What is Reflux?
Reflux has a pretty bad reputation! It is commonly treated for, but many families find little to no relief with medications. Why is that? Shocking to know that only about 1% of babies have actual gastroesophageal reflux disease (GERD). Many have gastroesophageal reflux (GER), but it causes little to no discomfort or undesirable symptoms like GERD does.
Signs and Symptoms of GERD
True gastroesophageal reflux disease is accompanied with some pretty nasty side effects for babies. They may have any or all of the following:
- Frequent spitting up
- Projectile vomiting after feeding
- Extreme fussiness
- Won’t settle
- Don’t tolerate being on their back
- Poor weight gain
Treatment
Treatment for GERD includes medication and habitual changes. Babies can be prescribed medication by a health care provider if they are diagnosed with reflux. To help with comfort, place your baby to feed in a more upright position, and keep them upright for at least 30 minutes afterwards.
What is Oversupply?
Let’s say, despite being on medication for reflux, your child is still having “reflux symptoms”. There are a few other culprits, which include oversupply of milk! Having an oversupply is a pretty common problem. Having too much milk may not seem to be a bad thing, but it can cause some negative symptoms.
Signs and Symptoms
Signs and symptoms of an oversupply of milk, which may be confused for reflux include, a fussy and gassy baby, green frothy poop, frequent spit ups, inability to settle between feeds, and always seems hungry. They may pop off the breast frequently and seem upset when you try to get them to latch. These babies typically are still gaining weight well, and can even be gaining weight faster than others. For the lactating parent, they may have issues with ductal narrowing (blocked ducts) or mastitis.
How to manage
Managing oversupply needs to be done carefully so as to not cause low milk supply. The goal is to continue feeding the baby, while reducing the excessive milk production to only make what the baby actually needs. This can be done with creating a feeding plan that: protects supply, and feeds the baby.
What is an overactive letdown?
A letdown reflex occurs when your baby is actively sucking at the breast. Sucking causes the release of two hormones, prolactin and oxytocin. Prolactin drives milk production, while oxytocin ejects it from the milk-making cells. The letdown causes milk to flow out of the nipple. An overactive reflex causes the milk to eject strongly causing an array of negative side effects for the child.
If the lactating parent has an overactive letdown reflex, it can cause the following symptoms:
- Frequent popping off the breast
- Breast refusal
- Fussy and gassy baby
- Choking and sputtering while feeding
How can we manage it?
Overactive letdown can be managed with position changes during feeding, and managing oversupply if that is also present. The letdown can be elicited before the baby latches using a pump, and then latched on after the initial letdown has ended.
How I can Help
As a Certified Breastfeeding Specialist, I am trained to assess your child for signs and symptoms of reflux, as well as assess you for oversupply of milk, overactive letdown, ductal narrowing, and mastitis. These are just a few things I assess for while I assess feeding. I can help develop a plan to treat symptoms, and can make appropriate referrals if more investigation is needed. My goal is to help take the stress out of feeding your baby, and bring a sense of accomplishment and pride back into your feeding journey!
If you are struggling with a fussy baby and feeding issues, book a Feeding Package so I can help!
