Thanks for your comments. Feedback from the mother today (three days since I saw her) is that feeding the baby for at least 20 minutes on the first breast (instead of allowing him to pop off after five and call that a meal) has resulted in a much more contented baby. Plus he slept six hours last night for the first time - parents are ecstatic. Posture feeding (uphill) worked for five minutes and then mother reported that baby screamed .Possibly the fast flow he was used to (and was choking on) had slowed down too much. I suggested she gradually sit upright at this point. I do have the Woolridge article and I think this case is less about reflux (baby is not vomiting) and more about oversupply and diet. I'll let you know further outcome later this week. Beverley Rae MSW CSW IBCLC in New York