3mo has more reflux at the breast than at the bottle (pumped milk). Is also more fussy at the breast. Should we take the prescribed reflux meds or could something else be causing it?

Hi everyone,

Babe is 12-weeks-old and has been combo-fed from the start, as I am unfortunately an underproducer. We usually start a feed with nursing and then she is topped up with a bottle (either breastmilk or formula) afterwards. Sometimes, if she is hungry again but I have JUST finished pumping and don't have much supply, she gets a bottle directly. She has a bit of a tongue tie but her ped, the LC, and a dentist have all said a release does not seem necessary.

For the last 3ish weeks, she has been getting really fussy at the breast after about 5-10 minutes. She unlatches, pulls away while crying, arms flailing, wants to relatch again but takes one suck and pulls away again, repeating the cycle. I assumed she was upset because there's such little milk (undersupplier), but when I check by hand expressing, there's usually a (single) spray still available.

The pediatrician thinks baby is getting frustrated at the low flow, but I've also read on here about silent reflux so we started tracking her reflux more closely. Turns out she tends to spit up a lot more (1-3 tbsp worth, uncurdled flow, like condensed milk) after a breastfeed, even if she is burped. She does not throw up like this when she's bottle-fed, even if it's breastmilk; at most, it's a little bit of curdled, yogurt-like spit up after a bottle.

Pediatrician has prescribed Lansoprazole tablets for 2 weeks as a trial. I don't feel like the reflux is THAT bad that she really needs medication, as she is not bothered by the reflux, takes the bottle, is gaining weight, etc.

But - can the meds help with breastfeeding? Or is she frustrated by my lack of flow? Is she taking in more air while breastfeeding compared to the bottle? Anyone have any similar experiences or advice? Would very much appreciate it. 🙏Thank you!