29 answers

Doctor Orders Mom to Stop Breastfeeding to Ease GERD -- Advice Requested

I have a friend who's a first time mom going through some tough times. She had a difficult pregnancy (weeks in the hospital), but is now safely home with her 3-week-old daughter, who has been diagnosed with an intense case of GERD. My friend had been trying to nurse with some success, but has now been told by the doctor that she has to completely stop nursing for two reasons, both associated with easing the GERD: the baby needs to be held upright when she eats, and anything that she ingests has to be mixed with a small amount of rice cereal. My friend is allowed to pump to maintain supply, but has to give her baby the milk mixed with cereal in a bottle.

I never encountered GERD with my son, so I don't know if this medical advice is standard, but it seems off to me. I nursed through some issues (low supply, bad latching, etc.), but persevered, and would have been dismayed if that intimate relationship with my son had been taken away from me. I'm curious if anyone else has had experience with this. My friend is devastated and is looking for support. Have any of the moms out there encountered this condition, and if so, what did you do?

What can I do next?

Featured Answers

As the mom of 3 reflux babies, I can tell you this is absolutely "standard" advice. Reflux babies do need to be fed in an upright position and kept upright at least 30mins after feeding. Thickening with rice cereal is also standard, especially with breastmilk since it is thinner than formula. It will not destroy their digestive systems or cause food allergies, although statistically reflux babies are more prone to food sensitivities. Eventually, the LES muscle (the muscle that controls the opening/closing of the flap between the esophageus and the stomach) will strengthen and function properly and the baby will stop spitting up. This is different for each child. Mine were 9mos, 6mos. And 4mos. Most likely the ped will put the baby on Zantac or something similar to prevent the production of acid so that they don't scar the throat while refluxing, which can introduce more food issues.

It can be a scary thing to go through, and frustrating at times. Just know that it doesn't last forever. If she has concerns, she should consult with a Ped GI. All that said, my daughters are now healthy, happy 6, 7 and 10 year olds with no food issues whatsoever! Hang in there, there is a light at the end of the tunnel!

2 moms found this helpful

Have her contact a lactation consultant. She should be able to get some good advice, and I would have her talk to another doctor.

2 moms found this helpful

Hmmm, seems odd to me too... 1.) because i didn't think children under 4 months (at the earliest!) were suppose to have cereal in their diet (they can't digest yet; it can cause constipation issues or food allergies if introduced too early) and also, this article on an infant reflux website says breastfeeding should be continued: http://infantrefluxdisease.com/infant_acid_reflux/index.p...

I'm not very experienced with GERD but perhaps she can get a 2nd opinion, or ask her doctor to clarify his advice.

1 mom found this helpful

More Answers

The intimate relationship of breastfeeding is secondary to the baby's health, A.. Your friend is enduring pregnancy hormones, new baby mothering and bonding intensity, and facing the realization that things aren't going well with the baby right now. Please don't argue about her doctor and make her feel worse than she already does. Your issues with nursing have nothing to do with GERD and shouldn't be compared. You didn't have to see the pain in your baby that she is going to be seeing in her baby if she doesn't get a hold of this problem.

Mothers everywhere who either can't nurse or choose not to nurse feel very strongly that they bond with their babies as intimately as if they were nursing. You may disagree (I nursed too), but it's not fair to take away from a bottle fed baby and mother's experience as if it's not close to a nursing experience. It would be so much more humane and helpful to your friend to help her get over that premise.

If you really want to help, find a pediatric gastroenterologist for her to get a second opinion from. Just to reiterate what you wrote, she can still use her own breastmilk - it's not like the doctor said to instead use a specialized expensive formula. The baby is STILL getting that wonderful breast milk. Help her find different kinds of nipples that are most like the breast so that possibly she can switch back to nursing as the baby gets better.

Cereal is not usually used before 4 months - but it is used to help babies who have this awful condition. A lot of moms don't know this if they haven't gone through having a child with GERD.

You say she wants support - please give her support that actually works for what's best for the baby's actual health rather than give her reasons to keep bucking doctors' recommendations.

All my best,
D.

10 moms found this helpful

I'm going to go another direction with this..and its not to tell you that she will have lost some connection with her child. While Breast is best as they say, sometimes its not. I find it wrong that people tell others that they should never give up on breastfeeding. I had too..I didn't want to stop but I had to ..when there is no milk, you cannot feed via the breast and it was simply gone..in the middle of the night and never came back until my next child..and it lasted just six weeks for her. I never made enough milk to support my children and I didn't feel guilty about it. The fact my children are in this world at all is a miracle..I wasn't supposed to be able to have them.
If the child is suffering due to this than you should tell your friend to do what is best for her child not what is best for her. No, she doesn't want to give up breastfeeding...but a doctor very rarely says one should quit breastfeeding without a good reason. Getting information off the internet on this issue will give you many many answers. Now, I am not saying trust one doctor blindly ...get a second opinion..but I realize money, insurance and other issues may prevent that. If there is no other option and she CAN pump, at least the child will get breastmilk..which we all know nutritionally is usually best. As far as bonding, there are many ways to bond with a child and breastfeeding is not the only way. (Ask a few dads about that..they know!) . While I totally support her reasons behind wanting to keep breastfeeding, maybe she can do both. Pump enough to fill her up and comfort nurse (using a more upright position...I found the football hold with a pillow underneath my arm worked best for me for all my kids. If I did it any differently they were too easily distracted. The child needs to be able to eat without throwing up or as she gets older she may develop issues with food in general because her first food caused her pain. I find nothing wrong with quitting breastfeeding if the needs of the child show that breastfeeding is NOT the best thing. If she is better off with a bottle then so be it..the mother can hold the child when feeding, she can use breast milk if she pumps and there is nothing wrong with nursing in between..at nap times, at bedtimes..when she wakes up at night as long as she can find a hold that doesn't cause the GERD flare up. If she can't..that's okay too..hold her while she has her bottle, she can even mix formula and breastmilk if pumping doesn't create enough. Nothing is worse than watching your own child suffer. If breastfeeding makes her suffer, why put her through it? My advice is..if she can afford a second opinion, get one..but be honest with the doctor and make sure the advice of stopping breastfeeding is reported. If the first doctor is right and the second one is wrong..you could be setting this baby up for more discomfort than she needs to endure.

