Fiona, I don't have anything really profound to say but thought of a few possibilities. Does the baby turn her head to one side while she is nursing? This would make swallowing more difficult and possibly cause her to swallow more air. As for the breath holding, my oldest daughter did that. It was very frightening. Julia was born with a diaphragmatic hernia and would quickly pass out when she held her breath. The only thing that really helped was too keep her in a sling or front pack most of the time. I wonder if your client's baby has been traumatized in some way. This behavior is not too uncommon in toddlers, but is pretty unusual in infants. If a baby does it because of insecurity, babywearing could be the best thing. Julia would still hold her breath sometimes when she wasn't being carried, but it got to be less frequent. After about six weeks, she would at least ride in the car seat for a reasonable amount of time without holding her breath (or gagging until she threw up, which she also did quite often). Has she ever tried sleeping in a recliner while holding the baby? I have found this useful. I put pillows under my arms, so I don't have to hold them up and then I can sleep while the baby is either nursing or lying on my chest. I understand the difficulty that this mother is facing. Mothers of such babies tend to feel very inadequate, so I hope she will get the reassurance she needs to get through this. I think trying eliminating all foods that may cause problems is worth doing too. One more thing I would suggest is that this mother try to get some help with housework, etc., so that she can concentrate on the baby and get as much rest as is possible. Best Wishes, Darillyn Starr