Breastfeeding

(My thoughts and experience about breastfeeding a baby with gastric reflux.)

Gem was my third child, but the first with diagnosed treated severe GORD.  I breastfed my first two children until age 14 months, and because of the risk of allergies in my family didn’t give them food that contained cow’s milk until they were one years old.

With Gem, breastfeeding was initially easy. She fed well, gained weight and was contented. By three weeks of age she started screaming after feeds and arching her back. She would have been happy to feed again, but this would have only made her pain worse, so I would persist with her screaming for at least an hour.

As time went by breastfeeding got harder rather than easier. However, even with the difficulties, I found there were many advantages to breastfeeding. If you are struggling, you are not alone.  Breastfeeding is not always easy.

These are some of the things that we experienced:

  • Choking while breastfeeding resulting in her pulling off the breast and needing to be held upright so she could clear her airway.  My milk continued to flow everywhere because I was too busy dealing with the choking!

  • Screaming while feeding.

  • Having to take frequent breaks from breastfeeding during most feeds.

  • Not being able to relax and watch television while breastfeeding, let alone hear it!

  • Not being able to breastfeed and do anything else at the same time e.g. read.

  • Not being able to breastfeed anywhere I wanted, like I had with the other two, due to breastfeeding a wriggly uncomfortable baby not being discreet or quiet.

  • Arching her back, making breastfeeding most uncomfortable.

  • Taking all products with cow’s milk out of my diet and after 10 days of this having a totally different child!

  • Dealing with other people’s need to feed me when we visited, and me not being able to eat it because I was on a dairy free diet.  This was more of a problem for them than me.

  • Dealing with other’s comments that “a little cow’s milk won’t hurt”, when I knew from experience it did.

  • The resulting nipple confusion because we had used bottles to give the Infant Gaviscon.

  • Not being able to feed in bed at night, due to her need to be upright, the likelihood of the bed being soaked, and the noise after or during a feed.

  • Wondering what had upset her that I had eaten.

  • At her worst when I had tried cow’s milk she was only able to breastfeed in the morning, and the rest of the day refused to feed for more than a minute at a time, and sat on the floor and grizzled due to hunger. At this time I had to supplement her with formula recommended by our paediatrician after a day or she would have dehydrated, and had to continue this until the cow’s milk was out of my breast milk (for us this would take 10 days).

  • It took seven days of me having dairy before she showed a reaction, and this was confusing. Somebody from GRASP (probably Rochelle) explained to me that this was possible/likely because cow’s milk seems to have an accumulative effect in breast milk.

  • Feeling guilty because I had mostly weaned her onto “safe” formula at 11 months but tried to retain night feeds thinking that the little dairy she would be getting in my milk wouldn’t be a problem, but not knowing if it was when she became unsettled.

  • Needing to feed in a quiet room without distractions.

So after reading that list I guess you are wondering if there are any positives. There are and these are the one’s I can still think of three years down the track:

  • Breast milk is easier to digest than formula, and therefore the stomach is emptied quicker and results in less reflux occuring.

  • Breastfeeding is cheap, especially when half of it gets wasted.

  • Breast milk contains antibodies and therefore helps prevent babies becoming unwell. With a baby with reflux this is doubly important as any illness can cause reflux to worsen.

  • Breastfeeding in the middle of the night in the lounge during winter with the fire going, the lights dimmed and the radio on quietly. If you have the right attitude this can be a special time.

  • Spilled breast milk smells less than formula.

  • Breast milk is especially designed for human infants, and has everything they need.

  • Breast milk requires no preparation. Preparing formula and getting it the right temperature while a baby screams isn’t much fun.

  • I felt no guilt in buying special things for me to eat while breastfeeding and on a dairy free diet. Although soy ice creams, soy milk, “safe cheese” and many other products are expensive I would have spent far more on formula if bottle-feeding.

  • A dairy free diet is a good way to loose that excess pregnancy weight – I should go on one again.

  • Breastfeeding creates a special bond between infant and mother.

  • Breastfeeding means you have to hold and be close to an infant that may not seem particularly lovable due to their screaming and/or messiness.

  • Breastfeeding can be a great comforter to the distressed infant.

