How much is he gaining? If it's more than about 2 lb a month, there might be oversupply/overfeeding happening. What were the results of pre/post feed weights? This is the sort of situation where this information is invaluable. This would allow you to figure out whether the baby seems miserable as the flow increases or as it decreases. Is the nasal congestion present all the time, or does it increase as the feeding progresses? The latter is a sign of microaspiration occuring, and would be a sign that the baby is not coordinating swallowing and breathing well. One common reason for difficulty coordinating swallowing and breathing is tongue tie, another is laryngomalacia or tracheomalacia. Constant congestion is more likely to be associated with allergy. A physician friend feels that swallowing issues resulting from tongue tie might possibly set up a dysrhythmicity along the entire digestive tract, increasing the risk of reflux and other gi issues. There is at least one case report of reflux in an adult resolving after lingual frenulum release. Some suggestions: Allow baby to feed until he seems fussy, then end the feeding and comfort the baby. When he makes any feeding cues, allow him to feed again. If he feeds frequently, let him use one breast several times before switching (once he learns to take the other breast). Make sure mom does not hold baby's head at the breast, let him feel in control so he can let go whenever he wants. Mom can support his shoulders. Try prone positioning (mom reclining, baby laying on mom's chest) to help baby have a microsecond longer to handle a bolus of milk for swallowing. Give the elimination diet a week or so to work, usually there is marked improvement within a few days of eliminating something baby is allergic to. In very severe cases of allergy that can't be traced to something mom is eating, elemental formula for a week or so can sometimes allow the gut to heal and baby to go back to breastfeeding. This would be my last resort personally, but has worked for several of my clients. Catherine Watson Genna, IBCLC NYC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [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(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html