Dear Ann,
Heard a talk on reflux lately and will share some with your case.
The cause of the reflux is what I would look for, but I'm not sure I would
start with mom's diet.
With a wt gain of 4# in 6 wks, I wonder if this reflux is brought on by an
excessive amt of milk. Were the stools always yellow and seedy or any signs
of green and frothy? Did the baby make loud swallowing sounds, almost
gasping? Did mom note excessive filling of her breast between fdgs?
If these are present I would look to decrease mom's supply, same side
feedings for up to 4 in a row. Express sm amts from unused side, but not
empting. I have found that if this is the case that babies tol fdgs much
better when they are side-lying. The trick is to have baby's head level with
their hips, then the milk tends to pool in their check before hitting the
back of their throat. The worst postion to brfd these babies is the football
hold, where the milk comes too quickly for them to handle. I have the moms
use cushions to elevate the baby's hip while using a cradle hold.
After a fdg the baby is held upright with torso kept straight (best in
partent's arms) for 20-30 min then to lie the baby prone, better if on a firm
surface where the head can be sl elevated. There are reflux wedges that are
sold.
For meds did they try something like Maalox or the gastric meds ( can't think
of them right now - sorry)?  They may want to try them again along with these
other measures.
Good luck.
Ann Perry RN IBCLC
Boston, Mass

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