Joy,
Thanks
In responce to you ideas

"Re Rob's case of the fussy baby, this has several characteristics of 
a baby with gastro-oesophageal reflux - possibly mostly silent reflux 
(which feels like heartburn): hates to be lying down, particularly to 
feed; squirms and screams at the breast; wants to feed frequently, 
etc. It sounds also like the whole situation has over-stimulated the 
mum's supply"

Reflux is an idea but why did he do better with the formula feeds?
I agree wiht the over supply.
As to his hating to be lied down, maybe reflux but maybe just a human baby.

>Mom is driving herself crazy trying to eliminate multiple foods from her
>diet.
"I wonder if she is doing this well enough, and for each food, long 
enough, etc to give any good clues. If baby is only 3 weeks, then 
there hasn't really been time to determine, for example, whether 
dairy products are a problem. This is further complicated by her 
feeding cow's milk formula to the baby. In fact cow's milk would be 
my first bet here as there have been studies that found a 
relationship between cow's milk protein sensitivity and reflux in a 
high proportion of babies with reflux."

I can agree with the elimination of cows milk from mom's diet but I wouldnt give it more than a week to have an effect. Again why did he do better, or percieved better, with cows milk based formula? 
There is only one article I know of with the CMP reflux link.

"However, as a first step, I would recommend a chiropractic check. 
Neck vertebrae out of alignment can be a major cause of reflux 
symptoms."

Youre not really suggesting a praticing Osteopathic physician refer to a chiroprator are you?
At risk of starting a war, we manipulated first.
 
" And then perhaps pursue the possible food sensitivities, 
and attempt to control the oversupply. This may need more than one 
side per feed, especially if the feeds are frequent - rather try 
using a set time period per side, eg 3 or 4 hours."

I'm going to call mom today based on this and other who agree with the over supply, maybe even have her pump 60 cc of so before feeding then stay single sided.
I'm cautious about the diet elimination without good reason. I think this is teling a mom "Its your milk and you falt b/c of what you ate" for a condition that is self limited.

Rob 
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia.   mailto:[log in to unmask] 
******************************************************************

Rob Cordes, DO, FAAP, FACOP
Wilkes Barre, PA
mailto:[log in to unmask] 

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