In the discussion of what causes reflux, I seem to remember reading sometime ago about a prospective ultrasound study where large numbers of infants were ultrasounded at birth with no evidence of pyloric stenosis, but percentage ultrasounded later had developed. Common thread was exposure to cow's milk. Recent cases: I have had babies diagnosed with reflux on Tagamet and Propulsid or other meds. Mom with decreased milk supply. When pumping used to improve supply, latch improved and mom stopped ALL dairy, reflux stopped. Mom still using meds thinks: "The meds are now working." Mom has macaroni and cheese for dinner. 6 hours later, baby starts the vomiting, stays up all night with misery. Mom now BELIEVES it was the dairy. Maybe we can get the baby off the drugs. This is not my first case to have success. And the results seem to be nearly immediate. I think there are two (or three) prongs to this approach. First, fix the latch. Second, make sure mom has good milk supply using pump if necessary to help improve. Third, stop ALL dairy. Any one solution may not be enough. Many times I have been sent kids with reflux who are 7-8 weeks with mom's supply seriously compromised and using lots of formula. Sometimes it's impossible to get the supply up enough to fix all the problems. What really gets me aggaravated is when a patient calls early with symptoms suggesting problems in the offing who needs help with the latch. When I ask her to call her pediatrician for a referral, he (sometimes she, but not often) will tell her everything's fine, don't worry. Only if the mother is very persistent about wanting to breastfeed and continues with problems and opts not to formula-feed do I see her. And by then we have low milk supply. Why don't doctors read Hartmann's work? Or anything about the physiology of supply and demand? A lot that I know think it's all in a woman's head. If she wants to breastfeed, she will. If she has problems, well ,she didn't really want to do it in the first place and to suggest anything else is to cause her unnecessary guilt since we all KNOW that formula is just as good! ARRGH! Thanks for the vent Jane Kershaw mailto: [log in to unmask]