Getting desperate!

So, the promised post about Micah's feeding schedule. Most of you can just skip this... (this is what most people call oversharing, I call it desperation)

For the last month or so, Micah can rarely hold down his morning feeding. Just this morning, I gave him 15 mL (1/2 ounce) of blended food/pediasure, and up it came within 5 minutes. Sometimes we can't get past his AM meds without puking.

This is his current feeding schedule.

9pm-5:30 am- 13 oz pediasure, 2 H20, multivitamin
8:00- Morning meds if he has them with 1 oz water
8:30 am- (Attempt) 4 oz pediasure, 1/2 oz water ("bolus" at fastest 15 ml every 15 min)
11:30am- 6 oz pediasure, 1 H20 (bolus 30-45 mL every 15 min)
3:00pm- 4 oz pediasure, 1 H20 (bolus 45 every 15)
6:00pm- 6 oz pediasure, 1 H20 (bolus 45 every 15)

He gets minimal food/drink by mouth, at max an ounce of each a day.

We've tried pediasure, blended food (although that usually gets mixed with 1/3 pediasure to thin out). Sometimes he even pukes with water in the morning. Occasionally he has trouble with other feedings, but about 75% of the time it's the first one. He has a BM a day, usually late morning.

I'm baffled as to why he barely tolerate anything in the morning. As you can see by our feeding schedule, we're packed the the max with feedings just to get them in. I've debated going continuous in the AM, but he doesn't have a pump he can carry and he's WAY too active to sit still for over an hour.

I'm thinking it's not a motility issue since it doesn't take anything to make him puke. I'm wondering if it has to do with his nissen... Maybe something is pooling up on top of it overnight. Sometimes the puking is caused by coughing, sometimes by suctioning, sometimes by nothing at all. Or maybe it's allergies, and he has too much going on 'junk' wise in the morning.

The puking has come and gone his whole life, but not with reason. He just came off 7 weeks straight of Keflex because of the drain. I'm sure that's left his system beat. We're doing probiotics to try to negate some of those problems.

Any ideas?