Thanks to everyone that has replied to my questions about a baby that is gassy and possible reflux vomiting. I will be speaking to this mom tomorrow regarding some of your suggestions and follow up with her. My feeling is that baby is doing better because she hasn't called me since our last conversation and suggestions I had given her. This baby is 4 weeks old, gaining weight very well. It was just recently that she has started spitting up and becoming increased after feedings and very fussy every evening and having so much gas. I also questioned dairy and mom is a big milk drinker. She was stopping the milk for a week. She does recline when she feeds her baby which helps some. My question was that the baby seems to spit up more on one side than the other. I will suggest to her about changing positions on the affected side as was suggested by one of you. 
My next question is goats' rue. How do you recommend it's use. Is it topical or ingested? I don't have a sourse to get it yet. Our local food co-op rep will be returning my call tomorrow and will try to find a source for me.
The client I am concerned about is 31 wks. Has a history of PCOS. Not a good breastfeeding experience with first sibling. Also has a history of hypoplasia. Other factors in last pregnancy was delayed feeding. Was supplementing even before discharge. Wants to be successful this time. She attended my breastfeeding class. I have been in touch with her via email and telephone since she found me in the phone book. When she called the hospital she plans to deliver she didn't get a very good response. I have made arrangements to be able to go to her and assist. My first thing was to empower her with information and that a birthing plan to not be separated from baby following delivery that baby breastfeed as soon as possible. My babies in my hospital breastfeed right after being placed on the perineum if possible. We try to make sure it takes place within the first hour after birth and bath and meds are delayed until after the first feed if possible. I have worked long and hard to make this
 happen. My bruises are healing. Ha, Ha funny! 
As usual I await your wealth of knowledge.
Terri Klein RN CLE CLC

		
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