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Personal Consultations: recent case Gina has solved

Gina offers a personal telephone consultation service to parents of young babies and toddlers who are struggling with feeding, sleeping and behavioural problems. Over the last twenty years Gina has helped over 10,000 parents resolve serious sleeping and feeding issues.

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Lily, 16 weeks, feeding difficulties

My daughter Lily is 16 weeks and has been on the routine since the sixth week. We are currently experiencing feeding difficulties after a series of complications due to silent reflux, ear ache, and overactive let down reflex, which have resulted in me having a very low milk supply.

After a couple of months of difficulty breast feeding and disrupted sleeping pattern, Lily was diagnosed with 'silent' reflux at 10 weeks and the paediatrician suggested I thickened feeds by giving a gel made from rice starch before and after feeds. We also changed formula for the 10.30 feed and used an Anti-reflux type. Thickening the feed does not seem to help much and caused constipation, so I have tried giving only one breast per feed and concentrated on positioning (holding up during and after feed, slanted mattress, slanted surface for playing). These all seem to help a lot and reflux crying is now kept at bay.

However, at 12 weeks Lily was vaccinated, then one week later we both got a very bad cold and she stopped eating properly. Since then she also had an ear infection. She was given antibiotics and recovered quickly. Meanwhile I thought my milk supply had gone down a lot, due to Lily not being hungry while ill, so I went to a breast-feeding consultant, who said she thought my supply was fine. She claimed that my problem was an overactive let down reflex, which explained why Lily pulled off the breast and got so upset at feeds. She suggested I tried to feed from the same breast for several feeds. I then wrote to the CLB forum for advice and a couple of mothers have suggested I feed lying down, which I have tried in the morning feed. I also make the feed a very quiet time and dim the lights or cover Lily with a blanket.

However, after noticing Lily's slow weight gain (80-100 grams per week), I have started the plan in the CLB book to help increase it. My supply must be very low since I can hardly express the amounts suggested, which makes me think the consultant was wrong, or at least only partly right. Over the past week Lily has had trouble settling for naps, and in the evening. She only sleeps properly after the 10.30 feed, and I think this is very likely to be due to hunger.

I would like some advice on how to increase my milk supply, if it is possible at this stage. Once the supply improves I would like suggestions on how to structure a feeding routine in order to minimise silent reflux and overactive let-down reflex. I would like to carry on breastfeeding throughout the weaning process, however if it was not possible I would still like some advice on how to structure the day once I have weaned from the breast to the bottle. I would like to solve the feeding problems so that I can correct the sleeping problems due to wrong sleeping associations linked to reflux (holding up asleep after feeds) and low milk supply (feeding near sleep time).


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