In the discussion of what causes reflux, I seem to remember reading sometime
ago about a prospective ultrasound study where large numbers of infants were
ultrasounded at birth with no evidence of pyloric stenosis, but percentage
ultrasounded later had developed.  Common thread was exposure to cow's milk.
 Recent cases: I have had babies diagnosed with reflux on Tagamet and
Propulsid or other meds.  Mom with decreased milk supply.  When pumping used
to improve supply, latch improved and mom stopped ALL dairy, reflux stopped.
 Mom still using meds thinks: "The meds are now working."  Mom has macaroni
and cheese for dinner.  6 hours later, baby starts the vomiting, stays up all
night with misery.  Mom now BELIEVES it was the dairy.  Maybe we can get the
baby off the drugs.  This is not my first case to have success.  And the
results seem to be nearly immediate.  I think there are two (or three) prongs
to this approach.  First, fix the latch.  Second, make sure mom has good milk
supply using pump if necessary to help improve.  Third, stop ALL dairy.  Any
one solution may not be enough.  Many times I have been sent kids with reflux
who are 7-8 weeks with mom's supply seriously compromised and using lots of
formula.  Sometimes it's impossible to get the supply up enough to fix all
the problems.
What really gets me aggaravated is when a patient calls early with symptoms
suggesting problems in the offing who needs help with the latch.  When I ask
her to call her pediatrician for a referral, he (sometimes she, but not
often) will tell her everything's fine, don't worry.  Only if the mother is
very persistent about wanting to breastfeed and continues with problems and
opts not to formula-feed do I see her.  And by then we have low milk supply.
 Why don't doctors read Hartmann's work?  Or anything about the physiology of
supply and demand?  A lot that I know think it's all in a woman's head.  If
she wants to breastfeed, she will.  If she has problems, well ,she didn't
really want to do it in the first place and to suggest anything else is to
cause her unnecessary guilt since we all KNOW that formula is just as good!
 ARRGH!
Thanks for the vent
Jane Kershaw
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