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Thread: How do I breastfeed my baby with Reflux?

  1. #11
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    May 2006
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    Default Re: How do I breastfeed my baby with Reflux?

    When you say pattern do you mean Centile?
    I think what LLLMeg is asking is whether your baby has followed a typical breastfed baby growth trajectory. That is, relatively rapid growth in the first weeks and months, gradually slowing as the baby gets older. If you tracked that growth on a curve, it would look like this: http://kellymom.com/wp-content/uploa...irls_p_0_2.jpg

    The average breastfed baby is going to gain about 155-241 g per week for the first 4 months, 92-126 g per week from 4-6 months, and 60-80 g per week from 6-12 months.

    If you have oversupply and you're having no trouble getting more milk than your baby takes, you have some nice weight-boosting options even if your baby is refusing to nurse. For example, you could offer bottles of double-cream breastmilk. You can make this sort of bottle by allowing one bottle to sit in the fridge for a bit, and when the fat separates out, taking the fat and adding it to a second bottle of expressed milk, a bottle which is then fed to the baby. You could also try freezing your milk and making a nice slush out of it. You could even make yogurt out of surplus milk! And of course, you could thin your baby's solids (if you choose to continue them) with breastmilk.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  2. #12
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    Jun 2009
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    Default Re: How do I breastfeed my baby with Reflux?

    An IBCLC is a International Board Certified Lactation Consultant. You can look up some here: www.ilca.org This will probably not be everyone in practice in your area though.

  3. #13
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    Default Re: How do I breastfeed my baby with Reflux?

    Quote Originally Posted by @llli*lllmeg View Post
    Ok. First I want to say that discussions on the internet are difficult and I am sorry if anything I said or how I have put my questions are off putting. I understand you are very worried and want to do what is best for your child. You have had a difficult few months and I really do understand that. Yet your child is gaining and I assume, developing normally, or else (Again I would assume) your hcps would have more concerns than they do. If how I have phrased things have made you feel defensive, I am sorry. I am asking the questions I am asking because I am trying to make sense of your situation in the hopes I can help. When a mom is looking for answers for issues that perhaps began much earlier, I feel I must look at the entire picture to give my best answers. It is not about assigning blame, it is about finding the answers, or at least trying to. Because sometimes, if you know what caused the problem, that gives you a path for solving it.
    Here are some reasons I am asking the questions I am asking.
    many, many moms are told they have low production when they do not.
    Many moms think they have low production when they do not.
    Many moms are told to supplement with formula when it is not needed especially in the early weeks
    Even when supplements are 100% necessary and appropriate, they can STILL be harmful to breastfeeding. This does not mean don't supplement or that it was wrong to supplement in the past. It means, there will possibly be consequences even when supplements were/are needed.
    Reflux is frequently misdiagnosed and/or the effects overstated
    Growth Charts and percentiles are often misleading.
    Pump output is a poor indicator of milk production
    infant behavior is a confusing indicator of milk production
    While pumping is a good idea & important if supplements are given, pumping is not the same as nursing and is, in some cases, not going to keep production where it needs to be. Plus, it is a very hard thing to do.
    You don't say how much you are able to pump or how much baby is taking in with the bottle?
    Solids are introduced at an early age for many reasons, usually ones for which there is no data or proof of effectiveness, such as for slow gain or as a treatment for reflux. But, as I noted above, according to Jack Newman, a breastfeeding expert, early solids are, in his opinion, an appropriate choice in some situations.


    I do not have any ideas for encouraging a baby to eat more solids. For understanding that issue better, I again suggest the book My Child Won't Eat.

    For encouraging nursing, I again suggest the ideas in the kellymom article. For encouraging baby to take a bottle, I would suggest trying paced bottle feeding which allows baby control over the flow and may be more relaxing for baby. Here is information on this: http://www.llli.org/docs/00000000000...astfedbaby.pdf and http://www.bing.com/videos/search?q=...FD00534CAAC56E OR, maybe seeing if baby would like a sippy or open cup better.

    Have you checked your expressed milk for signs of excess lactase? It gives expressed milk a soapy smell. The smell usually happens after the milk has been refridgerated or frozen. The milk is fine, but some babies object to the smell and will not drink it.

    I am still very confused about how often your child nurses or takes a bottle, I thought you said she has not nursed or taken a bottle for a month, which I guess is not the case, but this is why I was wondering about dehydration. Also, water- If baby will take a bottle, does it matter what is in it? If baby will drink anything, probably best to have that be formula or breastmilk. Both contain plenty of water so there is no need for additional water. It does not sound like baby is taking a lot of water, but if baby is quenching thirst with water that also may cause a baby to not nurse/bottlefeed as much as normal.
    Don't worry about causing offence, I am interested in reading anything anyone suggests.

    I have not noticed signs of excess lactose but will check next time I express. If this is the case what changes can I make to improve this such as diet changes etc?

    Its hard to say how often she nurses or takes a bottle. She has 60mls mixed with her food which she doesn't always eat and then around 40mls, 20mls for medication and 20mls to drink. This amount is usually because she refuses the breast at the beginning of a feed. If she does feed then less milk is had for meal. Sorry if my wording was confusing as you say its hard to convey over the internet. She can nurse but wont always we have good and bad days or weeks.