  • I found expressing milk for the times I wasn’t around much easier than with the other two children, and I think this was due to an extra supply I had, to cope with the extra demand at times.

Some other things I have learnt about breastfeeding an infant and particularly one with reflux that are important include the following:

  • It may be best to only feed on one side each feed, giving the baby less breast milk in volume and more hind milk.

  • It may be best to not have feeds too close together as this can increase pain. One recommendation is three hours from the beginning of one feed to the beginning of the next, but you need to be guided by your baby’s growth and your health professional’s advice – and of course the volume they have at each feed.

  • Some parents think (or are advised to by health professionals) that they should stop breastfeeding from the breast, and feed expressed milk in a bottle so that they can thicken it with cereal. This can lead to a decrease in milk supply and an exhausted mother who not only has to prepare bottles and feed the baby, but express the milk also. This doesn’t leave much other time in a day. Breast milk is just as effectively thickened by feeding a little cereal (preferably rice – check the ingredients as some brands of rice cereals, contains milk products) from a spoon, before, during or after a breastfeed. The cereal can be mixed until smooth and runny with some cooled boiled water, expressed breast milk or formula. In some countries parents are using oatmeal to thicken feeds. This is not recommended in New Zealand, as it contains gluten and may contribute to an intolerance/allergy later in life if given at a young age. Intolerance to gluten may also increase reflux pain.  Discuss thickeners with your Health Professional (doctor, Well Child Provider or dietician).

  • About one third of all babies with reflux will have a cow’s milk allergy or intolerance, and this can affect them through their mother’s breast milk.

  • Reflux occurs roughly equally between breastfed babies and bottle-fed babies. Changing from breast to bottle will not generally improve the problem.

  • The infant with reflux does not dislike their mother, or their mother’s milk!

  • You don’t need to wean……. however many times your relatives and friends tell you it would be best.

  • Look after yourself. Remember that you are important. If you are not happy and healthy, your family will not be happy either. If breastfeeding really is making you miserable don’t feel guilty about giving up, but do think about it long and hard first.

LLL also have a booklet entitled “Breastfeeding the baby with reflux”(L015 – $6). Available in New Zealand by contacting mailto:lllnz@clear.net.nz

Written by Roslyn Ballantyne (RN), National Coordinator for © Crying Over Spilt Milk Gastric Reflux Support Network New Zealand for Parents of Infants and Children Charitable Trust 14/11/2003. Edited March 2015.

This page may be printed for the personal use of families, as long as the copyright and source (i.e. Crying Over Spilt Milk’s URL) is also printed. It may not be copied to other websites or publications without permission.

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  • Hi there, my daughter has been on omeprozole granules (5mg, twice daily) since 6 weeks old. I've talked to our GP about how and when to wean, his advice was to go cold turkey "whenever we felt like it"..!

    I'm looking for some advice from other families on how they went about weaning - Would like to take a gentle path.
    Are there signs of readiness?
    What age did you start?
    Did you drop one dose and see if there was any effect before fully weaning?
    Or is cold turkey the right thing to do, after all?

    Thanks.

  • Hi all,
    Does anyone know if its okay to mix kiwiherb stuff with losec to mask the taste if you stick to the correct dosages? Eg .5ml each of kids calm, echinature, and chest syrup mixed with 3.8ml of losec?

  • 10 day old baby showing signs of reflux already. Similar to his brother (who is now 22months).
    He has the "breath that smells like stomach acid", looks like he's got a bad taste in his mouth, the "cottage cheese" spit up at times and obviously a very sore tummy after feeds.
    I am babywearing to keep him upright which is helping.

    I suppose what I'm asking is at what point do I go to gp and ask for a paed referral? My husband says don't go looking for trouble until it becomes a much more obvious issue.

  • Can anyone in the Wellington area recommend a good doctor with an understanding of allergies/ intolerances? I'm convinced our doctor doesn't get it! My poor bubba needs a formula top up and is intolerant to diary protein and soy. The doctor wants to start solids but he is only 4 months, I want to leave it until 6 as there is a family history of food intolerances.

