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Subject:
From:
Elien Rouw <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 23 Jul 2003 13:57:29 +0200
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Dear Lactnetters,
Although I am mostly lurking, I now also want to contribute to the
internation opinions on this subject. I am a Dutch MD, living and working in
Germany in a small private practice for babys and toddlers. I am active in
the AFS, one of the german breastfeeding counsellor groups, and I regularly
teach hospital staff about breastfeeding.
In my practice I seldom see babies with the symptoms you describe, Pat. It
is more like Rachel sees the situation in Norway. I think however, it is
really a hard diagnosis to make. Many of the children here wo cry a lot in
the pattern you describe, are diagnosed "KISS-syndrom", which is a
disturbance in the Atlas joint in the neck of the children. Both of these
diagnosis seem to me partly a cultural diagnosis for the same phenomenon. I
think some children really have GERD, and some children have really
KISS-syndrom, but in the one society too much children are diagnosed with
GERD and in the other society (with the same symptoms) too many children are
diagnosed with KISS-syndrom.
For me it is not clear from the discussion, if the children are crying after
every feed (also at night). Of course some children have periods where they
cry. Here this is mostly called "colics". I think that one of the
contributing factors is the uncertainty of the parents, especcially on
breastfeeding. The mother breastfeeds already with the expectation, that the
child will cry afterwards. Often she waits too long, and the child is so
hectic in breastfeeding, that it seems to me it cannot cope with  all the
milk. One of the things I find works out best is to tell the parents about
the development of babies, the importance of frequent feedings, the
importance of carrying the child and most and for all a certain relaxation
with the mothers. I am generally very cautious with drugs for babies. After
all it is a central working drug, and here in Germany it is seldom used. But
perhaps American children are different?
Many greetings to all of you
Elien Rouw, MD, Bühl, Germany (from the food of the Black Forrest).

Pat Gima wrote
Thank you, Rachel, for the international perspective.

Spitting up is not a major issue with GER, even though some babies with GER
do spit up, or attempt to, in their struggle to ease their pain. Actually
they do a lot of swallowing to prevent the stomach contents from entering
the esophagus. The symptom that sets GER apart is the severe pain.  These
babies are in agony for a long time after eating, so much so that some of
them decide that they will no longer eat since that is the "cause" of their
pain that grows in intensity.

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