Hi Rob, Thanks for your comments about my comments. ;-) >"Re Rob's case of the fussy baby, this has several characteristics of >a baby with gastro-oesophageal reflux - possibly mostly silent reflux >(which feels like heartburn): hates to be lying down, particularly to >feed; squirms and screams at the breast; wants to feed frequently, >etc. It sounds also like the whole situation has over-stimulated the >mum's supply" > >Reflux is an idea but why did he do better with the formula feeds? If the baby was held in a more upright position to bottle-feed, he may have less trouble with pain while feeding (if he has silent reflux). I think your original post mentioned that the baby did better with bottle-feeding EBM as well, so this would be consistent. >I agree wiht the over supply. >As to his hating to be lied down, maybe reflux but maybe just a human baby. True. I suppose I assumed that this may become evident even if still being held, eg cries when laid horizontal on mum's lap but OK when held vertical. > >>Mom is driving herself crazy trying to eliminate multiple foods from her >>diet. >"I wonder if she is doing this well enough, and for each food, long >enough, etc to give any good clues. If baby is only 3 weeks, then >there hasn't really been time to determine, for example, whether >dairy products are a problem. This is further complicated by her >feeding cow's milk formula to the baby. In fact cow's milk would be >my first bet here as there have been studies that found a >relationship between cow's milk protein sensitivity and reflux in a >high proportion of babies with reflux." > >I can agree with the elimination of cows milk from mom's diet but I >wouldnt give it more than a week to have an effect. Some of the anecdotal reports (I think from Lactnet in the past) indicated that for some people it may take up to 3 weeks to clear a mother's system, although many others say they see in a difference much sooner than this. > Again why did he do better, or percieved better, with cows milk >based formula? Short-term, I think you often see a baby settle well from a big feed of formula, just because it is like a big lump in their stomach that takes a couple of hours to digest. Sort of zonks them out, bit like we feel after a big Christmas dinner (actually probably more like your Thanksgiving dinner - you know, turkey and all that stuff). If it was casein-based (most modern formulas are whey-based, so this may not apply here), there is a further aspect that casein is digested down to morphine-like peptides that further zonk the baby out. Peter Hartmann talks about this and points out that a popular casein-based formula here in Australia has been advertised as good for 'hard-to-settle' babies. That's because of the caseinomorphins (spelling may be out!). Makes sense when you think about *what* the cow's milk was originally designed for - to keep the calf quiet and asleep, hiding in the grass, while mother cow goes off to graze for a few hours. Not very applicable to human babies, though! >There is only one article I know of with the CMP reflux link. The ones in my database are: Iacono G et al, 1996, Gastroesophageal reflux and cow's milk allergy in infants: a prospective study. J Allergy Clin Immunol 97:822-27 Cavataio F et al, 1996, Clinical and pH-metric characteristics of gastro-oesophageal reflux secondary to cow's milk protein allergy. Arch Dis Child 75: 51-56 Hill DJ & Hosking CS, 1997, Emerging disease profiles in infants and young children with food allergy, Pediatr Allergy Immunol 8 (suppl 10): 21-26 I haven't gone back to check exactly what they say - just used my key words to find them. > >"However, as a first step, I would recommend a chiropractic check. >Neck vertebrae out of alignment can be a major cause of reflux >symptoms." > >Youre not really suggesting a praticing Osteopathic physician refer >to a chiroprator are you? >At risk of starting a war, we manipulated first. Oh sorry, I hadn't realised the ramifications of what I wrote. Blame it on ignorance! I don't think we have osteopathic physicians in Australia (or not many, if we do). It would sound like an oxymoron to most Australians, unfortunately. We have nearly all conventional medical doctors *plus* chiropractors, with few of other types of practitioners. Conventional doctors hardly ever communicate or refer to chiropractors (political 'enemies' as I understand it), so it can get tricky sometimes. I really still don't understand how all the different disciplines and types of practice work in the US. Please accept my humble apologies. > >" And then perhaps pursue the possible food sensitivities, >and attempt to control the oversupply. This may need more than one >side per feed, especially if the feeds are frequent - rather try >using a set time period per side, eg 3 or 4 hours." > >I'm going to call mom today based on this and other who agree with >the over supply, maybe even have her pump 60 cc of so before feeding >then stay single sided. >I'm cautious about the diet elimination without good reason. I think >this is teling a mom "Its your milk and you falt b/c of what you >ate" for a condition that is self limited. Certainly I agree that it is best to try the simple things first - controlling the oversupply. However, in my experience, I find that it is useful for the mum to think about *why* the oversupply has occurred to this extent, and it *may* be diet-related, it may be birth-experience related or may be neither of these. Some mothers are so paranoid about 'not enough milk' (often pushed by others around them) that they go overboard in stimulating a supply to the extent that is becomes an oversupply. I am usually counselling the mothers as a voluntary Breastfeeding Counsellor on the phone, or as a private practice LC, and may only ever have one conversation with that particular mother, so I tend to be focussed on trying to get the mother to consider all the most likely possibilities, so she can go away and work out for herself what may be impacting her and her baby to create the distress. If the mother thinks it may be diet-related, I strongly encourage her to seek professional help with any elimination diet. I hope this clarifies some of my comments, which I must admit I tried to make very brief on Lactnet. ****************************************************************** Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC Nursing Mothers' Association of Australia Breastfeeding Counsellor Perth, Western Australia. mailto:[log in to unmask] ****************************************************************** *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html