The Reflux Mom's Nursing Guide

Jan Gambino Health Guide

    Nursing a baby with Gastroesophageal Reflux Disease (GERD)? Then you are probably working harder than the average mom. Reflux Moms tell me all the time that nursing a baby with reflux looks like a form of baby wrestling rather than a way to nourish the baby. A mom may adjust her positioning and hold the baby one way only to have the baby pull away from the breast, arch back and scream out. Then another position is tried, the baby latches on and then stops to pull away and spit up. This goes on over and over again causing frustration and exhaustion. 


    Your breast milk is most likely an easy to digest food for your baby and nursing is often a wonderful, soothing activity for your fussy baby. It can be a bit exhausting to be the main source of nourishment and comfort 24/7 for an irritable baby so I have assembled my best ideas for helping you and your baby work together for a successful breastfeeding experience. 

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    • Set the Tone: A young infant may relax and focus on nursing when swaddled snugly in a blanket. An older infant may need a darkened room with fewer distractions (TV, phone).


    • Take care of your needs: You will spend a lot of time nursing so find the most comfortable position for yourself. Check your posture and tension level and find ways to reduce your own stress. Maybe you need some soothing music in your iPOD or a quiet conversation with someone who cares about you. Let others do things for you and take away some of the worries on your giant to-do list.


    • Drink lots of Fluids: If your baby is attached to you night and day, there may be little time to eat and drink properly. Assign someone this important task. Dad or a family member can remind you to drink or better yet, bring you a cup of hot tea. Home alone? Keep a pitcher of water or a water bottle nearby.


    • Eat for two: How can you make healthy meals for yourself when your baby is fussy and attached to you 24/7? Well, you can't but someone else needs to do this. You won't be nursing and soothing forever. It is just for now-I promise. So let someone prepare a meal for you, remind you to take your vitamins and help you read labels if the doctor has recommended eliminating dairy or other items from your diet. Home alone? Keep dishes of healthy snacks nearby: trail mix, nuts, sliced fruit, string cheese and dry cereal are a few foods to try.



    • Check Rate and Flow: Sometimes a strong let down reflex can cause coughing and choking. You might need to express some milk before letting your baby latch on.


    • Minimize air intake: Make sure your baby is nursing quietly. Loud, noisy sucking may indicate that your baby is taking in extra air, a common cause of discomfort.


    • Foremilk/Hindmilk: A baby with reflux may drink a small amount at each feeding or want to nurse frequently. The baby may drink the rich foremilk and not drain the breast to get the hindmilk too. Try to guide your baby toward draining your breast, even if you only offer one breast at each feeding. It is thought that a foremilk/hindmilk in balance causes increased fussiness, a common problem with many babies with reflux.


    • Hold Upright: Your baby may digest better if you hold her upright during a feeding as well as after a meal. Her legs should be extended and not bent.


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    • Rule out other causes of Fussiness: Fussy baby? It is very common for a baby with reflux to experience fussiness and crying but it is not the only cause. Work with the doctor to rule out other common causes of fussiness such as constipation, infection, ear pain, sore throat or a new tooth.


    • Go to Bed: You are probably in a state of exhaustion by the time the sun is coming up then things go downhill from there. Caring for a baby with reflux does that to most moms. I think it is very important to put yourself to bed as often as possible for a half day or a full day of rest. Ask others to take care of you and hand you the baby for feedings. Your milk will be richer and you will feel better. You deserve a break!



    • Pump and Refeed: In rare cases, you might need to pump and refeed your milk(  You might need to measure how much your baby is taking, thicken the milk or see if a sucking/swallowing problem is making feeding difficult. If you need to try a trial of a hypoallergenic formula, you can pump and save your milk to maintain your supply during the formula trial.


    • Call the doctor: It is important to call the doctor if your baby is refusing to nurse, seems to be in pain during or after a feeding, is dehydrated or needs to be sleepy or asleep to nurse. These are worrisome signs that need to be discussed with the doctor.


    So what are your nursing questions? What are your best ideas for nursing a baby with reflux? Post your questions and concerns here.


Published On: October 13, 2009