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.

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