Welcome to Mommy's Milk : A Breastfeeding Series. Today I have the pleasure of welcoming a guest post from Melissa of Organic Birth on the very hot topic of reflux in breastfed babies.
In many countries worldwide reflux is over diagnosed. Unfortunately parents don’t really have an understanding of what real reflux is and so they medicate or operate before trying to fix the problem holistically. The majority of babies posset, and many of those majority spit up quite a considerable amount.
When does reflux become “gastro-oesophageal reflux disease” (GERD – in the USA oesophageal = esophageal) where it needs to be treated with medication and surgery?
Babies spit up because they have small stomachs and because they have a weak or under-developed gastro-oesophogeal sphincter. As long as baby is happy for the majority of the time, has plenty of wet and soiled diapers and is gaining weight, it is a completely standard expected thing.
It becomes a medical problem when the ‘spit-up’ contains stomach acids, baby doesn’t sleep, the baby is in pain and always inconsolable, arches back and neck (though most babies do this – we look for symptoms that are present for the majority of the time), spits up blood, breathing problems and the baby is not gaining weight at all. Babies who don’t vomit can also have reflux. When GERD is present without vomiting or spitting, it's referred to as silent reflux. Symptoms would be as above.
As mentioned before, most of the time it is normal – but there are situations where one can make it
worse:
- Formula feeding overfills the stomach and is not absorbed as easily as breast milk
- Babies lying on their backs for extended periods of time
- Swallowing air which causes distention
- Teething which causes baby to swallow saliva – its unnatural to have a large amount of saliva in the stomach, therefore baby will vomit it up to get rid of it
- Colds and a runny nose which causes baby to swallow mucous
- Food sensitivity to what mother eats which does follow through into breast milk
- Overabundant milk supply
- Rapid let-down causing baby to swallow lots of air
What can we do to assist in making this a little easier, before we go the medication or surgery route?
- Frequent nursing which ensures small amounts of milk consumed at a time. Science tells us that it takes 1.5 hours for a baby to digest breast milk. So keep your feeding as close to these times as possible to relieve the symptoms of reflux and/or GERD
- Ensure a good latch which minimizes air swallowing
- Skin to skin contact encourages frequent nursing and will calm your baby when it panics from possetting
- Upright nursing and posture for mom
- Baby can also sleep on its stomach during the day if it is going to be SUPERVISED the whole time, this will also sooth the stomach
- Put baby in a baby carrier or a sling but not in a car chair which makes the problem worse because it compresses the digestive tract
- Encourage comfort suckling at the breast
- Eliminate tobacco and caffeine from your diet
- Consider mother to child allergies (cow's milk, wheat etc.)
- DO NOT THICKEN FEEDS! Baby is not ready for solids anytime before 6 months. This is not as harmless as it seems and studies are showing that doing this is causing lung complications in some children. It works in a sense that there is less spitting up, but the baby still has internal reflux (silent reflux)… this will increase the chance of perforating the oesophagus and the pain is terrible for baby.
- Buy and let your baby wear a hazelwood necklace – this reduces acidity within the body
- Antacids (Telement Drops)
- H2 Blockers and PPI (Zantac and Losec)
- Prokinetics (Maxallon)
- Cytoprotective Agents (Alsanice and Gaviscon)
There is no cure for true GERD, though many children grow out of reflux. Medication and surgery only serve to hopefully ease the pain and symptoms.
In conclusion, is spitting up bad? No, God created babies this way. The majority of the time, it’s just a laundry problem!
Melissa Jacobs is a professional doula, holistic women’s health emissary and placenta specialist. Qualifying in 2008 as a doula she has spent the last 5 years being involved and becoming an activist for women’s issues. Her passion is to serve women and families, encouraging them to make informed choices for their children.She attended courses with Rosalia Pihlajasaari, Sally Baker and Maria Sterrenberg (The Village Doula Workshop), and mentored with Sally Baker; Social Worker and Doula. She attended the advanced doula course with Jacky Bloemraad de-Boer; a midwife based in Holland; covering rebozo, moxa,n acupressure, cupping and reflexology. Melissa attended a workshop on Limbic imprinting with Elena Tonetti; Russian Spiritual Midwife. She organised and attended a workshop by MarianneLittlejohn; Cape Town Spiritual Midwife; on the Polyvagal Theory and Rebirthing. She has also completed the Holistic Women's Health Emissary qualification, a course on pregnancy and; post-natal massage, placenta encapsulation and; acupuncture.
Melissa has created and organized various short workshops for aspiring midwives in practical skills and attended various midwifery conferences and breastfeeding workshops, and continues to do so.She has contributed and written articles for various pregnancy and parenting magazines, including Mamas and Papas (South Africa) and Oh Baby! (Canada - French/English).
Melissa offers various services to couples wanting to fall pregnant, pregnant mothers as well as during the birth and postpartum. Including professional doula services, bodywork for women, holistic baby-care classes and placenta encapsulation. Melissa’s company; Organic Birth; has grown into a national presence with Placenta Specialists offering encapsulation in Johannesburg, Durban and Cape Town. Melissa consults from her offices in Westville, KZN. You can contact her on melissa@organicbirth.co.za, 0826014108 or www.organicbirth.co.za
The medical protocol for true GERD is wrong. ANtacids kill the acid in the stomach, whereas GERD is a problem of too little acid in the stomach. GERD can be cured in kids and in adults, by taking a closer look at the diet. In babies, the mother could try to cut out dairy or gluten, or look for other possible allergens or upsetting foods and the baby should be fed smaller meals. If she is breastfeeding, the supply should be considered, if it is a bottle fed baby, smaller, more frequent meas can be a solution.
ReplyDeleteFull disclosure: I am a long time sufferer of GERd and only since I have started treating it naturally have I seen any results. True GERD is horrible. It gives you pains that make you feel like you are dying... so imagine that in a baby
Even in adults true GERD is often underdiagnosed, brushed off as 'psychological' etc...
Hi Laura
ReplyDeleteThank you so much for visiting the blog and for your reply. I am terribly sorry about your long suffering with GERD, I can't even imagine the pain that must be involved. It's absolutely unacceptable that your issues have been dismissed by medical practitioners, but I suppose this is what leads us to seek more holistic treatments.
I absolutely agree that a natural approach to treatment would be the best, unfortunately I do not have any experience with this so I am not able to write about it. Perhaps you can give us further ideas as to natural treatment, specially with regards to diet? Christine and myself are definitely more inclined to recommend natural treatments, therefore my recommendations mentioned above to reflux treatment before Allopathic medication is used.
The medical protocol given above was from a prominent International Board Certified Lactation Consultant at a Breastfeeding Conference, this is what medical practitioners would recommend.
Most medical practitioners do, indeed, prescribe antacids for GERD. Most of them are wrong. ;) They cause a recurring cyclical problem, because they're trying to treat symptoms instead of the underlying cause - as is typical of allopathic medicine.
ReplyDeleteNot likely to be a problem for infants (unless you're using powdered formula), but for adults...check your tap water, too! I was having horrible acid reflux that I was eventually able to link to drinking water. (!) As it turns out, most (even really GOOD) filters don't actually filter out chlorine - they filter out most of chlorine's breakdown products. But some of the breakdown products don't ever get filtered out, and can cause reflux. I would NEVER have thought that!