Relux is common in infants, and it is not a big problem for most.  The baby
in the case I shared yesterday did not manifest many signs of reflux disease
other than refusing to eat.  She was bright, developmentally appropriate,
and happy (except when someone was trying to get her to eat.)  She had some
nasal congestion.  At 4 months, when facing up to the FTT was unavoidable
(lots of denial here --- she'd been dropping across percentiles since birth)
the lab tests were negative for organic disease.  Why did I think (from 4
weeks on) that it was reflux?  Basically it was a clinical "hunch."
Although I am very evidence based in my practice, certainly having many
years of experience working with problem feeders gives one a feel for
things.  What I base everything on is my belief that feeding is an enjoyable
process for the normal baby and that excellent growth is the norm for the
breastfeeding infant.  Any departures require consideration as to what could
be the problem that is preventing the baby from this normal experience.
Often, when I see babies who self-limit their intake, severe reflux is part
of the problem.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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