to be upset by what the paediatrician said?

[frakyouveryverymuch]

I took DS (3 weeks) to the paediatrician today because I suspect he has silent reflux. I know I'm not a doctor but I also know his levels of distress aren't normal for babies and he's got most reflux symptoms bar the projectile vomiting.

Apparently because he is gaining weight he can't have reflux. TBH I'm sceptical about that because I think he's sucking for comfort, and therefore getting milk, because he's refusing a dummy - but why would he have silicone when he can have a mummy-dummy! When I said we'd tried a dummy (against my preferences but if it helps, it helps) and that he was feeding frequently but only taking small amounts she told me that I'm causing his reflux by 'giving in' to frequent feeds, I have to wait at least 2,5 hours between feeds and 'if he cries, he cries', and I have to make him get used to a dummy.

Now I'm not one to whip out a boob when DS squeaks. I check to seee whether he's hot/cold/needs changing/etc unless it's been ages since the last feed and he can go up to 4 hours at night without waking for a feed but during the afternoon evening he can cluster feed for ages and daytime feeds are more like every 2 hours.

She might have a point but AIBU to be upset by the way she said it? Please be honest because if I am BU or oversensitive we'll keep her as our paed - she comes recommended by friends (who have quite different parenting styles admittedly) - but if I'm not I want to find a new one before DS's next scheduleed checkup.

Setting time limits to how long it takes to reach the hindmilk is incorrect, as this will vary depending on how long/how recently the baby last fed, the storage capacity of the breasts etc.

How long breasts take to fill will also vary as storage capacity varies.

Colic and Reflux are also different things, and some babies may or may not grow out of Reflux.

This article might clear up some confusion www.analyticalarmadillo.co.uk/2010/07/foremilkhindmilk-and-lot-of-confusion.html

It's also not necessary to ensure a baby stays on the breast for a certain about of time to get to the hindmilk, or to limit the baby to one breast per feed.

Hindmilk is not released after a certain duration of feed.

As Kellymom says: "moms's milk gradually increases in fat content until the end of the feeding."

The timing of this change is dependent upon the interval since the last feed, as the longer the interval the more time the milk has had to stand and separate.

None of us has attacked you, we have been quite polite. I'm not going to turn this into a fight over who has more bfing experience, but, on top of our own experiences, many of us have a lot of experience supporting bfing mothers in RL as well as on MN.

Frakyou, you may like to report yourOP to MNHQ (linky on the coloured header bar above every post) and ask them to move this thread to the breast and bottle-feeding topic.

You will be inundated with support .

DS had reflux when little too. As both a mum and a medic (not paediatrician though) I would say that if the reflux is minor to moderate, rather than moderate to severe, it probably isn't helpful to you or to baby by having great worries and arguments about whether there is or isn't underlying reflux. I wasn't at the consultation, but I am guessing that possibly your paediatrician might have meant that it wasn't a severe enough case of reflux to warrant drastic intervention.
That said, a lot of infant reflux goes undiagnosed, because 1) the doctor isn't there to observe it when it happens, 2) you can't exactly ask the baby how he feels, and symptoms of reflux could look like other things. We didn't use a dummy to treat it, but we did have infant Gaviscon (worked very well) and we did things like elevating the head of the cot (either by propping it up, putting a book underneath the base of the cot, or by making the bed with some folded linen underneath the sheet, so it's sloping but not using a pillow). Our baby didn't want a dummy (always spat it out).
As regards feeds, babies with reflux get hungry too and so of course will suckle and get milk, but as they get full or reflux quickly, they then won't take any more milk or at least not much. Hence that's why some put on some weight. The right thing to do which you are doing, is feeding frequently, as it gives baby enough chances to get some calories and protein in before the symptoms take hold.
We had one GP who was said to be the most experienced in babies' and child health but who was really condescending and unhelpful to parents - he was of the belief that nothing should be treated unless the child was almost at death's door! While that is good for some things, it isn't really a helpful approach generally. We switched to a different GP and later also saw his more junior colleague and both were completely brilliant and very helpful. If you are not getting on with this doctor, by all means go see a different one - no need to beat yourself up about who is right or wrong, if the dr-patient relationship is not working.
In the meantime, infant gaviscon (you can request your GP to prescribe it) will do no harm for your baby whether he has reflux or not, and will possibly help a great deal. I would wait for a more certain diagnosis (or more severe reflux) before pressing for domperidone, which has more potential side effects than gaviscon.
Hope your DS gets better and feels better v soon.

