How Reflux Can Sabotage Breastfeeding

3 ways reflux can sabotage your breastfeeding journey: How to not let it!

Breastfeeding can be so much harder than you think right?

It’s a steep learning curve trying to nail the latch, establish a good supply and feel confident it’s going well.

But what if your baby starts displaying signs of reflux?

Constantly crying in pain?

Never settled or sleeping! 

A smiling and content baby, well what on earth is that?

You may feel trapped in your home. Unable to leave for fear your baby will scream the entire time you are out, and everyone will judge you as a terrible mother!

It’s a far cry from your expectations of parenthood!

You feel ashamedly full of regret and disappointment in your experience of motherhood so far.

Without a doubt, reflux throws a real curve ball into your breastfeeding journey and can lead you down a path to the end of breastfeeding without you even realising that’s where you are heading!

I’m going to explore 3 ways reflux can potentially sabotage your breastfeeding journey, but also share how you can safeguard against this, enabling you to breastfeed your baby with confidence!

What is reflux?

Reflux means something coming through a valve the wrong way.

It’s when milk comes back through the value at the top of the stomach, and up the food pipe (oesophagus).

It can come completely up and out, known as regurgitation, or be swallowed again by your baby before it leaves their mouth. This is often referred to as silent reflux.

Now what’s important to know is, not all reflux is equal.

Let me explain how it differs.

Physiological reflux

Physiological reflux occurs in about 40-50% of all babies. Meaning, about half of all babies will regurgitate some or all of their feed, at least once a day.

Your baby may cry and be a little unsettled when it happens, but not particularly distressed about it.

If you’ve ever had reflux yourself, (most of us have experienced this at some point), you know it isn’t a pleasant experience! 

Most babies though will settle with a cuddle or a little feed. Generally, it’s not causing you or your baby large amounts of distress or concern, although as the parent of a reflux baby, I acknowledge the stress that comes from all the additional washing! Fundamentally though your baby is happy, settled and content at times.

This is physiological reflux known as gastroesophageal reflux.

There are ways to manage reflux like this, to reduce it from happening. 

How we feed and care for our babies can make a big difference in managing physiological reflux.

Gastro-Oesophageal Reflux Disease

Unfortunately, some babies may have what is classified as Gastro-Oesophageal Reflux Disease (GORD or GERD).  

This is where your baby is crying for long periods of time, or has excessive amounts of reflux.

They are in pain, it’s causing them marked distress and their weight gain may be faltering. It is thought (although not fully proven) that it’s acid that is causing this pain when your baby refluxes.

There is something that is very often overlooked here though.

Underlying factors can exacerbate reflux, causing it to happen more frequently or be more painful when it happens. The bottom line is,

There is a root cause of the reflux!

These underlying factors can be identified and addressed.  This can improve the reflux and result in a happier baby and a happier mum!!! 

This is not the same as medical GORD/GERD. 

In my experience most babies get diagnosed with ‘Reflux’ without the right support to correctly identify what is causing the reflux, or help you, the parents cope with it.

See my previous blog, ‘Reflux is it normal or not’, for more information about this.

You can access that HERE

Reflux Sabotage #1

There could be many ways that reflux causes challenges or potential stumbling blocks on your infant feeding path, but let’s look at 3 of the most common, and what you can do to protect your breastfeeding journey.

Doubting your boobs!

Does this resonate with you?

Maybe my milk isn’t good enough?

What if it’s because I’m feeding them too much, or not enough?’

Breastfeeding is the only way they settle, but then they are sick again!’

‘Maybe they are allergic to my milk?’

Is any of this ringing true?

When you are breastfeeding and your baby has reflux, you are bound to, at least on one occasion (probably way more) wonder if the reason is down to breastfeeding and maybe you should stop.

Am I right?

Now, even if the thought hasn’t crossed your mind, I expect someone, a friend or family member has planted a little seed of doubt by suggesting,

‘Maybe you should just give formula?’

‘Do you think it’s something you ate?’

‘Maybe your milk isn’t quite right for them?’ (This last one is completely incorrect by the way. Mammals are incredible species that make exactly the right milk, individualised for their own baby).

If every time you breastfeed, your baby starts crying in pain, bringing back up their feed, arching their back, and refusing to go to the breast, it really doesn’t take many feeds like this before you start to worry that it might be your fault!

One of the biggest worries parents often share with me is just how much milk their baby is bringing back up! When breastfeeding you can feel anxious that you have no idea how much milk your baby has had.

This doubt has very successfully been planted into our minds for generations,(formula manufacturers I’m looking at you!)

We feel the only way to ‘know’ how much our baby is having is by measuring the volume.

But I’ll let you into little a secret…

There are other factors that help identify how well your baby is feeding and growing, that don’t include measuring the milk in ounces or millilitres!

This confidence, and trust in our boobs, takes time, understanding and support! Something that is missing from the generations before us, because they weren’t told this either!

