My middle son spit up quite a bit less when bottle-fed my milk instead of nursing directly. He was a near-term infant with very significant reflux causing intermittent episodes of laryngeal irritation/bradycardia/hypoxia. So we had to be pretty aggressive in trying to manage it, and in retrospect, I was in a bit of denial about the association with breastfeeding because we were working SO hard at it. I think there was just something about the unpredictability/variation when breastfeeding as opposed to bottlefeeding that caused him to regurgitate afterwards a lot more. Never had formula, so it was the mechanics involved with nursing vs sucking on a bottle rather than the composition of the milk.
He was finally diagnosed a couple years later with a laryngeal defect that likely accounted for his early difficulties, but he didn't self-wean until he was 5 so I was glad that we stuck it out early on when the reflux was so overwhelmingly bad.
-Sarah Reece-Stremtan M.D.
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