    In terms of water, this tends to be offered as a last resort to ensure hydration. With formula she is even fussier she either rejects it completely or has horrific tummy pain, this is one of the reasons she has not had a formula topup for a while. I do offer breastmilk but again the cycle repeats, she will have a few sucks and cry at the bottle. We have also tried a range of bottles and teats and have the same problem with all. She is currently on Medela Calma bottles which are the best we have had, she takes it better than any others, theses are designed to replicate the breast so should make it easier if anything.

  4. #14
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    Apr 2014
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    Default Re: How do I breastfeed my baby with Reflux?

    Quote Originally Posted by @llli*mommal View Post
    I think what LLLMeg is asking is whether your baby has followed a typical breastfed baby growth trajectory. That is, relatively rapid growth in the first weeks and months, gradually slowing as the baby gets older. If you tracked that growth on a curve, it would look like this: http://kellymom.com/wp-content/uploa...irls_p_0_2.jpg

    The average breastfed baby is going to gain about 155-241 g per week for the first 4 months, 92-126 g per week from 4-6 months, and 60-80 g per week from 6-12 months.

    If you have oversupply and you're having no trouble getting more milk than your baby takes, you have some nice weight-boosting options even if your baby is refusing to nurse. For example, you could offer bottles of double-cream breastmilk. You can make this sort of bottle by allowing one bottle to sit in the fridge for a bit, and when the fat separates out, taking the fat and adding it to a second bottle of expressed milk, a bottle which is then fed to the baby. You could also try freezing your milk and making a nice slush out of it. You could even make yogurt out of surplus milk! And of course, you could thin your baby's solids (if you choose to continue them) with breastmilk.
    Thanks that makes more sense, yeah shes following 9th although does drop off it regularly.

    The problem is I never have enough milk to freeze, I only tend to be a feed or two in front or if I am lucky a day. Your suggestion of double-cream breastmilk may help with weight gain but the problem is getting it down her most the time. Yoghurt may work, probably a daft question but how do I do that? I don't think she would eat a slush as she doesnt like cold milk. Thank you for these ideas.

  5. #15
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    Apr 2014
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    Default Re: How do I breastfeed my baby with Reflux?

    Quote Originally Posted by @llli*lllmeg View Post
    An IBCLC is a International Board Certified Lactation Consultant. You can look up some here: www.ilca.org This will probably not be everyone in practice in your area though.
    Thats fabulous, thank you so much. There is one in Manchester city centre which isnt to far from me. Are they expensive to see? If they can help I would defiantly want to see them.

  6. #16
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    May 2006
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    Default Re: How do I breastfeed my baby with Reflux?

    Your suggestion of double-cream breastmilk may help with weight gain but the problem is getting it down her most the time.
    Understood. The nice thing about double-cream milk is that even if you can't get baby to eat much, whatever she does eat will have more calories than her average bottle.

    Yoghurt may work, probably a daft question but how do I do that?
    Not daft. It's a crafty thing that some people get into... Basically, you want to add some yogurt with live cultures in it to expressed milk and then maintain the temperature for a certain time period. This link (and many others) explain how to make yogurt: http://www.granny-miller.com/how-to-...ck-pot-yogurt/

    The thing is, if you're only a bottle or two ahead of your baby's intake, making yogurt is probably not how you want to be spending your time. And you probably don't have enough excess to waste on a yogurt-making adventure. The yogurt idea works best for moms whose freezers are spilling over with expressed milk!

    This might be a long shot, but have you tried taking cow's milk out of your diet? It's not like your baby is giving you tons of allergy symptoms- but my understanding is that reflux can be worsened by an allergy or intolerance to the proteins in cow's milk. And if you're using a cow's milk-based formula, an allergy/intolerance might explain why baby is so miserable after a formula top-up.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  7. #17
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    Apr 2014
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    Default Re: How do I breastfeed my baby with Reflux?

    Quote Originally Posted by @llli*mommal View Post
    Understood. The nice thing about double-cream milk is that even if you can't get baby to eat much, whatever she does eat will have more calories than her average bottle.



    Not daft. It's a crafty thing that some people get into... Basically, you want to add some yogurt with live cultures in it to expressed milk and then maintain the temperature for a certain time period. This link (and many others) explain how to make yogurt: http://www.granny-miller.com/how-to-...ck-pot-yogurt/

    The thing is, if you're only a bottle or two ahead of your baby's intake, making yogurt is probably not how you want to be spending your time. And you probably don't have enough excess to waste on a yogurt-making adventure. The yogurt idea works best for moms whose freezers are spilling over with expressed milk!

    This might be a long shot, but have you tried taking cow's milk out of your diet? It's not like your baby is giving you tons of allergy symptoms- but my understanding is that reflux can be worsened by an allergy or intolerance to the proteins in cow's milk. And if you're using a cow's milk-based formula, an allergy/intolerance might explain why baby is so miserable after a formula top-up.
    That's a shame with the yoghurt because that may have worked. Having said that with her maybe not. I spend a lot of my day trying to feed and then expressing. I don't understand why I don't have a large oversupply considering how much I express.

