Have you observed a full feed on the breast and a full feed with the
bottle? What is different about the mechanics of what is going on?  Is
there a different flow rate?  Is the baby coping better on the bottle?
Is baby taking the same volume?  How much does mum express in a session?
How long does it take her to get it etc?
How is the latch on the breast compared to the bottle?
Obviously vomiting is reflux as milk is refluxing from the stomach, but
reflux is just a description of a symptom.  If the method of feeding is the
only difference then look at the feeds to see what is different for the
baby.

Carol Smyth
Northern Ireland

Date:    Fri, 22 Jan 2016 17:38:20 -0500
From:    Isabella Mendoza <[log in to unmask]<[log in to unmask]>>
Subject: vomiting after direct feeds but not EBM in bottle

Been a long time since I posted: stumped on this one.
3 month old boy,  mediocre weight gain (not terrible though), has been
spitting up since early on.  He began vomiting breastfed breastmilk at
about a month   Mother is now only bottlefeeding EBM, which the baby
tolerates beautifully, he takes 3oz in 10 minutes or less.  She is really
tired of pumping.  When I suggested a (choke) nipple shield, she said she
had already tried it and that it "tore up" her nipples.

Any thoughts?
Isabella

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