Breastfeeding and Infant Reflux

RMacLean
February 2005

It's certainly no secret, breastfeeding is best for baby, but that's particularly true for babies with reflux.  There are a few reasons why this is the case:

• Breast milk is digested twice as fast as formula, this is beneficial for babies with reflux because the faster food moves out of the stomach, the less chance it has of being refluxed.
• Breast milk, particularly the proteins, are more hypoallergenic than formula, especially cow's milk based formula.  Reflux can—in some cases—be aggravated by milk or food allergies so providing the most hypoallergenic possibility is extremely beneficial.

More—non-medical—benefits: spit up from breast milk is much easier to clean up, less likely to stain than formula spit up and smells better.

Babies with reflux can take two completely different approaches to mealtime. Some become frequent and aggressive feeders, guzzling fast and demanding more. These babies seem to get relief from the natural antacid effects of the milk, likely from the closeness to mom and soothing action of suckling. This is exhausting for the mothers and can actually increase reflux episodes if babies tummy gets too full.

Others take the complete opposite approach.  They learn that food hurts and decide to protect themselves from the pain and discomfort they associate with eating, they become very difficult to feed or refuse food altogether.  Some things that can help are keeping the baby as upright as possible, feeding while the baby is sleeping, the use of white noise like a vacuum or the shower running, have proven effective for many moms.  Try keeping the baby as relaxed as possible and avoid the natural reaction to panic or get upset that baby won't eat.  Since your baby senses and reacts to your distress, this will only prove to increase their anxiety over mealtimes.  If these things, along with the rest of the lifestyle adjustments for reflux don't help, medication may be the next step.  For these babies it's important to stop the pain they feel when they eat.  If they are able to eat without pain, the bad associations will stop and so will the feeding problems.

Eliminating milk products and even some of the other foods* known to irritate reflux can benefit some breastfed refluxers.

*fried or creamy style vegetables, tomatoes, citrus: such as oranges, grapefruit, pineapple, anything prepared with whole milk or high-fat, cold cuts, sausage, bacon, fatty meat, chicken fat/skin, all animal or vegetable oils, chocolate, carbonated beverages, chicken, beef, milk, or cream-based soups

Reviewed By Dave Olson, MD
Fellow, American Academy of Pediatrics
Graduate University of Michigan School of Medicine