Hello all,
I was called today by a mother of a two months old baby. For the last month
the baby has several episodes a day of spitting up, coughing, making
choking sounds, breathing fast for a short time, and then recovering. This
happens with no obvious relation to nursing - can happen right after a
nursing, and three hours later, before the next nursing, and in between. It
happens while changing her diaper, while lying in an infant seat - no
obvious trigger. The baby is gaining well (including this last month), is
alert and seems healthy, exept for these choking episodes. The mother
describes them as frightening, and the baby's pediatrician, who saw this
occur, was also quite alarmed, and even sent her to the emergency room. (I
haven't seen the baby.) So far she was prescribed Cisapride and Gaviscon,
with no relief. She also tried eliminating dairy with no constant
improvement (it helped a little at first). One doctor suggested that maybe
the baby is allergic to breastmilk, and why doesn't she try formula for a
few days!!! The mother knows enough to ignore him...
In order to try and diagnose the problem she has been offered to perform a
test where the PH in the esophagus is monitored, and also a radioisotope
scan with radioactive labled milk.
The baby is nursing every 3-4 hrs, usualy from one side, content, gaining
well (as mentoined).
My questiones are: Does this sound like reflux? Do you have any
suggestiones the mother could try? Can EBM used in the isotope scan (can it
be labled)?
I usually like to leave well, happy babies alone, and this baby does sound
fine to me, but I haven't seen the choking happen, and the mother describes
it as frightening. So far the baby has recovered very fast every  time, but
I don't really dare to tell the mother not to do anything.

Mira Leibovich, MD
Kibbutz Hama'apil, Israel