How to tell breastfeeding is going well.

Here are some of those other ways to recognise how well your baby is feeding.

The amount of wet and dirty nappies (5- 6 heavy wet nappies after day 5, at least 2 poos, soft and yellow).

Can you hear swallowing during the feed?

How content are they after a feed? Are they settled (mostly) between feeds? So not immediately looking for more milk.

How do your breasts feel before and after a feed, fuller and less full?

Is your baby going up sizes in clothes and nappies, are they gaining weight?

Path to the end of breastfeeding

Regardless of whether you measure the amount of milk out before you give it or feed it directly from the breast, if it comes back up, it,

A) Always looks more than it actually is!

B) Without understanding the root cause of the reflux, it’s likely to happen however you give it, be it from a bottle or from the breast!

The dangers to your breastfeeding journey when we question if reflux is being caused by breastfeeding are:

1. Feeling it may be better to give from a bottle (so you can see how much they get). You may try and express to get the milk, but this is hard to maintain long term, it’s really time-consuming. Of course, women can do it, mums are incredible, (expressing/pumping can at times save a breastfeeding journey) but it brings another layer of complexity to your already overloaded life! Potentially it’s not something you can keep up with in the way you hoped.

This can lead you on a path to stopping breastfeeding

2. You may start to schedule feeds! You time the feed and stop it, or make them go longer between feeds, to eek it out! Having a good understanding of breastfeeding is key here. It works on demand and supply. The more your baby feeds, the more milk you make. Babies need to feed little and often. Stopping them short or not feeding frequently can impact how your supply regulates (especially in the early weeks) and may result in lowering your supply long term. 

3. You may think you should try a ‘specialist milk’. There are so many milks marketed as special colic or anti-reflux milks. You may wonder if these might be better for your baby than your own milk.  Unless you continue to express, giving milk to your baby in a different way will reduce your supply and quite possibly mean the end of your breastfeeding journey.

Protecting breastfeeding

So how can your safeguard against reflux leading to the end of breastfeeding here?

You need to identify the root cause of the reflux!

Why has your baby got reflux? 

Is it a feeding issue, how can we optimise this?

Is it down to something else?

Understanding normal baby behaviour can help reduce the worry breastfeeding may be to blame. 

Babies need to be held close. They don’t like to be away from our bodies. They are biologically programmed this way!

They want to feed often, and this is hard to navigate, but doesn’t mean something is wrong!

Get the right skilled support to help you identify the underlying reasons. Evidenced-based information will help inform your decisions, regarding what you feel is the right way to feed your baby.

Reflux Sabotage #2

Medication

When your baby is suffering from reflux, one of the first suggestions (although it really shouldn’t be) is ‘try this medication’.

You are feeling so worried about your baby, and the pain they are in, you just want anything that will help them to feel more comfortable and stop the reflux.

Unfortunately, medication can bring other complications. Most parents given these medications for their babies have not been informed of the possible risks or side effects!

There are different medications used to treat ‘reflux’. Many of these can really interrupt breastfeeding.

Gaviscon is often the first suggestion. This is an alginate therapy. It works by thickening as it meets the stomach contents, forming a raft at the top of the tummy. In theory, stopping the milk beneath the raft from coming back up the food pipe.

Gaviscon needs to be mixed with some expressed milk or water and given before a feed, usually via a spoon or a bottle. This may mean you are introducing a bottle before you may have chosen to and most parents I support, feel giving Gaviscon is a right ‘faff’!

Mixing it prior to a feed, trying to get your baby to take it when they are hungry and crying, and needing multiple pairs of hands, just adds more stress to an already stressful situation. You can feel it might be easier to put it in a bottle with their milk and feed it all that way! Hence it really starts to interrupt breastfeeding!

Another common medication or treatment for reflux is thickened milk, (so those anti-reflux milks). A thickener can’t really be added to breastmilk as the enzymes in breastmilk start to break it down straight away, so your only option here is a ‘specialist formula, or thickener added to an infant formula.  

Although these are sold on the shelves of the supermarket, these anti-reflux milks are known as ‘food for special medical purposes.’ Technically a formula, they are being used as a medication, but they don’t come under the same regulations as either formula or medication!

There is limited evidence that either of these treatments are effective!

Good evidence-based information, free from bias about different formula milks can be found at First Steps Nutrition Trust 

A common side effect of both these treatments is constipation. This can cause your baby to be uncomfortable, feed less, and have fewer dirty nappies. This increases your worry, what if they aren’t getting enough milk, and you start to doubt your milk supply.

Can you see a pattern here?

Protecting breastfeeding

Get a skilled breastfeeding assessment by a qualified practitioner. This can correctly identify any issues with breastfeeding that could be worsening or causing the reflux.

These avenues should be explored first. It can reduce the likelihood of your baby being given a medication, they don’t need, as well as ensure your breastfeeding journey isn’t halted prematurely.

