Isabella wrote: 

Been a long time since I posted: stumped on this one. 
3 month old boy, mediocre weight gain (not terrible though), has been spitting up since early on. He began vomiting breastfed breastmilk at about a month Mother is now only bottlefeeding EBM, which the baby tolerates beautifully, he takes 3oz in 10 minutes or less. She is really tired of pumping. When I suggested a (choke) nipple shield, she said she had already tried it and that it "tore up" her nipples. 

Any thoughts? 
Isabella 

I'm wondering if it is a case of a mother with a large supply and very strong milk release where the baby is gulping large amounts of air. I have seen great improvement when the mother either leans back so baby is above the breast, letting gravity slow things down, or has the baby in a more sitting position facing into the breast, sometimes even straddling the thigh, which would also let gravity work to slow the flow. This is often accompanied by nursing from one side only. I suspect that the bottle flow is slower than mother's forceful milk release and that she may even be holding baby in a more sitting position than when she nurses. This would also elevate his mouth higher than his tummy and result in the bottle being almost horizontal, which would also slow the flow. 

Keep us posted!! 

Cindy Garrison BS IBCLC 
practicing in Pittsburgh PA 

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