OK all, I have a thought.  (My goodness, they say, she has a thought!).  Bear
with me a moment, 'cuz I want some thoughtful input on this:

As I confessed a few Lactnets back, I've been on the Atkins (high protein, low
carbohydrate) diet for about 9 months.  One of the very best side effects of
the diet was the surprising (and very delightful) NO HEARTBURN/REFLUX!!
Anyone I have talked to that has been on it, even for a short period of time,
has said the same thing -- no heartburn.  No carbo intake, no heartburn.
Hmmmmmm, sez I.....

While I realize that reflux is one of the prices we tend to pay for growing,
um, wiser.... <g>, the fact that it has disappeared completely made me start
thinking about babies -- especially after Barbara Wilson-Clay posted her very
good info on babies who self-limit their intake.

Why do some babies have reflux -- and reflux to the point that they can be in
such pain they self-limit intake -- or have ulcers on the esophagus?
Generally speaking, it starts with a mom who may have a really GOOD milk
supply (not always, but often).  Typical treatments have consisted of
positioning after feeds; attempting to take the baby off the breast more
frequently and burp; giving bottled breastmilk thickened with cereal; giving a
variety of medications.

I think we all know that for most babies, positioning upright after a feed, or
semi-upright, doesn't work for babies with a lot of reflux.  Taking the baby
off the breast frequently is annoying to both the baby and the mother, and
doesn't work all that well either.  Giving EBM with cereal precludes the
breastfeeding, as does switching to formula.  Also, mixing cereal to make a
thicker potion increases the carbohydrates in the milk.  And medications can
have their own set of problems.

I was wondering -- and I truly do not know the answer to this -- is some of
what we are seeing r/t increased carbohydrate intake without a concurrent fat
intake (the old foremilk-hindmilk imbalance?)  Are some babies more sensitive
to carbohydrates?  Would increasing their fat intake help decrease the reflux?
For example, if a mom has a tremendous milk supply, expressing the first bit,
and feeding mostly hind milk (which would decrease volume of intake without
sacrificing calories).  What about giving the baby a few cc of some sort of
fat (if mom has enough milk, there could be some lactoengineering with
siphoning the hind milk off the top); or something else like -- well, olive
oil comes to mind -- I've never seen a baby allergic to an olive, though I
suppose it could happen.  I'm sure there are other sorts of fats that could be
used if this would be helpful.

Thoughts?

Jan B (who just finished wrapping most of the C'mas presents, but hasn't
started shopping for dear Bob yet...)