Have you tried prone feeding, or baby straddling mom's thigh and sitting 
up? This does sound like either a swallowing problem or an undiagnosed 
issue in the airway - laryngeal clefts are one possibility. Some babies 
can tolerate flow better if we try these positions while they get seen 
by speech/occupational therapy and otolaryngologist.

Catherine Watson Genna BS, IBCLC  NYC  www.cwgenna.com

On 8/6/2019 1:43 AM, Jessica Billowitz wrote:
> Thank you to those who replied.
>
> There is no over supply issue.  Don't forget this is a 15 week old baby with
> no suck problems that I can see- so that is normal if she was effectively
> sucking and swallowing.
>
> Laurie, when you mentioned the 45 minute feeds, I meant only because of the
> breast refusal it takes forever to get her to eat, not that it takes 45
> minutes for her to remove milk.
>
> The only thing I can think of is some sort of swallowing disorder which
> causes her to not be bothered when she is sleeping and her muscles are
> relaxed.  I do not think it makes sense for there to be a small cleft
> because when she finally eats she does so effectively.  There was absolutely
> no choking or stress when she finally ate!  Stools are normal yellow, not
> runny mucousy or green.  She cannot block feed because it could be hours
> till the baby finally eats!  And I don't think this has anything to do with
> milk.  The clue is that the trouble started in the hospital.
>
> I referred her to an ENT to check structure, etc and see if she sees
> anything.  I am not very optimistic.
>
> Thanks again for any input
>
> Jessica Billowitz, IBCLC
>
> Israel
>
>
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