"
Date:    Fri, 22 Jan 2016 17:38:20 -0500From:    Isabella Mendoza <[log in to unmask]>Subject: vomiting after direct feeds but not EBM in bottle
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"
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I've encountered this a couple or so times.  The first time, I was an intern, and the mother had leaky gut and a fast flow.  I sometimes go back and think about this case.  Was the leaky gut--or the medications she took for it--causing the fast flow?  Perhaps her milk flow was faster than the bottle flow?  So, was the baby drinking too much too fast when breastfeeding but not when bottle feeding?  It's a conundrum, but I think the answers--in this case, anyway--are 'yes.'  
Maybe your client's nipple shield was the wrong size?  
I also had a client who was supplementing with formula, and then a cousin sent her some of her milk.  Her baby could drink her milk or formula without a problem, but would spit up after her cousin's milk.  This cousin was also donating milk to a milk bank, so I wonder how the babies who drank her milk tolerated it.  I this case, I was guessing it was something the cousin was eating that the baby couldn't tolerate.  
Julie Tardos, who has a purple finger nail from dying my daughter's hair with a small hole in the glove

===="I asked a librarian if she had a book on Pavlov's dog and Schroedinger's cat. She said it 'rang a bell, but she was not sure if it was there or not.'"
 

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