Camille just called with the following situation.  Any help or comments would
be appreciated.  Mother breastfeeding 3rd baby; breast fed other children 1
yr and 6 mos respectively.  This baby born 1/17/97; weighed 9# 2oz; at 2 wks
had gained 1#; at 4 month check up (5/16/97) weighed 13# 1 oz.  Breastfeeding
first month to 6 wks went very well.  Did have one yeast infection; both
mother and baby treated with nystatin.  Mother did not eat a lot of dairy
until the baby was 2 months old.  Mother has begun drinking milk and eating
other dairy products, but there are no milk allergies in the family.  Since
mother has been drinking milk she noticed that baby began spitting up more.
A feeding goes like this--breastfeed on 1st breast as long as baby wants,
burp baby, she spits up; breastfeed on 2nd breast, burp, baby spits up.  30
minutes to an hour later the baby vomits.  Mother stopped dairy last Sat.
Meanwhile, ped put baby on propulsid (1.5 ml 3X/day) and zantac (.8 ml
3x/day).  Mother gave baby meds for 1 wk, noticed no improvement and d/c meds
for 3 days; has now started giving meds again (1 day).  Baby is still
spitting up.  Mother describes her let down now as painful when it wasn't
before; nipples are tender with latch when they were not tender before.
Mother and baby asymptomatic for yeast.  Baby has set her own schedule--eats
at 6 am, 10 am, 2 pm, 6 pm, and 9 pm, then sleeps through the night in the
room with her parents.  Baby's spitting and vomitting continue.  Any ideas
out there as to what we may be dealing with?  Is it long time between feeds?
Could it be dairy?  Could it be yeast?  Do propulsid and zantac relate to
yeast infection?  (An aside, I though propulsid had to be given 15 to 30
before meals and that it strengthened the muscle between stomach and
esophagus.  How would one do this with a breastfed baby?  That is, know 15 to
30 minutes before she wanted to eat?)  Any ideas greatly appreciated.  Please
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Thanks!  Keitha :)  (& Camille)