Jessica Billowitz wrote:
>   Now, the past week, baby has been often miserable at breast. She 
>begins to eat, then fusses, pulls, turns, and eventually unlatches 
>and then refuses to go back on.  The feed that I observed, in this 
>time she had eaten 22 cc, and that was it.  After that, the mom 
>pumped and she took another 60cc happily from the bottle.  Sometimes 
>a feed will go better, but it is totally random, and most feeds are 
>miserable.  It does not seem allergy related because she takes the 
>milk by bottle with no problem.

Jessica, I would not be too quick to dismiss allergy issues - baby 
still has reflux, no?

I always remember a lecture I attended some years ago by a doctor who 
works in a children's hearing centre, treating many children with 
otitis media. She showed a video of a baby refusing to breastfeed, 
and it looked all too familiar to me as a breastfeeding counsellor. 
She explained that these babies have allergy issues and have 
Eustachian tube irritation - like a precursor to otitis media, and 
that it hurts them to lie down and feed in the breastfeeding 
position. When the mother in the video gave the baby a bottle of her 
milk, the baby took it fine - but was being held more upright for 
bottle-feeding. The doctor pointed this out as the difference. Also, 
the baby started to associate pain with breastfeeding so would not 
even try.

She mentioned that some doctors can do a tympanogram on a baby - 
non-invasive test of their ears - to detect this irritation, but I 
understand that it is not a commonly used test at a GP surgery in 
Australia.

Other options for this sort of problem combination (ie including the 
reflux) would be to investigate structural issues arising from the 
birth or before, ie chiropractic or osteopathy. I usually ask how the 
baby was born, whether there was any pulling by the head, etc to get 
an idea of the likely risk of this sort of cause.
-- 
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Australian Breastfeeding Association counsellor, Nutrition student
Perth, Western Australia.   mailto:[log in to unmask]
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