    I wish that was the answer but I hardly have cows milk in my diet as I have never enjoyed milk generally. Milkshake is the closest thing I have but it's a rarity and I don't drink hot drinks so none in that either. The only other thing I have is butter but again that's minimal. Thanks for the suggestion. I used to drink a lot of fizzy drinks but when she started with colic in the early days, I cut them out too and went to cordial. Is there anything else that you know of that I could eat or need to stop eating that May help? If I knew the answer I would do it.

  8. #18
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    Default Re: How do I breastfeed my baby with Reflux?

    I wish that was the answer but I hardly have cows milk in my diet as I have never enjoyed milk generally. Milkshake is the closest thing I have but it's a rarity and I don't drink hot drinks so none in that either. The only other thing I have is butter but again that's minimal. Thanks for the suggestion. I used to drink a lot of fizzy drinks but when she started with colic in the early days, I cut them out too and went to cordial. Is there anything else that you know of that I could eat or need to stop eating that May help? If I knew the answer I would do it.
    When I went to the acupuncturist because I've been battling low supply, she actually told me NOT to drink cold drinks. To make sure I let everything warm up to at least room temperature and in the morning definitely I needed to drink HOT beverages since cold stagnates and can slow milk production and flow.

    But besides that, if a baby is having a bad milk allergy it can even be from the "hidden" milk in processed foods in your diet and the fact that the formula top up seems to cause really bad problems you might consider eliminating ALL milk/dairy for 10-14 days to see if it helps.

    Other thing might be to check for tongue/lip ties, they don't always affect breastfeeding (though bad ones usually cause some pain or compression of the nipples) but they can actually sometimes still affect a babies ability to swallow and if baby is having trouble there she may be getting more air when she swallows and that might cause difficulty with gas and reflux.

  9. #19
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    Apr 2014
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    Default Re: How do I breastfeed my baby with Reflux?

    Quote Originally Posted by @llli*tclynx View Post
    When I went to the acupuncturist because I've been battling low supply, she actually told me NOT to drink cold drinks. To make sure I let everything warm up to at least room temperature and in the morning definitely I needed to drink HOT beverages since cold stagnates and can slow milk production and flow.

    But besides that, if a baby is having a bad milk allergy it can even be from the "hidden" milk in processed foods in your diet and the fact that the formula top up seems to cause really bad problems you might consider eliminating ALL milk/dairy for 10-14 days to see if it helps.

    Other thing might be to check for tongue/lip ties, they don't always affect breastfeeding (though bad ones usually cause some pain or compression of the nipples) but they can actually sometimes still affect a babies ability to swallow and if baby is having trouble there she may be getting more air when she swallows and that might cause difficulty with gas and reflux.
    Thank you.

    She does have a slight tongue tie but everyone has said it shouldn't cause a problem and she has and can feed. That's the part that doesn't make sense she could feed for a good hour or two in the early days but now we are having these problems and I have never really had any pain. I knew when she wasn't latched on properly because I would get pain but then when she was latched on properly I was fine. It's like we have always had something fighting against us. To be honest I couldn't put her through snipping a tongue tie anyway. In my opinion it's barbaric.

    When she drinks bottles it's like she can't breath with it and has to take a break and eventually refuses it or doesn't take it in the first place. We also tried cup feeding but again she hated that cried and spat it out.

  10. #20
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    Default Re: How do I breastfeed my baby with Reflux?

    Quote Originally Posted by @llli*xjemmaxlouisex View Post
    Thank you.

    She does have a slight tongue tie but everyone has said it shouldn't cause a problem and she has and can feed. That's the part that doesn't make sense she could feed for a good hour or two in the early days but now we are having these problems and I have never really had any pain. I knew when she wasn't latched on properly because I would get pain but then when she was latched on properly I was fine. It's like we have always had something fighting against us. To be honest I couldn't put her through snipping a tongue tie anyway. In my opinion it's barbaric.

    When she drinks bottles it's like she can't breath with it and has to take a break and eventually refuses it or doesn't take it in the first place. We also tried cup feeding but again she hated that cried and spat it out.
    Getting a tongue tie corrected is a little traumatic but only very briefly (and probably worse for mom seeing/hearing the screaming.) To be honest I think my son hand more of an objection to being pinned down than to the actual pain of the procedure, he nursed immediately following. His tongue and lip ties lazered at 8 weeks but then we needed to do some oral motor therapy to retrain muscles in his tongue, lips, cheeks and jaw so that he could learn to suck and swallow more effectively. Before that he would be trying to nurse for hours at a time and still not be able to get enough milk even when there was milk there to get (I'd been using a lactation aid from about day 5.)

    Now I can't be certain that tongue tie would be giving your LO the reflux problems but I have read of cases where correcting tongue tie did relieve the problems.

    It is far less barbaric to correct a tongue tie in an infant that to wait till it is discovered to hinder speech development in an older child. Unfortunately some Dr/dentist won't correct a tongue tie in an infant older than a certain age without anesthesia since once they get to a certain size/strength it won't be that easy to hold them still while doing the procedure.

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