I need to pick the brains of the smartest people I know when it comes to lactation.

This will be long because I want to be thorough.

I have counselled many moms through the years regarding all the reasons babies spit up even with breast milk.

Now it's my own daughter and something just happened that has me questioning what I think I know!

Background: She is a 26 year old first time mother. She has a history of PCOS and fibrocystic breasts. She was treated with metformin for the PCOS for a few months when first diagnosed 3 years ago with the PCOS. It made her very ill (she had no problem with her blood sugar) so she stopped that. She underwent hormonal infertility treatments for 3 months that also made her feel very sick. She stopped those treatments before moving on to clomid.

She had begun acupuncture treatments as an adjunct to the infertility treatment. She and her husband made the decision to stop all medical intervention and use acupuncture, chinese herbs and the best nutrition possible and see what would happen. 

After several months she began having periods every other month. Before that she had gone 2 years with none at all. Her acupuncturist told her to take a break after a year of the treatments. A few months later they were thrilled to find they had gotten pregnant all on their own.

The pregnancy was completely normal and she delivered at full term after a natural 4 hour labor. Noah was 9lb 4oz and perfectly healthy. Skin to skin and laid back nursing got them off to what looked like the perfect beginning.

He began vomiting after breastfeeding by the end of the first week. She did have a high milk supply but minimal engorgement during the first week. I instructed her on the usual things- deep latch, prone or more upright positions to minimize forceful MER, feed from one breast only (which is Noah's choice to this day) and don't lie him down right away after feedings. 

There was no change in the spit up/vomiting episodes so during the second week I suggested trying to pump for a few minutes before a feeding and see if that made it more comfortable for him. It made things much worse. He vomited violently after that feeding and it was very thick. Didn't try that again.

At 2 weeks Noah stopped breathing while in his mother's arms. It took a couple of minutes to get him breathing normal again but it only took his parents stimulating him. They were of course scared out of their wits and took him to the hospital. After 2 days of testing the conclusion was reflux had irritated his larynx to the point it spasmed. He was put on Zantac and she was advised to begin an elimination diet.

The Zantac made his vomiting worse and that was stopped. She has been diligent about eliminating dairy, soy, caffeine, chocolate, etc. The only last big allergens to take out is wheat and corn but she's running out of things to eat! The diet is helping because Noah is not in pain. She quickly learned about hidden dairy and soy because he would be in pain from what seemed to be the tiniest amount of soy or dairy. He still spits up many times a day and vomits several times a week. But at least he's a "happy spitter" now instead of screaming in pain. He is now 3 months old.

All this brings me to the present. A good friend of hers is struggling with low milk supply. Rather than using formula my daughter offered to pump for her friend's baby. This baby also spits up every time he drinks my daughter's milk. This has been so disheartening for her and I am at a loss. She is on an elimination diet, takes no meds at all, no supplements of any kind, no alcohol, no smoking-she should have the cleanest milk available! This other baby has not had any problems with spit up at all. He has had some formula in the past month also with no problem either.

What is going on here? I have had mothers report to me their babies reflux improved or even resolved with formula. Now I don't know what to think. What can be in a mother's milk that would cause these symptoms?

There is no chance my grandson will be switched to formula, he is thriving in every way except he spits up constantly. But I am at a loss as how to explain this and how to advise my own daughter. Her confidence has been shaken.

It has been said before and it is so true, lactation consultant kids will often be our most complicated cases. Some day I'll share the nightmare of my other grandchild's posterior tongue-tie!

I am confident that the collective wisdom here will lead me to some answers, thank you all in advance.

Christine Young, IBCLC
Sacramento, CA

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome