On Wednesday, Dec 18, 2002, at 06:46 Australia/Perth, Sharon Knorr
wrote:
> I might add that babies with GERD also need extra support while in a
> car seat as the slouched position will often exacerbate the reflux by
> putting extra pressure on the stomach and/or diaphragm.
I can speak from experience on this one - in his capsule, my son Luke
screamed bloody murder all of the time. This abated about 75% when he
started on ranitidine[1], and completely when we switched him to a
rear-facing convertible seat in which he is more upright and his spine
is straighter.
Speaking of reflux, and admittedly this is getting a bit off topic so
feel free to reply by private email - is there an increased risk of
GERD in infants whose parents have severe GERD?
And to get it back on topic - GERD, dietary allergies and mother's milk
- has anyone any _evidence-based_ links on the subject? My patients[2]
ask me about diet and their breast milk all the time, yet the
literature seems to range from "reactions to allergens in MM are
incredibly rare" to "if the baby fusses, you must start an elimination
diet now". I'm coming from the camp that is very reluctant to start
mothers distrusting their own milk, and living a restrictive lifestyle,
without a very good reason; the flow-on effects not just to the mum but
to those around her ("well my friend/sister/workmate had to give up x
and y and z, no way am I going to breastfeed if I have to do that!")
are just too great.
I can't remember who mentioned kinesiology for allergy diagnosis, but
there is no valid science behind it. I'm extremely uncomfortable with
aligning myself with pseudo-science, and I don't think it does the
profession of lactation consulting any favours to be moving in that
direction.
Argh, I've reworded that last paragraph four or five times in an
effort to make it non-flamey, I hope I succeeded! I think the issue of
evidence-based lactation consulting is one worth debating. Example: I'm
on the pumpmoms list, where all new exclusive pumpers are told "you
_absolutely must_ pump at least 8-12 times a day for the first four or
five months without exception, or your supply will never get
established and you won't be able to get enough mm for your child". I
wonder how many moms are put off pumping and switch to formula then and
there due to this advice? There are a number of mums on the list,
myself included, who can drop to pumping five times a day early on and
consistently get well over a litre. I get 1200-1400 ml, and actually
had to back off the pumping a little just to slow down the increase -
there's no milk bank here, and we have limited deep-freeze space.
Lara
[1] It took me several weeks to convince myself that my scrawny
screamer had GERD - "all babies fuss", I thought, and "GER is vastly
overdiagnosed and overtreated in our society", etc. Then I finally sat
down and looked at Orenstein's work, and went "aha". I'd even managed
to ignore the gagging stridorous episodes and the Sandifer's syndrome.
Doctors' kids get the worst care, eh?
[2] Some health care agencies use "clients" here, but I have gone back
to "patients" since a study showed that over 80% of medical consumers
prefer it.
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