Breastfeeding Positions for Babies with Reflux

Breastfeeding Positions for Babies with Reflux

Are you a breastfeeding parent of a little one with reflux?. If you are this can be a very distressing time knowing how uncomfortable your infant is feeling. Much has been written on how to manage a baby who is formula fed, however, there appears to be very little information on how we can assist breastfed babies. Luckily, there are ways that we can help give some relief to our breastfed babies who are experiencing reflux. I will go through some of the best breastfeeding positions that could help alleviate the symptoms and minimize the episode of reflux.

So, what are the ideal breastfeeding positions for babies with reflux? To help alleviate the symptoms and minimize the episodes of reflux the Cradle Hold, The Australian or Koala Hold and the Laidback/Upright position are the most suitable ways to give relief. These positions will ensure that the baby’s head will be above the level of his bottom and that he is at a 30 t0 40-degree angle which will help prevent the stomach contents entering into the esophagus.

However, along with these breastfeeding positions, there are other things we can do to help alleviate this painful condition for our infants. I have also discussed some ways that could help improve your breastfed baby’s symptoms.

Reflux in Breastfed Babies

Reflux happens when the stomach contents go back up into the esophagus or the tube that connects the mouth to the stomach. It can occur during or after feeding. In the medical field, it is more properly termed as Gastroesophageal Reflux (GER) and may be related to regurgitation or the condition when the stomach contents already reach the mouth. It is more popularly known as “spitting up” in babies.

Reflux is very common among young and healthy infants, primarily due to their due physiologic development. The esophageal sphincter plays a vital role in the GI system because it should open during feeding and should close to keep the food or fluids in the stomach and prevent them from coming back up. Among babies, this mechanism needs time to fully mature. In addition, infants initially have a shorter esophagus and a tiny stomach which can only hold a small quantity of milk.  So, your baby is more likely to spit up any excess milk after a feed. Other causes may include an oversupply of milk, swallowing excess air or lying down immediately after a feed.

According to the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), when breastfeeding a baby with regurgitation or reflux, it is important to position the baby so that gravity can help keep the milk from coming back up.

Signs to look out for

Some babies who experience more frequent and more severe symptoms such that it develops into a condition called Gastroesophageal Reflux Disease (GERD). GERD is a more serious condition that needs medical attention since it can already interfere with your baby’s weight, nutrition, and respiratory functions. If you’re worried that your baby’s reflux might be getting worse, you can always discuss it with your pediatrician. According to the Australian Breastfeeding Association, these symptoms suggest you need to seek medical attention for your baby:

  • Bringing up a large amount of milk after most feeds
  • Seems to experience pain after a breastfeed or may refuse to finish a feed
  • Irritable and unhappy between feeds
  • Arches her back after most feeds
  • Not gaining the ideal weight
  • Has ongoing breathing or respiratory problems

Breastfeeding Positions

Cradle Hold

This classic breastfeeding position works well in keeping your baby’s head a bit elevated while minimizing pressure on his tummy. In this position, your baby can be tilted at a 30 to 40-degree angle which will help keep milk in her tummy without spitting up.

nursing position
  • Sit in a recliner or in a rocker with feet raised on a stool or a coffee table to avoid the
    strain in leaning towards your baby
  • Cradle your baby’s head in the crook of your arm
  • Place baby on your lap. You may also want to place a pillow on your lap and put your
    baby above it for more elevation
  • Breastfeed while your baby’s face, stomach, and knees are facing towards you and his
    lower arm tucked under your arm

Australian/Koala Hold

This breastfeeding position allows your baby to keep a more upright position. It is also a nice way to feed discreetly when breastfeeding in public. This position is more suitable for a slightly older baby as they require to have sufficient head control to support this position. It also gives your older baby a better chance to look around them as their curiosity increases.

Australian/Koala Hold
  • Sit down on your bed, chair or sofa.
  • Your baby sits straddling on your thigh or hip, keeping his upper torso
    upright while also ensuring that your baby’s head and neck are supported.
  • Nurse while you lightly support the back of your baby’s head using your arm on the same side where your baby is positioned
  • Try not to hold your baby’s head firmly as this can make it difficult for them to feed and it will enable him to tilt his head back to feed
  • position your breast to enable baby to latch on well

Nursing in a Sling/Standing Position

An alternative way to nurse while keeping the least strain to your baby’s tummy and promotes the downward pull of the milk he ingests. Nursing in a sling or carrier will provide support for your baby, making this position a lot easier. No matter what sling you use it’s important to have your baby’s mouth positioned in line with the natural fall of your breast to make breastfeeding more comfortable for you and baby.

