In a message dated 5/21/01 12:11:40 AM Eastern Daylight Time, [log in to unmask] writes: Kathleen states: " After correcting and achieving a deep latch baby nursed for about 15 to 20 minutes obtaining 22cc at the right then another 22cc at the left, we switched and recorded another 24 cc at the right and then 26 cc at the left. There was no obvious gulping, chocking, sputtering or rapid intake of large volumes, as I would suspect with oversupply. I thought I had identified the slow gain as related to the suboptimal latch. Additionally the baby had gained 1.5 ounces from the previous day since the mom had started to supplement. The baby had several episodes of reguritating into the throat and re-swallowing it and eventually spit up about 5-10cc total. Today the mom tells me she is noticing the baby seems most uncomfortable and spits up the most when on the breast, is a little better when given bottled breast milk and is best when given bottles of formula. She really does seem motivated to breastfeed and is understandably very upset. I definitely think this baby has reflux that probably needs some medical intervention in the way of medications but why in the world is he doing better with a cow's milk based formula than his own mom's milk and why the difference between breast and bottle when there doesn't seem to be oversupply?" I've seen moms who are so uptight when they are breastfeeding that they experience few MERs and communicate their stress to their infant who remains uncoordinated and uncomfortable throughout feed and therefore unable to coordinate suck effectively. This baby might not get the reward of faster flow and be working hard to extract milk due to poor MER. It just strikes me when moms say "my baby does so much better with the bottle" that their confidence is shot and they feel something is wrong with them. This may or may not be the case with your mom but may be worth exploring feelings with her and trying relaxation techniques, etc. It may only be part of the picture but I find that stating to mom, "It must be frustrating, make you feel bad, or the like, that your baby seems to do better with the bottle," and then go on to inform her that you're there to help solve the puzzle. If I feel mom is perhaps unsure of her desire to breastfeed a simple "How do you feel about BF and what is your BF goal," can clarify her intent. Just some thoughts about factors I find can be overlooked initially and sometimes I'm late in dealing with this because I get caught up in mom's emergency of the situation. Barbara Latterner, BSN, RN, IBCLC Brewster, NY *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html