Fiona,

I don't have anything really profound to say but thought of a few
possibilities.  Does the baby turn her head to one side while she is
nursing?  This would make swallowing more difficult and possibly cause
her to swallow more air.

As for the breath holding, my oldest daughter did that.  It was very
frightening.  Julia was born with a diaphragmatic hernia and would
quickly pass out when she held her breath.  The only thing that really
helped was too keep her in a sling or front pack most of the time.  I
wonder if your client's baby has been traumatized in some way.  This
behavior is not too uncommon in toddlers, but is pretty unusual in
infants.  If a baby does it because of insecurity, babywearing could be
the best thing.  Julia would still hold her breath sometimes when she
wasn't being carried, but it got to be less frequent.  After about six
weeks, she would at least ride in the car seat for a reasonable amount
of time without holding her breath (or gagging until she threw up, which
she also did quite often).

Has she ever tried sleeping in a recliner while holding the baby?  I
have found this useful.  I put pillows under my arms, so I don't have to
hold them up and then I can sleep while the baby is either nursing or
lying on my chest.

I understand the difficulty that this mother is facing.  Mothers of such
babies tend to feel very inadequate, so I hope she will get the
reassurance she needs to get through this.  I think trying eliminating
all foods that may cause problems is worth doing too.

One more thing I would suggest is that this mother try to get some help
with housework, etc., so that she can concentrate on the baby and get as
much rest as is possible.

Best Wishes,
Darillyn Starr