Great list of possible factors, Pat.  I, too think that GERD has
become the "diagnosis of the day".  Sometimes all it takes is one
spitup and baby is on Mylicon drops or something similar!  Of
course, there are legitimate cases also.  Talked to a mom of a 3
week old who was nursing well for a very short time, then "popping
off" and screaming while seeming to want more.  Milk would still be
readily available and it was long enough after the initial MER that
I didn't think OALD was the most likely culprit.  She also said that
baby seemed miserable as soon as he was laid back in the crib.
We talked about several possibilities, but I also suggested she have
the baby's doc take a look.  Baby had had a couple spit-ups at the
last office visit and the doc told mom if this was an ongoing
problem, she would check it out.  I told mom what she was describing
did have some consistencies with reflux (while telling her that only
the doc could actually diagnose anything like that) and it might be
worth checking out.  This was a ped that I feel very comfortable
with.  I might not have suggested it so readily if it had been the
doc that weems to bput every one of his babies on drops for the
least little whilper.
So yes, we need to look at why the big increase and not jump to the
conclusion that all the cases are really GERD, but not lose sight of
the fact that some cases really are GERD.  As you have said, the
question then is why the increase?

Winnie

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