Time limits are subjective.
TYPICALLY, it does take two hours for your breast to fill to the previous capacity. I never said you should strictly wait to feed baby. TYPICALLY, on demand feeding will occur every two hours baring growth spurts.

Storage capacity also depends on demands of infant. Feeding for longer, more often WILL produce more milk. Trust me, once you experience the feeling of engorement, you will never forget it!

From the website you just gave - 'When baby is feeding she will let you know she has finished with that side by either falling asleep, or pulling away from the breast. This is likely to take roughly 10-20 minutes.'
Umm...didn't I say ''The hindmilk is typically released only after 10 minutes or so of feeding.'

Yes, colic and reflux are different things.....both based on the digestive tract/stomach and they TYPICALLY resolve themselves after 3 months.

Notice I keep saying TYPICALLY? No hard and fast rules.

Also, notice how I am not 'wrong' about what I said. (Since the conversation was led in a 'I'm right, your not' direction)

I'm not at all confused, but again, where exactly am I wrong?

Angel, I think you are fundamentally wrong that hindmilk is released after X minutes. But I also see no point in arguing about this.

PS. Yes, DS also preferred being upright. Cried a lot when put down flat unless he was sound asleep. Preferred to go around (esp after feeds) leaning on my shoulder in the burping position. (didn't use a sling because I had the feeling of a sling around me but I am sure that works well for many). Another symptom of probably reflux - babies preferring to be upright (or nearly upright), so the acid doesn't come back up (their muscles to hold the stomach acid contents down are weaker than grownups').
IMO I don't see anything wrong with feeding a baby very frequently if that is what baby seems to be wanting, despite what the baby experts or nannies say. Other than inconvenience to the mother.
Feeding a baby frequently doesn't harm them and might even be the one way to help them thrive better. There is now a trend among researchers that doesn't believe in the foremilk/hindmilk stuff in relation to the timescale (beginning or end) of the feed; eg if the baby stops feeding abruptly, the hind milk doesn't "drip" back into the depths of the other like it liquids would in a bottle! It is now believed it stays there till baby starts the next feed, during which baby will get some hindmilk at the start too, which is of course very logical. It is of course shown that there is more fatty milk ("hind" milk) later on in the secretion of the glands, but the glands are not a machine - you can't turn the different cells on and off like you do the cycles on a dishwasher; there will be fore- and hind-milk throughout the feed, though in variable amounts. Don't be led by some posts here into stressing yourself about where and what percentage of milk/fat/protein your baby is getting like many first time mums (me included) do - just feed your baby when you feel he's asking for one and he'll thrive.

Typo: "depths of the mother, like liquids would in a bottle", (line 3 of paragraph 3). Sorry - temperamental laptop.

DD had silent reflux that took a long time to be officially diagnosed and lasted until her first birthday.

She never wavered from the 91st centile.

Infant gaviscon ha little effect but ranitidine was brilliant.

Getting her diagnosis was a tough slog, and I had a lot of idiotic "oh she's

And I second the sling recommendation - perfect for refluxy babies.

www.babies.sutterhealth.org/breastfeeding/bf_production.html

'Hind-milk
Hind-milk is released after several minutes of nursing. It is similar in texture to cream and has the highest concentration of fat. The hind-milk has a relaxing effect on your baby. Hind-milk helps your baby feel satisfied and gain weight. Feed your baby until you see a sleepy, satisfied look on your baby?s face.'

To be fair, I would have to do some deeper research to give you a better answer to how long (about) it does take. i.e. medical journals, etc. However it is widely known that it takes 'several minutes'.

What is several minutes? My Dr. told me ABOUT 10 minutes. Also,I pumped my breasts quite vigorously to have milk for DH to feed with and when I did, guess how long it took for that lovely pale milk to start to cream up? ABOUT 10 minutes.

