• 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.

• 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!

• Lactation Consultant: A baby with ongoing feeding issues may present special challenges. A lactation consultant (http://www.healthcentral.com/acid-reflux/c/96/87260/consultant) with reflux experience can be very helpful.

• Pump and Refeed: In rare cases, you might need to pump and refeed your milk(http://www.healthcentral.com/acid-reflux/c/96/53704/nursing-troubles).  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.