My baby & Reflux

Signs and Symptoms

  • Spitting up during or shortly after feedings

  • Sounding congested after feeds

  • Sharp movements (i.e. kicking legs, flailing arms)

  • Pulling away from bottle or breast during feeds and gulping

  • Sputtering milk out of mouth

  • Breast refusal

  • Choking during feedings

Causes

  • Infrequent burping (you DO need to burp a breastfed baby)

  • If bottle feeding: Nipple flow could be too high (i.e. 0 flow for newborns)

  • If breastfeeding: Over active letdown could play a part

  • Placing infant in crib or bassinet directly after feedings

  • Overfeeding (bottle, you can’t over breastfeed)

Now that we know the signs and potential causes, Let’s talk about the remedy.

Remedies

  • Paced Bottle Feeding - Find more here on how to pace those bottle for your babe, which can help with feeding more appropriate amounts, decrease reflux, and assist infant in developing their breathe/suck/swallow patterns needed for nutritive feedings.

  • Elevated Side Lying - This is a different position which can be helpful for infants who are preterm (<34 weeks), late preterm (<37 weeks) or infants with tone issues (hypotonia/hypertonia) and special needs. Find more pics and info on this position here.

  • Frequent Burping (Before, During and After Feedings) - Let me just say, you can not over-burp your baby. During the first few days of life our babes can retain a high amount of amniotic fluids causing gassiness, bloating and a sensation of fullness. Burping before, during and after feedings at that stage of life can be super helpful. It can also be helpful in the coming weeks while our babes are developing GI tract maturity. Here is a helpful resource on burping.

  • Slower Flow Nipple - Using an appropriate nipple flow means that our infant will receive an appropriate amount of intake. Every bottle is different but every nipple is labeled with NB or newborn or “0” for 0 flow/newborn. If you’re struggling to find the marking, message me and we can find it together!

  • Keeping Infant Upright After Feeds - (i.e. in stroller, bouncer, car seat) can help with reflux. Just like with us, lying down soon after a meal can cause reflux and indigestion. A good rule of thumb, is keeping them elevated for 10-15 minutes after a feed.

  • Warming Formula and/or Expressed Milk (cold liquid can cause gas) - Some infants will take a bottle at any temp, however most will want it warmed, like when it comes from “the tap”. Breastmilk is lukewarm straight from the tap, so mimicking this temperature in a bottle is always best. If you’ve been offering cold bottles and you see a increase in gas or GI distress, try warming it.

  • Feeding in Laid-Back Breastfeeding Position - This position is exactly what it sounds like, you lay back and then latch your baby. Think about reclined positioning, not all the way prone. This position can help gravity and your infant latch in a natural position and also alleviate the rate of letdown which can sometimes cause choking, sputtering and reflux.