Also, babies CAN feed from only one breast at a time. I did it as to make sure my DC were getting all of hindmilk. And what do mothers of twins do?

en.wikipedia.org/wiki/Breastfeeding#Latching_on.2C_feeding_and_positioning

'When tandem breastfeeding, the mother is unable to move the baby from one breast to another and comfort can be more of an issue. As tandem breastfeeding brings extra strain to the arms, especially as the babies grow, many mothers of twins recommend the use of more supporting pillows.'

No I am not going to argue about it, but I am not going to be told I am 'misinforming' people.

My friends little boy had reflux and the paed recommended they use this instead of lying the baby flat.

"Well guys, in the end what matters is that the baby breastfeeds for as long as possible"

Er, no. The most important thing is that proper reflux is treated and that MAY mean totally milk free formula. In severe cases the oesophageal tract can become so enslaved the baby has to go onto an NG tube because they just can't/won't swallow.

"Well guys, in the end what matters is that the baby breastfeeds for as long as possible"

I said this in reference to the percentage of breastfeeding mothers (36%) that make it to 6 months. I wasn't even talking about reflux there. Sorry if I confused you.

"Storage capacity also depends on demands of infant. Feeding for longer, more often WILL produce more milk. Trust me, once you experience the feeling of engorement, you will never forget it!"

How patronising. When feed after feed after feed cones straight back out, sometimes it's impossible for the breasts to catch up.

And reflux DOESN'T typically resolve in 3 months. That's colic. Paediatric GERD (reflux) typically takes up to a YEAR to fully resolve.
I note you say you didn't have any problems breastfeeding. Good for you. Me neither, actually, with my first child - 13 months - but reflux is a totally different ballgame."trust me."

BAG - I am not an expert of reflux. I was talking about breastfeeding in general. I was supporting my arguement with Rita. I think two threads were going at the same time, one about reflux and one about the generalities of breastmilk.
I'm sorry you see my post as patronizing, it wasn't meant that way but is what I am saying there untrue? Of course you couldn't keep up with your DC if they wanted a feed all the time, that is an excetptional case.
For the bog-average breastfeeder, this is generally the case.

Angel, you have it wrong about hindmilk and it being 'released' - sorry. This misunderstanding can be very misleading to mothers when it comes to everyday breastfeeding :(

How on earth did women breastfeed before mumsnet?

colic? try colief.

Tiktok -
As the baby breastfeeds, the foremilk is consumed until the hindmilk (i.e. basically just the foremilk with more fat in it) is then take your pick of next verb -> (consumed - released - moves towards nipple).

www.kellymom.com/bf/supply/foremilk-hindmilk.html

A woman's breast really only makes one type of milk, the higher-fat milk that we typically think of as hindmilk. As milk is produced in the breast, the fat globules in the milk tend to stick to each other and to the walls of the alveoli (where the milk is made). Between feedings, milk collects in mom's breasts and gradually moves out toward the nipple, leaving more and more of the fat "stuck" further back in the milk ducts. The more time between feedings, the lower the fat content of the foremilk available to baby at the beginning of the feeding.

Sqee- I do wonder how I managed to be completely misinformed by every health professional I have come in contact with, and the experience of both of my own children whom I breastfeed for a 9 month period each......kinda glad I didn't do mumsnet back, I would be soooo confused!

Angel, I don't think there were two threads merged here, I think you have diverted a very important one about reflux into a general one about breastfeeding, which with the greatest respect, has been done to death.

Anyone else have bottles attached to their chest or is it just AngelD? Last time I looked I had breasts.

Got to say I'm ROFL at someone trying to fight TikTok with Wiki! Definitely a popcorn moment!

My first ever post in this thread began with 'I've not read all of the thread so forgive me but.....there is some truth to what the dr. said. Frequent, short, episodes of breastfeeding do not allow the baby to get the hindmilk. The foremilk can cause tummy upsets, which is what it sounds like your DS is getting a lot of (due to comfort feeding).'
Sorry if I wanted to voice my opinion......

"I've not read all of the thread"

And therein lies at least some of the problem. It's not a thread about breastfeeding, or a bloody upset tummy or hindmilk, or kellymom or wiki.

You voiced Wiki's opinion and tried to argue it with TikTok. Classic. Are you new?