Liane writes of a 4 mo. old baby who yanks and pulls at breast. Dxed  with 
reflux but mother is not consistently giving meds.
 
I have a few thoughts about this. First of all I would have mom start  
giving the reflux meds consistently--if baby is demonstrating discomfort  
secondary to reflux it will take a week or more of consistent meds for baby to  
get any relief.
 
I also wonder if this baby has some sensory integration issues. The babies  
I've worked with with these issues are true wiggle worms, can abuse the 
nipple,  and tend otherwise to be very social. I would have mom try nursing 
baby lying  down in side lying. I'm not sure why this works but I've had 
mothers report  to me that their wiggly, yanking, unfocused babies do much better 
in this  position.
 
I can imagine how frustrating this must be for this mother.
 
And good luck to all who are taking the test. As others have advised put  
the books away, have a good night's rest and remember MOST questions on the 
test  are not ambiguous. 
 
Kathy Boggs, RN, IBCLC
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