Reflux Nursing Troubles? Pumping and Re-feeding 12-28-08

Many parents and doctors find that breast milk is easily digested by a baby with Gastroesophageal Reflux Disease (GERD) and Gastroesophageal Reflux (GER). But what if your baby with reflux is having trouble nursing?

Parents sometimes tell me:

“My baby doesn’t like my milk.”
“My baby fusses and pulls away.”
“It takes a long time to nurse and I am not sure he’s getting enough.”
“Others are telling me to switch to formula and stop nursing.”

Some babies have difficulty with the mechanics of nursing such as latching on, maintaining a seal and managing the rapid release of milk during let down. If a baby has Milk Soy Protein Intolerance (MSPI) or food allergies, a food consumed by the mother may make reflux symptoms worse. Remember, it is typical for a newborn or a preterm infant to struggle initially with nursing until she is able to catch on. It can take a few days or a few weeks for a newborn and mom to get in rhythm with each other.

While many babies with reflux thrive on breast feeding, some babies with reflux just can’t manage the mechanics. The milk comes too fast causing choking and crying or a poor seal leads to gas and burping. The first step is to ask an experienced Reflux Mom, lactation specialist or nurse to assist you with positioning yourself and your baby for a successful latch on and feeding. There are many other techniques and hints to learn-see if you can network with other nursing moms for their best ideas. If your baby is still fussy and unable to settle down after a few days or weeks, it might be time to try pumping and re-feeding the breast milk. Using a breast pump to pump and then feed the breast milk in a bottle is a common method of feeding for working moms. This feeding method may be adapted for a baby with reflux and offer another feeding option. The flow of milk can be controlled with a bottle. Further, you can see how much is consumed in a meal. If a thickener is needed, bottle feeding pumped breast milk is possible. Note: Keep in mind that thickened breast milk thickens very rapidly. Mix and feed small amounts of thickened breast milk at a time for the best results.

Like every feeding method, there are pros and cons. Pumping and re-feeding is A LOT of work when your day is already full. A nursing mom must continue to take excellent care of herself (healthy eating, plenty of fluids, sleep) as well as find time to pump and also feed the baby. If a nursing mother is on a restricted diet due to food allergies, it may be necessary to prepare special meals too.

Pumping and re-feeding may offer you and the doctor important information that will assist is planning a successful treatment plan for reflux. On the other hand, you can determine if the milk or the mechanics of breast feeding are causing the problem. If your baby fusses at your breast but takes the same milk just fine in a bottle, perhaps your baby is struggling with the mechanics of nursing and needs special assistance. If she cries and fusses at the milk regardless of the feeding method, eating might be too painful no matter what and other treatments might be considered (positioning, diet, and medication).

A big advantage of this method is you can maintain your supply and resume breast feeding at any time. So many parents and doctors have blamed the breast milk only to find that the baby fusses on breast milk and the 19 most popular formulas on the grocery shelf. It is good to have the option of resuming nursing if you want.

Most of the time, pumping and re-feeding is used for a short period of time. Perhaps a baby is fearful of eating and associates the breast with pain. Often a short break is enough to break the cycle and nursing can resume. Sometimes a doctor needs more information on the cause of a feeding problem and or feeding data such as how many ounces consumed and the effect of a thickened diet.

I know a few moms who have successfully nourished their babies for weeks or months using this method. It certainly puts a greater burden on a mom who is already taking care of the endless needs of a baby with reflux. Most moms tell me they are willing to take on the extra work needed if there is a decreased need for medication, testing or tube feeding. I admire these moms who must endure the extra work and stress to nourish their babies. I hope doctors, spouses and grandparents realize the extra work involved and offer support and assistance.