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  • I have a 11 month old who will be 1 in a weeks times who has silent reflux. Gaviscon seems to work for him at them moment however I am looking at reducing the number of bottles he has a day. I was therefore wondering if anyone had any ideas on how to get the gaviscon in to as he current has four doses a day?

  • I have an 18 month old with silent reflux. It seems to flare up dramatically when she is teething. She can wake up to 10 times in a night! I am still breastfeeding and although this is good for her as it helps to comfort her I get very little sleep. I co-sleep so I at least can doze while she's latched. When the reflux is at its worst she gets very angry and lashes out, often banging her head on the ground. It's heartbreaking to watch and when she is in that state she doesn't want to be cuddled. I'm finding it so emotionally challenging as she is generally a happy, giggly, cheeky little girl in between times.
    She was so bad last week I was in full meltdown mode.
    She has had this since birth, I've always had a dairy free diet and from about 6 weeks old I took out dairy,soy, added probiotics and started her at the osteopath also. This helped heaps and at one point she was sleeping 6 hour stints at night. Then at 12weeks old it came back and has never left and I would say the last couple of months is the worst it's ever been. I've upped the probiotics and added other probiotic foods and am taking out acidic foods as much as possible. She has been a little better the last 3 days so hoping she'll keep improving.
    Has anyone had good results with osteo or similar at this age? I'm wondering if it's worth trying that again.
    I also want to know if people have had success with medications because I read forums online and it seems like only approximately(total estimation)
    2/10 people will write that it really helped them so I don't want to pump her full of things if there's not a good chance of it even working. What are your experiences?
    Help! And thanks in advance 😊

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  • Hi There I am looking for support for a toddler with reflux. She had terrible silent reflux as a baby and then we thought she had grown out of it by 1ish. Then she has been rediagnosed with it age 2 years one month - after countless ENT problems (She has grommets and has had her tonsils and adenoids removed) and constant constipation. The medication is starting to kick in but she is so upset and so angry all the time (also partly because she is a toddler). Any tips people have to soothe her and help her not be afraid of sleeping/ lying down much appreciated, We are also considering reintroducing her dummy as it worked so well last time, but are conflicted about wether it is a terrible idea or not.Thanks

  • For those dealing with a silent refluxer, what are the symptoms you've noticed? We've been treating my 9 month old for this but never had much success which makes me second guess if that's what the problem is :/ she wakes within an hour of going down at night (if we get her down!), won't settle until around midnight, sleep during the day is never guaranteed and now since starting solids she wakes very frequently dumb the night with what looks like either sore tummy or wind pain. Sound like anyone else's baby?

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  • Hi Team. My now 3month old has been on Losec for quite sometime now and we had a different chemist make up the liquid and it looked different to out usual dose. Well he now seems like he is back to that child he was before we started on it. I have been back to the old chemist to get it better batch...how long will it take to kick back in,if it has gone out of his system? Cheers. Very exhausted mum

  • Emma has asked a question.

  • Can anyone help us? We have an almost 8 month old she's on Pepti jr, omeprazole and gaviscon. The last 2 weeks have been not very fun for us. She goes off to sleep nicely at 6.30-7 then ban at 9.30-10 inconsolable crying. Her reflux through the day is also much worse. We give losec in the morning and gaviscon with her bottle before bed but not at other feeds because it made her constipated. She's not interested in crawling and rolling anymore because she gets a lot of acid coming up and just wants to stand all the time. She is on a variety of solids is there anything I shouldn't give her because it makes reflux worse? We thought about taking out citrus peaches and apricots?? Too make everything so much more fun she is teething just got her first tooth yesterday ... Any advice much appreciated we would just like some sleep :-(

  • We have a question from Sara now too.

  • Hi there! Im just wondering if anyone has gone down the line of bubs having to have an endoscopy and pH probe study because of reflux lasting too long? My bubs is 15 months and still on high doses of reflux meds and she gets so bad when we try to wean them down. Her Paediatrician has referred us for an Endoscopy +/- pH probe. Has anyone had this? If so, what was the outcome and did it even change their management? Thanks!

  • Hi everyone, Brylee has asked a question. Have a look at the posts to the page. Thanks for sharing your experiences in advance.

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