I have been working with a mother of a now 6 week old infant born at 36.5
weeks.gestation. Started off breastfeeding really well. At two weeks infant
was spitting up measurable amounts, maybe 1/2 -1 oz. per feeding.  The thing
that is puzzling me is that this baby does not throw up expressed milk taken
by bottle, even though parents report she guzzles it and can take up to 5 oz.
per feeding. I've watched her breastfeed several times. The last
breastfeeding I observed she clicks, (tongue smacking noises not jaw clicks)
manages flow well, took about 52 ml in first 12 or so minutes and then nursed
for about 20 minutes more. Total intake for that breastfeeding (per test wt.
) was 82 ml. Over the next 1/2 hr she regurgitated about 3 times--estimated
about 2/3 oz.  She then acted frantically hungry and took 30 ml pumped milk
in the bottle.  Baby is on Zantac for reflux--diagnosed just by symptoms, but
parents haven't been giving it really regularly.  My question is: Has anyone
had experience with a baby who throws up only when breastfed but tolerates
even larger quantities of pumped mother's milk by bottle?  Baby, by the way,
is gaining 1.5 oz./day, and otherwise appears to be thriving.

Eagerly awaiting responses so I can share with mom tomorrow.

Kathy Boggs, RN, IBCLC
Mountain View, CA

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