Dear Kathy,
I am not clear why this gastrointerologist gave a dx of breast milk allergy.
All I saw in your note was the problem of reflux, slow weight gain, and
fussiness.  Was there anything else?
Reflux can present as slow weight gain and definitely fussiness because the
babies are in pain.  None of this has anything to do with allergies,
especially to mother's milk.

This is the care plan I give parents with babies dx with reflux.  My
reference for this is at work and I'm at home presently.  If you want the
reference please write to me.
-Breastfeeding is preferable over bottle feeding
 -Watch for the baby to show cues they are done and not over feed
-Small frequent feeds are better than large infrequent
-After the feeding, hold the baby upright (so trunk and abdomen are straight)
for 10-20 mins
-Then during the day place the baby prone on a firm surface for 10-20 mins
-During the night elevate the head of the bed by 40 degrees
-Try to avoid placing the baby in a car seat or infant seat right after a
feeding, to wait at least 20 mins
-Babies may need meds
-Last to try thickened feeds (this is especially true for formula feed
babies)

Hope this helps, please give them encouragement and not give up the
breastfeeding because this is the best thing going for this baby.
Over production or over active let-down demonstrates itself with; frequent
engorgement and plug ducts, noisy nurser, frequent spit ups, and baby
coughing, gagging and pulling off the breast for air.
Ann Perry RN, IBCLC
Boston, MA

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