Cindy, from what you wrote I strongly suspect a case of overabundant milk
supply and/or a too forceful let down. There certainly could be an
underlying physical issue making things worse. Reflux could make a baby
reluctant to eat, I would expect to see this on both breast and bottle.
Craniosacral therapy can help these fussy babies and chiropractic can help
with reflux. I have seen several babies with similar body language who
struggle the whole time at the breast and they are miserable. I have seen
test weights that show a huge intake in a short period of time (5 minutes
for 3 oz). I have also seen some babies do ok with a forceful let down,
meaning they swallow just fine. If mom is able to pump out a lot on the
Avent, this would also point me in the direction of the milk supply.  I try
to see when the baby's behavior starts and what the breastmilk intake is at
that point, plus I try to watch for mother's let downs to correlate them
with baby's behavior. I have seen a baby or two who is ok during the feeding
but only fussy afterwards, and this seems to be a baby who never got to
comfort suck and get "gentled down" into a quiet or asleep state (again a
huge intake in a few minutes). I have also had a mom pump off one to two
ounces per side and then we nurse the baby and watch his behavior. Usually
that calms the baby down.

Best wishes to this mom, Kathy Eng, BSW, IBCLC

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