>Baby is 3 Mths old and has been diagnosed with GERD, she is under a Paed ( who wants the baby to go onto formula) and is on medication( Losec)Mum had a very strong let-down reflex initially, baby battled to cope with it, so she expressed for a few minutes and then fed her which improved things. But baby keeps arching, crying and pulling away after fixing and does this throughout the feed.<

Penny, I wonder if this mother has tried (or would consider trying)
block feeding?
It sounds to me as if this might be a case of too much milk coming too
fast for the baby to handle, something which is often misdiagnosed as
GERD because the symptoms are similar.

Block feeding entails having the mother nurse the baby as often as the
baby wants, but keeping to the same breast for a block of time. This
is one time when you DO watch the clock - but only to switch breasts.

Start by assigning the baby to breast A for three hours, then breast B
for thee next three hours, back to breast A for three hours, and so
on. If there is no improvement after about four days, lengthen the
time between breast-switching. While many mothers find that four or
five hour blocks works for them, others may need to go six or eight
hours, or even longer.

Less milk is made because milk is removed less frequently - supply and
demand. That is why it is important to wait a few days before changing
 the number of hours between feeding at each breast.  If the *unused*
breast becomes too full, the mother can express or pump just enough
milk from it to relieve her discomfort.

Here are some articles which may be helpful:

GERD and the Breastfed Baby
http://www.llli.org/llleaderweb/LV/LVFebMar03p12.html

Am I making too much milk?
http://www.llli.org/FAQ/oversupply.html

Overactive Let-Down: Consequences and Treatments
http://www.llli.org/llleaderweb/LV/LVSepOct95p71.html

Hope this helps!

Norma Ritter, IBCLC, RLC
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