Reflux Sabotage #3

Allergy

Now this is a whole blog post on its own. In fact, I could write so many blogs about allergies and breastfeeding!

Allergies and reflux often go HAND IN HAND.

Food allergies are thought to be a factor in up to 65% of reflux cases (Rubuk et al 2017). The way reflux can sabotage breastfeeding here relates to the GUILT you feel, and the BLAME you put on yourself.

Guilt that choosing to breastfeed is causing them to have reflux! 

Blamimg yourself if your baby reacts to something you have eaten.

Both put HUGE pressure on you! 

But here are some important things you need to know.

Firstly, your baby is NOT allergic to your milk! (*This is so rare and would have been identified in the very early days). They are reacting to the food proteins in your milk.

Monitoring your diet, cutting out foods may help, but also needs to be done cautiously. It can become very difficult to identify the correct allergens your baby is reacting to, and your own diet can become very restricted, very quickly and often unnecessarily.

Worry and guilt result in you wondering if your baby might be better off without your milk. But this is why you really need the right evidence and support to help you make your decision. This includes:

Understanding the protective factors of breastmilk.

  • Breastfed babies are less likely to have allergies long-term!
  • Breast milk has anti-inflammatory properties that help the healing process when inflammation occurs due to an allergic reaction.
  • The benefits of breastmilk to your own health and well-being, the connection and way breastfeeding help settle and calm your baby.
  • Breastmilk is more than just food

 

How YOU feel about this is an individual decision, but you need all the facts and information to help inform your decision!

Incorrect information!

Now this is a HUGE bug bear of mine.  There is so much misleading ‘advice’ about how to eliminate allergens.

What to take out, how long to remove it for and so little support to help you correctly identify what is going on!

I still support families that have been told they need to remove a specific food group from their diet for 6 weeks to see a difference!

This is INCORRECT!

This creates massive obstacles to breastfeeding.

Also, I  often hear, I was told ‘just knock dairy out of your diet’.

Yes, cows’ milk protein may be the most common allergy in babies, but it’s not the only one! You need to know:

  • What are you looking for when you take something out of your diet (i.e. how to identify if this is what your baby is reacting to)
  • How long to remove it for.
  • Why it’s important to add it back in, how and when you do this (called a challenge).

 

Exposure to allergens via your breast milk actually helps reduce the likelihood of allergies developing later on.

If your baby isn’t reacting to it now, then you really shouldn’t stop the exposure they are getting to it. It’s not ok to just ‘knock’ something out of your diet if it doesn’t need to be!

Misleading information and not getting the right support if your baby does have an allergy, risks you stopping breastfeeding when it may not be necessary! 

It can be tough going at times breastfeeding and if restricting your diet, it really can make it harder. So doing it unnecessarily, well that’s a door opening to the end of breastfeeding right there!

Protecting breastfeeding

Find the right practitioners to support you!

You need an evidenced-based, holistic approach, rather than a ‘try this and see if it works’ one!

Keeping a food diary can be a massive help in correctly identifying what allergens your baby might be reacting to.

You need to feel confident you are taking the right steps to stop your baby from being in pain.  Correctly identify what is causing the reflux symptoms, but without having to stop breastfeeding if you don’t want to.

What steps next?

There are many ways, more than described here, that reflux can sabotage your breastfeeding journey.

The common themes are the feelings of guilt and worry having a baby with reflux places on you as a parent. I know you are telling yourself it’s ‘selfish’, wondering if the reflux is your fault and that maybe stopping breastfeeding would result in everything being better.  

Many parents consider stopping breastfeeding because they will do anything for their baby to be better. We are often clutching at straws, desperately searching for the answer!

But stopping breastfeeding rarely provides the silver bullet you were searching for and adds another layer of guilt and failure that you really don’t deserve!

So many parents do not get the support or correct information to help inform their choices. You can end up on a road leading to the end of breastfeeding before you even realise that’s the way you are heading.

Supporting families with evidence-based information and empowering them to correctly identify the root cause of the reflux, is how I enable many families to not only reach their infant feeding goals but to have happier, calmer, more settled babies.

I want to empower you to find enjoyment in motherhood allowing you to thrive, not just try and survive life with a baby suffering from reflux.

If you want to know more about my unique programme, which uses my proven framework to get incredible results for families with unsettled babies, then you can book a FREE call HERE

We will chat about what’s going on for you right now and explore if working together is the best way to help you and your baby get the results you need!

There are ways to avoid reflux sabotaging your breastfeeding journey, and ruining your experience of motherhood. Please reach out for support.

Alice 

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Alice Lucken

I am an International Board Certified Lactation Consultant and Parenting Practitioner. I have been a nurse for nearly 20 years and have over 10 years of experience working with families as a Health Visitor and Infant Feeding Specialist, supporting complex infant feeding challenges. I now work independently to help families overcome any infant feeding or parenting challenges they are facing.

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