do ammonia, lactate, pyruvate
do extende metabolic screen
do urine organic acids
if any stress occured in the form of infection losses, reducing oral feeding --> instruct the mother to seek medical advice and withdraw ABG, anion gap, RBS, urine ketones, ammonia, lactate and pyruvate and start IVF , STOPfeeding and reconsult again
start carnitine 100mg/kg/dfay
coenzyme Qcap once daily
epicozyme 5cm/12h
biotin forte cap once daily