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Reduction of Symptoms

You may unintentionally be exacerbating your baby’s condition. You can make some small changes immediately. Since it is most likely that your baby is chronically crying, you may tend to overfeed thinking your baby is hungry. The presence of vomiting may also lead you to assume your baby is hungry sooner. However, the chronic crying is most likely due to pain caused by reflux and overfeeding your child will contribute to the condition. Yes, infants may overfeed. Observe your infant and consider the following changes.

Positioning

Your baby must remain vertical for a half hour after each feeding with no stimulation (both light and noise). If it is too difficult to hold your baby, then you should maintain a 30-40 degree angle which is ideally found in your baby’s car seat. Preferably, use a left lateral position if side lying and/ or on a wedge for elevation as well. Prone position has been indicated to reduce reflux in some babies and there is a reflux wedge/sling to sleep inclined while on stomach. The sling must be used along with heart rate monitor. The reason for the monitor is safety. There is an increase in vomiting with infant reflux. The S.I.D.S research promotes back lying positions to prevent infants from choking. Recent findings also indicate that fans in the room have decreased the rate of S.I.D.S. Another suggestion is to incline the changing table with a wedge. Finally, when soothing your infant, lean back at a 40 degree angle with baby on his /her stomach and against your chest. This is the optimum position for your baby.

Dr. Sears “Coping with Infant Reflux and Feedings”

Pace Feedings

Change to small frequent feedings i.e. 2 oz every two hours for formula. Breast feeding will tend to be 1-3 hours and extremely demanding. It is difficult to get a dry burp so burp your baby frequently, change his/her position, return to burping 5-10 minutes later. Rub his/her back rather than pat if necessary. An air bubble many times may be located below the contents in the esophagus. A burp may bring those contents up leading to spit up. This is a “wet burp.”

Assess Formula Change

Historically there had not been formula designed specifically for acid reflux. That has changed. In addition, the milder formulas however may result in a reduction of symptoms. There is a range of formulas from least sensitive to completely pre-digested. Speak with a pediatric nutritionist to assess the best fit for your infant. PAGER makes the following suggestions on their posted article : “Pediatric Reflux 101:

“Babies on formula may need a special diet (milk-free, soy-free or hypoallergenic formula). Amino acid based formulas are available by prescription for milk soy protein intolerance.

Liquids often reflux more than solids. Your doctor may recommend thickening with 1 Tablespoon (3 teaspoons) of cereal or calorie free thickener per ounce of formula. It will be as thick as tomato sauce so special cross-cut nipples will be needed.”

Keep in mind the difference between colic and acid reflux. It is possible that your infant has both. A breast fed baby on only one bottle of formula per day will have the same level of colic as an infant completely on formula. Colic is chronic consistent crying usually between the hours of 6-9pm. Symptoms of acid reflux usually peak after 9pm and may appear as intermittent crying or an awake state with discomfort but not crying.

Enfamil Acid Reflux
Blog: What is best Formula for GERD
Formulas are not alike
Infant and newborn articles: Acid reflux
Infant formula 101

Nursing

In researching, there has been some discussion that breastfed babies have milder symptoms of Acid Reflux. We have not located much empirical data to support this. However, The Pediatric Adolescent Gastroesophageal Reflux Association (PAGER) does address this in “Breastfeeding The Baby with Acid Reflux.” Here is what they have said:

“GER is less common and less severe in breastfed babies. If your baby is suffering with GER, it is important to remember that your milk is still the best possible food for your baby. Any feeding problems caused by GER can be resolved or handled, and you and your baby will both benefit from continued breastfeeding.” To learn more about how to breast feed a baby with reflux Click here

Spitting up in the reflux breastfed baby at KellyMom

Your infant may be fussy not because of poor milk supply but due to discomfort or pain. Here are some options to help you through the beginning stages of nursing a baby with acid reflux. Remember, they will begin to eat less frequently in a few weeks and you may reduce the severity of symptoms in the long run.

There are breast shields to minimize pain caused by frequent feedings. The shields also make latching easier for your infant. Pumping every 3-4 hours and bottle feeding may be an option so that you get relief and ensure your baby is eating. Altering maternal diet is usually the last resort. However, it is helpful to remove foods from your diet that will agitate the baby. In most cases people eat normally then remove foods that appear to irritate. But you will do this in reverse since s/he has an underdeveloped gastrointestinal system. Remove most acid / gaseous foods from your diet and add slowly. Here are some suggestions on what to avoid:

Onions
Cauliflower
Pears
Garlic
String Beans
All fruit skins
Tomato Sauce
Broccoli
Anything Spicey
Turkey
Cold Cuts
Cabbage

Props and Appliance Sounds

Appliance Sounds: Place your infant in a swing, vibrating seat, or car seat in front of a running washer, dryer, or dishwasher. Run a hairdryer on high/ cool. You will need loud appliances such as vacuums, hair dryers, washer machines, or volume controlled waves. Set it all on maximum. We have found a combination of sounds were most effective. In particular the sounds of forced air, a motor, with running water. We were unable to locate sound machines or CDs that would satisfy an infant with reflux. So, we created them for you. Due to infant safety and the preservation of environmental resources, we created a series of CDs for you. Please see our products page for more information.

Sucking: Sucking increases swallowing thus reducing the acid build up. It may also prevent overfeeding. Many times, a pacifier helps with babies suffering from acid reflux. If your baby is resistant to nursing or eating, the pacifier may not be a good option. Consult with your pediatrician or nutritionist.

Swaddle: There are products that allow you to swaddle older babies. You will swaddle your baby slightly differently. Swaddle tightly around the tummy with arms out and legs looser.

The Miracle Blanket is devised for babies older than 3 months.

Swings and vibrating chairs: Vibrations help with gas but wait 45 minutes after feeding to do this. There are swing attachments for your car seat. They even have vibrations on them as well.

The goal for most parents is to diminish props by 3 months. However, forgive yourself if you are unable to achieve this. Sleep deprivation is also occurring in your infant and should be taken seriously. Soothing your infant or toddler is your top priority.

Other Products Sites:

www.Babystayasleep.com
www.napnanny.com
www.sootheyourbaby.com/
www.tuckersling.com