Dear Lactnetters, Although I am mostly lurking, I now also want to contribute to the internation opinions on this subject. I am a Dutch MD, living and working in Germany in a small private practice for babys and toddlers. I am active in the AFS, one of the german breastfeeding counsellor groups, and I regularly teach hospital staff about breastfeeding. In my practice I seldom see babies with the symptoms you describe, Pat. It is more like Rachel sees the situation in Norway. I think however, it is really a hard diagnosis to make. Many of the children here wo cry a lot in the pattern you describe, are diagnosed "KISS-syndrom", which is a disturbance in the Atlas joint in the neck of the children. Both of these diagnosis seem to me partly a cultural diagnosis for the same phenomenon. I think some children really have GERD, and some children have really KISS-syndrom, but in the one society too much children are diagnosed with GERD and in the other society (with the same symptoms) too many children are diagnosed with KISS-syndrom. For me it is not clear from the discussion, if the children are crying after every feed (also at night). Of course some children have periods where they cry. Here this is mostly called "colics". I think that one of the contributing factors is the uncertainty of the parents, especcially on breastfeeding. The mother breastfeeds already with the expectation, that the child will cry afterwards. Often she waits too long, and the child is so hectic in breastfeeding, that it seems to me it cannot cope with all the milk. One of the things I find works out best is to tell the parents about the development of babies, the importance of frequent feedings, the importance of carrying the child and most and for all a certain relaxation with the mothers. I am generally very cautious with drugs for babies. After all it is a central working drug, and here in Germany it is seldom used. But perhaps American children are different? Many greetings to all of you Elien Rouw, MD, Bühl, Germany (from the food of the Black Forrest). Pat Gima wrote Thank you, Rachel, for the international perspective. Spitting up is not a major issue with GER, even though some babies with GER do spit up, or attempt to, in their struggle to ease their pain. Actually they do a lot of swallowing to prevent the stomach contents from entering the esophagus. The symptom that sets GER apart is the severe pain. These babies are in agony for a long time after eating, so much so that some of them decide that they will no longer eat since that is the "cause" of their pain that grows in intensity. *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] 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