Hello Wise Ones,
I am hoping that someone will have some insights about this mother baby couple I saw today.  Mother wanted me to post.
Baby is 11 wks old.  Birth weight was 4.225 kilos.  Mom said that birth was amazing and totally drug free.  Baby nursed in delivery room and mom and baby roomed in.  Discharge at 36 hours, baby weighed 3.950.  Baby weighs 6.225 today. Exactly 2 kilos over birth weight.   Copius milk came in at 2 and half days.  Mom says that baby nursed like a dream for 5 weeks - absolutely no problems.  At 5 weeks old baby started to fuss at the breast.  Mom describes him as gassy.  Says he releases a lot of gas during a feed from his bottom and is sure that the fussiness is gas.  However the baby isn't fussy in between feeds.  He has 2 to 3 explosive yellow diapers a day with dad holding him in a special position to help.  But with every wet diaper he has a bit of  green stingy stuff.  Mom and dad say that the baby has one really good feed a day where he latches and eats and falls asleep relaxed besides that its a struggle. 
I observed a typical feed today.  Baby latched on beautifully despite being in bad position.  He ate rapidly, suck swallow, suck swallow for about 4 minutes and then began to fuss.  He pulled off and reattached repeatedly.  He extended and raised upper leg - which mother says he does during every feed and takes it as a sign of gas.  Mother took him off and he burped but then continued fussing.  Better positioning made no difference and switching sides didn't help.  He did no better in the clutch hold or lying down.  He was super tensed up.  He eventually calmed down with pacifier in mothers arms and fell asleep.  Mother said that the past two weeks have been the worst and imagined that he hadn't gained any weight nursing like this but has actually gained 475 grams in the past 2 weeks.  
There was no sign of over active MER and compression didn't make a difference - incase the flow was too slow.  Weight gain seems to be indicative of a normal supply - abundant but not too much.  There is no history of food allergies in the family and baby has no rashes or any other symptoms.  The mother seems to eat a healthy well balanced diet.  She doesn't drink/eat a lot of dairy and has no caffeine at all.  When baby was a month old mother took Moxipen for a sinus infection for 10 days.  At 6 weeks post partum, mother started a progesterone only birth control pill.
I advised her to offer small frequent feeds, switching sides the moment before he starts fussing.  She does feed him on a schedule which is very important to her, but won't hold him off if he's obviously hungry.  She's going to try feeding him every 2 hours and more often if he asks.  She will let me know tomorrow how that is working out. 
What could be going on here?  Should we be considering an elimination diet?  Please let me know.
I'm sorry this is so long and I hope not to full of errors, I'm falling asleep writing it (it is almost midnight in this part of the world)  I'm just not as young as I used to be.
Thank you so much for any help,
Good night,
Chayn Fogelman IBCLC Israel

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