I would lay most of the blame for this situation on the Ezzos' warped ideas about how to care for human young.  Someone who is following that book will have expected the baby to cry more than what a lot of us would consider acceptable, so when the mother describes the problem as sudden in onset after about 3 months, it may be because by that time even someone following BabyWise would have to acknowledge that the child is not happy, whereas some of us may have seen the crisis coming weeks before.  

That said, good for the mother (!!!) for deciding to abandon a strategy that isn't working, and try something else.

My hunch is there is no reflux going on either.  I have seen one child whose parents used BabyWise who was hospitalized at the parents' insistence, to investigate her refusal to feed.  She was several months old and thriving, just a sparkling, lively, roly-poly, curious, gorgeous kid whose parents were frantic because she declined to feed for ten minutes at each breast, every three hours.  Their increasingly desperate efforts to get her to feed whether or not she was hungry, and possibly their failure to feed her when she showed signs of hunger outside of the scheduled times, led to a complete strike that looked outwardly a lot like what is described in the current case.  While the baby's unhappiness could be physical pain, it could also be emotional, and it's pretty typical for that distress to be shown when in close contact to the mother.  In the case I am thinking of it was a lot harder to get the parents to wean themselves from BabyWise than it was to convince the child to come back to the breast.

In my experience a lot of 'low supply' cases around 3 months are simply the natural consequence of not responding consistently and diligently to hunger cues.  The baby will be OK for a while because it takes some weeks for hormonal control of supply to give way to mechanical control, and a lot of mothers have transient oversupply in the beginning.  Then, as the baby grows, or tries to, its discontent increases gradually over several weeks.  At first the gap between supply and need are not so great, but with each week of not letting the baby regulate supply by simply feeding spontaneously and on cue, the gap between what the baby needs and what the mother produces, gets bigger and bigger until finally the baby really has to get the message across loud and clear.  Another argument in favor of this explanation in the current case is that it doesn't make sense that a reflux problem would get worse as supply goes down.  

Of course I am seeing all this from my viewpoint, which is that BabyWise is very destructive and certainly not based on love of children.  But I would start with the simplest measures and only pursue all the other things, like reflux or need for CST, if the problem shows no sign of resolution.

This baby is young enough that they have really good odds at turning it around, and a good old fashioned babymoon (lounging around in close bodily contact with the baby and feeding at every opportunity) would be my best recommendation on how to do that.  I would worry less about how much the baby is getting, and concentrate on making the baby *happy*.  When the baby notices that feeds are on his terms he will probably be much more content to feed, and it will let the mother discover for herself what she and the baby were missing out on before.  She may be able to drop the pumping soon too, if the baby is willing to pitch in.

It may be necessary to do some improvised crisis psychiatry with the mother if she realizes how off base BabyWise is, and blames herself for actually trying to follow what appeared to be legitimate advice in a book sold in mainstream bookstores all over the world.  Keep it in mind, because the last thing she needs is to feel guilty.  She should be praised for seeing her baby's unhappiness and wanting to do something about it.

Please let the list know how this goes, if you can.
Rachel Myr
still amazed at how many ways we have to complicate something that really ought to be simple, in 
Kristiansand, Norway

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