My baby has reflux. Can I still breastfeed him?
In the past several years, there has been a dramatic increase in the number of babies who are being diagnosed with Gastroesophageal Reflux, (GER).
Breastfeeding should continue when the baby has reflux. There are few studies done on method of feeding for babies with reflux; however, breastfed babies with reflux are proven to have less severe reflux at night.
If a diagnosis of GER is new to you:
Gastroesophageal reflux is the return of stomach contents into the esophagus.
Symptoms and complications of GER vary from patient to patient but may include:
Difficulty swallowing, frequent burping or hiccuping, gagging or choking, frequent red or sore throats, poor sleep patterns, sudden or inconsolable crying, severe pain, arching during feeding, frequent spitting up or vomiting, vomiting hours after eating, food refusal or constant eating/drinking, slow weight gain, frequent ear infections, respiratory problems--wheezing, labored breathing, asthma, bronchitis, pneumonia, and apnea.
Please note that overactive let-down (over-abundant milk supply or over-active milk ejection reflex) can sometimes be confused with reflux. You may wish to visit our collection of articles on milk supply issues and read the informative articles on overactive-let down (especially our Oversupply FAQ), in case that is what's happening with your baby. You may share the materials with your health care professional.
When breastfeeding your baby with reflux, it is important to remember basic breastfeeding management comes first. Baby should be getting enough to eat. Baby should be latched on correctly and positioned correctly.
Positioning With Reflux
Position the baby so that gravity can help keep the milk from coming back up.
- Baby may be most happy in an upright position
- Use a sling or front carrier to position the baby at breast level and nurse while standing or walking
- Feed lying down, side by side, with baby elevated on mother's arm
- Try feeding in a recliner or reclining on pillows on a bed. Put baby tummy to tummy with mother, face in to the breast.
The doctor may advise adding cereal to thicken feeds. Although this is not proven effective, many doctors want to try it before prescribing medication.
- This can be done on a trial basis
- Try using expressed breast milk or water instead of formula
- Give cereal by spoon or cup to avoid introducing artificial nipples until breastfeeding has been well established.
Some babies with reflux breastfeed acceptably. They want to nurse and don't overwhelm their mothers with wanting to nurse 24 hours a day.
Other babies with reflux quickly learn that eating causes their pain and then promptly refuse to nurse. These babies may benefit from techniques such as expressing milk to get flowing before putting baby to breast, varying positioning, nursing while baby is sleeping, eliminating distractions, walking while nursing, a warm bath, skin contact, or infant massage. All these can be helpful.
Still other babies with reflux want to eat all the time! The milk acts as a natural antacid and is soothing. However, if the baby overfills his stomach capacity, reflux symptoms can worsen. For this baby it may be helpful to nurse one breast at a time. As the lactating breast never truly empties, the baby will be rewarded with a slower flow of milk that may soothe a burning throat, but not overfill his stomach. Some mothers have reported pacifier use to be helpful for these babies.
It may be tempting to consider another method of feeding for a baby with reflux in hopes that the symptoms will improve. Remember, reflux is a medical condition, not a feeding problem. In most cases, time will improve baby's reflux.
Continuing to breastfeed provides many benefits to the baby and the mother by way of improved health, development, and most importantly, a strong bond that can help get you both through this difficult time.
Resources for additional information
Breastfeeding the Baby with Reflux: Pamphlet that provides information and support for breastfeeding a baby with gastroesophageal reflux (GER). Helps mothers understand why their babies are uncomfortable and what they can do about it. 16 pages.
La Leche League International BREASTFEEDING ANSWER BOOK, by Nancy Mohrbacher and Julie Stock is the LLLI popular resource book that includes up-to-date references, expanded information, and three new chapters. This publication is an indispensable resource for all who counsel breastfeeding mothers. (Hardcover, Spiral-bound, 680 pages)