I saw a 15 week old with a history of reflux being followed by a gastroenterologist currently on 
12mg of Prilosec still spitting up and uncomfortable during feed.  This baby began sleeping 
through the night 3 nights ago, goes 12 hours without a feed, feeding q3-4 hours, 4 feeds a day. 
There was a question of over supply with the reflux symptoms 2-3 weeks back, mom assessed 
yield and reports getting 3-4 ounces per breast. Now with sleeping through the night mom 
pumped 8ounces off one breast while the infant fed and emptied the other at first AM feed. Mom 
says the rest of the feeds are inconsistant as the baby is a bit uncomfortable pulling off breast at 
times when she does not feel emptied mom will pump after a feed and get 2 ounces at times.
  Weight gain is great birth weight 7# 1oz, today 15#2oz, up from 14#6oz 11 days ago. I 
suggested trying to fit in another feed during the day, pump post feed if not emptied and 
pumping at bedtime for mom, 4 hours after baby's last feed to keep supply.

Any suggestions?
Joan, APRN

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