Speaking of hanging upside down...which positions have you tried to burp her? I have found that for most of the babies I work with, the typical sit-em-up-brace-chin-with-one-hand-burp-with-other doesn't usually work. Instead, I've had remarkable luck (and if you don't believe me, look in this forum back to my own thread entitled 'Newbie can't burp her babies!' or something to that effect...rofl..) with two positions: Over the shoulder- very high on the shoulder so that my actual shoulder is sitting right into their stomach (the upper body is sort of laying over my back) and on my knee (again, with their tummy situated squarely over the highest point in my knee-thigh area). The pressure has forced out some mighty burps! Also, sometimes just tilting the baby will allow the gas out when it becomes trapped down there...I tilt gently forwards and backwards a couple of times. Be careful with preemies, though- tilting can increase ICP and contribute to cranial hemmorrhage. Tilt just a bit, just enough to let the gas bubbles move out. Lastly, I use gentle massage over the stomach, very very light pressure, in circular motions, when I absolutely cannot get them to burp. This works about half of the time. After all this, if they still won't burp, I will roll them or sit them up. Some babies won't burp because they don't take in a lot of air- there's nothing to burp up. However, if she's throwing up frequently, you're right that there may be another problem. You know, some kids have an association problem- their response to invasive tubes, etc. is to vomit. I was just reading about this the other day. She may have an aversion to feeding, which I think is something OT could work with her on. I had a baby with pyloric stenosis, and NICUGal is right..they puke A LOT. A lot a lot a lot. Could it be the formula? Perhaps she needs something more gentle, like Pregestimil or Neocate? Could it be the nipple? Hole too big allowing too much down at once? It could be a lot of things! What about reflux? Have they done a pneumogram yet? Let us know what happens! Good luck!