Actually, what I think I said is that I've always noticed that babies
rarely spit up while they are on the breast.  Even the rare one that
does still usually spits up once taken off the breast.  Therefore, with
the breastfed baby, we should look carefully before we take the advice
the pediatrician would give for the formula fed baby--give small
frequent feedings.  Besides the fact that this may result in a hungry or
fussy baby, it does not work.

I asked a pediatric gastroenterologist in Melbourne (forgot his name)
why this should be--that the spitting up should occur usually only after
the baby goes off the breast.  Though there is no evidence in normal
children, he said that it had been shown in some situations, that as
long as the baby is sucking, there are small ripple like waves in the
esophagus towards the stomach which may prevent regurgitation.

So, no studies.  But a better approach, I think, and one I think helps,
is:  allow the baby to fall asleep on the first breast, allowing as much
non nutritive sucking as he'll do, during which time reflux may not
occur, and, at the same time, the stomach is being emptied (exactly what
the cisapride is supposed to be doing).

Jack Newman, MD, FRCPC