Help, dear friends!
I have a case that has me stumped.  Maybe our collective heads will come up
with something.  Baby is 7 weeks old.  Was breastfed for the first 3 or 4
weeks but seemed to vomit after nursing but not after ABM feedings so the
mother stopped nursing.  She said she was sad about it and wished she could
have continued.  She said she still had milk in her breasts.  After talking
about the possibility of relactating she said she wanted to try.  The baby
nursed well from both breasts, with some audible swallowing.  Mother was
not willing to stop the bottles, didn't want to use an SNS and said she
would just try to nurse the next few days and see whether or not the baby
vomited.  She was finishing up getting her WIC vouchers and the baby was
happily sitting in his little seat.  As mom is getting ready to leave, the
baby spit up.  Not vomit, just regular spit up.  But the mother said he
NEVER spit up after ABM.  I reassured her that even with the spitting up
her milk was still far better for the baby so she agreed to continue trying
to nurse.

She called me back today to say the baby spits up every time she
breastfeeds, not after bottles.  She is concerned that the baby is "sick"
from her milk.  I reassured her that the baby will be healthier because she
gives him breastmilk but she only sees the spitting up as a sign of
illness.  We talked at length about the benefits of breastfeeding but she
is having a difficult time buying this package because of this difficulty.

The mother has an ulcer, and is taking Biaxin, and another ulcer med, which
I can't remember now (I'm not in my office) but checked out ok in the Hale
book.  AND she was not taking these meds when she originally was
breastfeeding.   Baby  has a tight frenulum but seems to extend ok in spite
of it and I don't think this is a factor.  He does have a very sensitive
gag reflex, but I don't know why that might be a problem when the
artificial nipple does not trigger a gag.

I asked the mom to bring me a diet history for the next few days when I see
her on Tuesday, because that is the only thing that I think might be a
factor.  The AVM the baby drinks is a cows milk based.
Any ideas and/or help, would be greatly appreciated.  Please send responses
to me privately as well as to the list. (I may never catch up on my
reading!)

Thank you for your help.
Barbara Leshin-Zucker, IBCLC
Breastfeeding Coordinator
Morrisania WIC, Bronx, NY