In a message dated 98-01-22 16:32:50 EST, you write:

> . For the last month
>  the baby has several episodes a day of spitting up, coughing, making
>  choking sounds, breathing fast for a short time, and then recovering. This
>  happens with no obvious relation to nursing - can happen right after a
>  nursing, and three hours later, before the next nursing, and in between. It
>  happens while changing her diaper, while lying in an infant seat - no
>  obvious trigger. The baby is gaining well (including this last month), is
>  alert and seems healthy, exept for these choking episodes. The mother
>  describes them as frightening, and the baby's pediatrician, who saw this
>  occur, was also quite alarmed, and even sent her to the emergency room

Sheesh, my two year old lost most of my first response.  Thanks, Michael!

Anyway, I am not a doctor nor do I pretend to be one!  <vbg>  My first
question would be:  just how much is the weight gain?  My second child was
born at 8 lbs 10 ozs and was 17 lbs 3 ozs at his two month check up!!!  He was
gaining a lb a week - we were in the pedi's office at least once a week as
well.  I felt just like a nervous first time mom!

The first time he gagged and choked on us was when he was about 1 week old, in
the middle of the night.  Talk about scaring the pants off of mom and dad!
Just about the most frightening sound I have ever heard as a parent - rates
right up there with hearing your children tumble down a flight of stairs!  We
snatched him up - he was sleeping between us - and patted him on his back,
etc.  He then started crying.  He didn't spit up that time but he was a great
spitter until about 9 months of age, continued quite regularly still until
about 12 months and then occasionally still gagged on my milk until I
unexpectedly became pregnant when he was about 18 months old.

The problem was not pyloric stenosis nor reflux.  My pedi was reluctant to
subject him to an upper g.i. as he was gaining so well but one of the backups
ordered one when he was 6 weeks old.  This child would choke, gag, spit, just
about anytime day or night.  It *usually* happened during or after a feeding
but not always.

The problem turned out to be that I have an overactive letdown and an
overabundant supply of milk.  He was choking and gagging even though I was
tandem nursing him along with his older brother, who I swear, was nursing as
much if not more than he was!

It took me awhile to figure out what the problem was.  A few times he would
have green stools (foremilk/hindmilk imbalance) but not often.

If this baby is having enormous weight gain, I would check into a supply
solution.  If she has a lot of milk, then offering one breast for every 2-4
hours (starting at two hours and working up to 3 or 4 hour intervals to
prevent engorgement) might be helpful.  There have been some good articles on
dealing with this in LLL publications.  If they are not on LLLI's website, I
would be happy to scare them up for you and send them to you.

Good luck and I hope this was at least a little helpful!

Barbara Moreda