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Wow that's a big feeding for a 9 day old. What if you cut the session short but feed her more often? That may help if it's reflux. And I know they all say no pacifier, but I let T have one sometimes because I don't want to be his pacifier! You can just stop giving it if you sense it's causing problems

I think it's over feeding. DS had reflux, but it was never huge puking. He also had a hard time feeding.

I have a similar problem, but the lactation consultant, ped, nurses, and everything I read says you CAN't Overfeed a breastfed baby, to keep on nursing on demand, and not to give her the pacifier. "Baby is sending sinals to establish your supply so continue to giver breast whenever she asks," is what the lactation consultant told me yesterday. I'm at a loss too. She eats and eats and eats, throws up, and wants to eat again. I'm scared to give her the pacifier though, and my finger does not console her in the least. I don't see how they're not overeating!

@78h2o: I would agree on the over feeding. When my son was 9 days old he was probably taking 1.5-2 oz of formula and a lot of people thought THAT was a lot.
I asked my ped and she said "if you over feed him you'll know. He will vomit as opposed to spit up". He only truly vomited once and it happened to be a bigger than usual feeding.

@jetsa: my point is can't they still Overfeed even on the breast!?!

For some babies it's a total myth that they won't overeat. My LO would eat as much breast milk as I would give her and never knew when to stop. It's definitely sounds like your LO is eating more than her stomach can hold.

@dc yoga bee: I think over feeding can happen with breastfeeding too. I think it was my body's fault tho. I know each of my breasts hold a lot of milk and coupled with the fact that I have a forceful letdown, my DD would get too much milk. The spit up and throwing up of milk didn't stop until she was older and could handle the amount of milk/forceful letdown.

@mrskc: @jetsa: I'm just waiting to get to four weeks so I can give her the paci!

My DD did a lot of puking through her nose in the early days and it did seem like a lot of milk every time. If your DD isn't fussy, I would guess its over eating and not reflux. Both of my LOs puked a lot, DD more than DS, and an LC told me to offer a paci right after feeds for like 5 minutes, it worked really well with my son to help keep milk down. My DD hated the paci though, so it didn't work as well with her to help curb puking.

My first thought was FPIES, however it sounds like she is vomiting immediately following a feed. With FPIES the reaction (projectile vomiting) is typically delayed 1-3 hrs after a feed with 2 hrs after being the most common). Is it projectile or just larger quantities? Also our docs always said that baby vomit can look like a lot more than it is because it is thin and spreads.

My DS had FPIES and also really bad reflux. He nursed non-stop and projectile vomited all the time until we figured out what it what and what foods in my diet were causing the issues. I just wanted to mention it, but again based on what you described it doesn't necessarily sound like it.

I would contact the pedi and LC again, but if there is no medical reason for the vomiting it might be something you just have to work through until your supply meets her demand.

I had this very same issue with one of our twins. He bottle feeds and was taking in a lot for a baby his size, right from the beginning. He'd drink a lot, be perfectly happy, and then anywhere from minutes to hours later, projectile vomit huge amounts from his nose and mouth. His brother drank the same amount and while he was a happy spitter, never projectile vomited. I talked to our ped about it and he didn't sound concerned at all, in fact he didn't tell me to do anything different. As he's gotten a bit older it has decreased, although it still happens on occasion. I have just sucked it up as normal for us, and gotten used to the occasional explosion. Both twins are in the 75th and 50th percentiles for weight respectively, so I think they're doing just fine. I am glad to hear that this happens to other people though!

My older daughter puked and it came out her nose several times in the newborn stage. I tried to slow down her feeds just slightly, like right when my milk would let down Id remove her for a second, sometimes I'd even use my manual pump just to take a little of the pressure off. But our pediatrician was unconcerned and said it happens with some babies. It didn't last too long.

@78h2o: I think it's very possible that your Lo is still learning how to regulate her sucking and feeding and the puking was a result of gorging herself! Mother Nature designed new mothers to have abundant / oversupply so that a newborn would still get plenty of milk while learning to feed so great supply combined with a well-feeding newbie can be a recipe for copious amounts of spew.

I don't think there's any harm in offering a paci if she's feeding well and frequently, it could be that she would rather suck, I also wouldn't be too concerned about the spew if LO is otherwise happy and content.

Something you could also try is spilling 1-2 ounces of water on your bench, it can look like a lot more liquid than it actually is!