Nursing in a Sling/Standing Position
  • Use an over-the-shoulder baby sling or front carrier to position the baby at breast level. It’s a good idea to wear a buttoned shirt or wide-necked shirts for easier access to feed your baby or a layered outfit for coverage top and bottom
  • When walking you may have to support your breast with one hand
  • Place your thumb over the top part of the nipple with your fingers underneath. This looks like the shape of a “C” and will help latch your baby to the breast
  • the upper part of the sling can be used to support her head
  • try practicing at home at first to get familiar and confident nursing in this position

Laidback Position/Biological Nurturing

Reflux can occur in some breastfed babies due to mom having an oversupply of milk or a fast “let down reflex”. This can result in baby taking in a large amount of milk in a short period of time or may have taken in too much milk resulting in reflux. This position will ensure gravity will help slow the flow of milk and become more manageable for baby when feeding. The laidback position or also known as biological nursing is known to help encourage your baby’s natural breastfeeding instincts and can create a harmonious breastfeeding relationship between mom and baby.

  • lean back in a comfortable chair with pillows to support to ensure all of your body is supported
  • lie baby on top of you where her body is facing you
  • most babies will instinctively find the nipple or guide and support her at first as he finds her way
  • when her mouth is near to your nipple, she will lift her head, open her mouth wide and latch

Other Tips to Help Breastfeeding Babies with Reflux

When breastfeeding your baby, there are also other ways where you can help reduce the occurrence of reflux. Along with the breastfeeding positions mentioned earlier, these strategies can help keep your baby’s reflux episodes to a minimum:

  • Always feed with the head higher than the tummy  

Whatever breastfeeding position you try, make sure your baby’s head is slightly elevated than the rest of his body. This position will allow the gravitational pull in keeping the breast milk in baby’s tummy

  • Avoid bending baby’s abdomen

We don’t want to apply too much pressure to baby’s tummy. Therefore, it is best to avoid breastfeeding positions where her abdomen will not be in a straight position

  • Short, more frequent feedings

If you feel the reason for reflux is your oversupply of milk, having shorter but more frequent feedings can help. This will satisfy your baby’s appetite without consuming to much milk than her tummy can hold.

If you observe that reflux is being triggered by the forceful ejection of your breast milk, then you might want to try this strategy. Some moms hand express their breast milk. Hand expressing will let it flow for a couple of minutes prior to breastfeeding. The pressure will then be released within the breast and lessen the force of milk ejection when your baby is ready to nurse.

  • Don’t forget to burp after breastfeeding

Burping will help keep the excess air out of your baby’s stomach and thus, make it less likely for reflux to occur.

Related Questions

How do you comfort a baby with reflux?

After you have breastfed your baby, spend around 15 to 20 minutes keeping him in an upright position. This will allow enough time for the breast milk to be digested. Isn’t it nice to cuddle your baby and place him on your shoulder or chest for a while after breastfeeding? Experts advise that keeping a baby in an upright position after feeding helps minimize reflux episodes. This way, you can alleviate reflux, as well as keep your baby warm and feeling loved.

Can breast milk give baby heartburn?

Either breast milk or formula can give reflux, but according to experts, milk has natural antacid properties. Reflux, therefore, normally can’t harm your baby’s esophagus. Heartburn is more of a manifestation of GERD, so if you feel your baby is in pain while or after feeding, it is important to bring him to a pediatrician for appropriate evaluation.

Does gripe water help with reflux?

Gripe water is a popular, herbal remedy for colic, reflux, and other stomach-related problems. However, there are no studies to support its efficacy and safety at present. If your baby is less than 6 months of age, it is also better to follow the exclusive breastfeeding recommendation of the World Health Organization. These guidelines advise avoiding introducing any other substances to your baby. Should you want to offer gripe water to your baby, make sure to check with your pediatrician first before giving.

Overall, reflux episodes are pretty common among young babies. They will usually have resolved by the time your baby has reached 1 year old. It is definitely worth trying the recommended positions and breastfeeding tips until you find which one will work best for you and your baby.

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References: (by NASPGHAN) (by International Foundation for Gastrointestinal Disorders)

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