I just returned from a FP conference where there was a pediatric gastroenterologist from a large Nebraska border town that surrounds Carter Lake who spoke about GE reflux in kids. I noted that he omitted to talk about incidence and characteristics of the infants at risk for this at the start of the lecture and when he got to the treatment talk about the lecture, I could contain myself no longer. He was covering the part of his lecture when he said, "Some doctors feel that 'thickening' the feedings will help the problem. Mind you breastfeeding was not mentioned once up till this point. So I raised my hand and naively and somewhat sarcastically asked, "How to you thicken Breast milk?" He was momentarily stunned by the question, and stammered out a reply that of course you can't and that "we really do encourage the mother to BF because that is better." He then followed with the observation that "some kids actually do better on Similac rather than BM because the Similac curdles in the infants stomach more and 'sets' there better so that it is less likely to be refluxed". I am quoting him as best as I can remember. I latter came up to him after his lecture to tell him that I hope I didn't give him too hard of a time. (Actually I think he needed it, but it was polite to offer this peace offering.) I then asked him, "You know you really didn't tell me what the ratio was of formula feed infants to breast fed infants was in your reflux clinic? Can you give me an estimate? His reply; "Basically everybody we see in the reflux clinic is formula fed." Another example of a medical professional who is really ignorant of the true inherent risks of BMS (Breast Milk Substitutes). If he really wants to do his job as a doctor he should be as concerned about helping his colleges convince the mothers to BF as he his with his technical skill of endoscopy and his medical management of those with reflux. This analogy is like the doctors of the 40's and 50's solely focusing their treatment of polio on the proper use of iron lungs and forgetting about the use of vaccine to prevent the disease in the first place. He needs to try and work him self out of a job, something he probably is not likely to do. Jon Ahrendsen MD FAAFP Clarion, Iowa If you have figured out the thinly veiled description of the town where this Dr. was from and would like to visit with me more (especially if you are from that area), please email me privately.