We’re using carobel in feeds, I wouldn’t say she’s constipated as she is still going everyday but she is definitely straining a bit harder to pass her stools.
Any advice / suggestions welcome 🤗

What are her symptoms?

You can hear it coming back up but she is never sick & congestion / wheeze after feeding. As soon as you take her off the bottle to wind she will hysterically cry until drinking again (this definitely isn’t due to hunger as it happens every single time even with 1oz left)

Having a TT divided isn't the holy grail it's painted to be for several reasons. Lots of prep work beforehand is necessary, as well as lots of aftercare - anyone with a TT needs to relearn how to use not just their tongue but all of the associated musculature. Not to mention it can be very difficult to effectively do with a baby because they simply cannot be compliant. Then there's whether or not the TT was sufficiently released, because (presuming you're in the UK), there are lots of providers who make a somewhat blind cut and say it's done. There may be other associated tension in the body; other oral ties, and the revised TT often reattaches. These are all things to bear in mind even though you've had it done.

Congestion/wheezing after feeding also sounds very much like an allergy at play. What about soy derivatives, have these also been eliminated?

She does have a lot of tension following a very long and trauma birth so we’re currently seeing an osteopath for this.
What other oral ties may she have for example?
She is now exclusively formula fed on cow & gate

My daughter is 4 and still has reflux and we haven't identified the cause.
She does have food allergies which does make it worse but it's there even when she has no reactions. Teething made it worse but she now has a full set and still has reflux. Colds make it worse but it's there when she's well. The absolute worst thing for her reflux is a growth spurt which would suggests it's a weak sphincter and will improve with age but we are still waiting. It happens when she gets taller rather than gains weight so it's not medication dosages reducing. She was checked for a tongue tie but as she has got older I have suspected she might have a mild one as she has limited movement to the middle of her tongue.

We are under a general paediatrician and have seen a gastro specialist for now they don't want to run tests as they would just show if she has reflux or not and we know she has reflux and is being treated for reflux so that wouldn't change. She's on a lot of meds for it. I have a family history too. My mum has just had an operation to fix her reflux as it was severe and didn't respond to medication. My sister had projectile reflux until 2 but I do suspect she had cmpa as she has issues with dairy since.