6 moms found this helpful

When my grandson was in NICU, weighing only just over 3 pounds, he had bad reflux. My daughter was unable to breastfeed OR pump because she has to take immunosuppressants and they cross breastmilk. The ped in the NICU put him on formula with rice cereal with the explanation that rice cereal gives a little weight to the milk causing it to settle further into the stomach and not be spit up so easily. It seemed to work for him, although at 16 months he still sometimes "burps up" stuff.

Not breastfeeding doesn't make you a bad mom. My daughter got many nasty looks and even rude comments for bringing out a bottle at feeding time. I felt SO bad for her. But really - sometimes it just isn't working. A good mom does what is necessary for her baby.

3 moms found this helpful

Don't let this turn into a battle over breastfeeding vs bottle feeding!!! The doctor is not telling her to quit breastmilk..he is telling her, for her baby's health and comfort to start using a different delivery method! I don't understand the addition of the rice cereal into the breast milk and i would certainly as for clarification on that but I do understand the needing to nurse in an upright position.
That being said, I can think of ways that you could nurse the baby while in an upright position...if they can get the GERD under control that might be an option for her. But she doesn't want to just ignore this GERD issue as "just heartburn"...it can do all sorts of permanent damage to the esophagus and cause some life long problems...so she needs to take this seriously.
Help your friend concentrate on the POSITIVES...after a difficult pregnancy and a lot of time in the hospital she has a wonderful new little life to delight in and this is just the first of many things that she will have to make decisions about, and putting her child's best interests above her own desires is just one of the things that Moms and Dad's do!!

3 moms found this helpful

I would tell your friend to contact a Lactation Consultant ASAP! There is no reason that she could not nurse the baby in an upright position. Also, do they know for a fact that it is GERD, and not just an oversupply or forceful letdown? That can also cause the baby to spit up a lot. Reflux is not *as* common in breastfed babies, as with formula fed babies.
Mom should try adjusting her diet, the baby may have some food sensitivites. If she has a lot of caffiene, she should try eliminating that.

I am glad your friend does not want to immediately listen to the doctor, they are not always right!! Good Luck to her!! Keep us posted! You should check out Kellymom.com, type in GERD, and it should pop up some good info ;)

2 moms found this helpful

Have her contact a lactation consultant. She should be able to get some good advice, and I would have her talk to another doctor.

2 moms found this helpful

As the mom of 3 reflux babies, I can tell you this is absolutely "standard" advice. Reflux babies do need to be fed in an upright position and kept upright at least 30mins after feeding. Thickening with rice cereal is also standard, especially with breastmilk since it is thinner than formula. It will not destroy their digestive systems or cause food allergies, although statistically reflux babies are more prone to food sensitivities. Eventually, the LES muscle (the muscle that controls the opening/closing of the flap between the esophageus and the stomach) will strengthen and function properly and the baby will stop spitting up. This is different for each child. Mine were 9mos, 6mos. And 4mos. Most likely the ped will put the baby on Zantac or something similar to prevent the production of acid so that they don't scar the throat while refluxing, which can introduce more food issues.

It can be a scary thing to go through, and frustrating at times. Just know that it doesn't last forever. If she has concerns, she should consult with a Ped GI. All that said, my daughters are now healthy, happy 6, 7 and 10 year olds with no food issues whatsoever! Hang in there, there is a light at the end of the tunnel!

2 moms found this helpful

My daughter had GERD and my niece currently has GERD. I exclusively breastfed my daughter for 8 months before introducing any solid food because the gastroenterologist told me that babies with GERD have an increased instance of food allergies and sensitivities. I wanted to do everything I could to avoid that. There are positions that you can breastfeed that keeps the baby in an upright position. My daughter actually did best when I fed her while I was reclined back a little and she so upright that she was almost laying on her tummy. I was very careful about what I ate and avoided foods that tend to upset a baby's stomach like dairy, caffeine, and spicy foods. I made sure to keep my daughter in an upright position as much as possible around the clock. I carried her in a wrap and she slept in her carseat or on my chest. Also, my daughter took medication to help with the acid.

My sister introduced cereal mixed with breastmilk at 4 months old to her daughter. She says it seems to make a little bit of a difference. She feels that the medication helps the most.

I would recommend that since your friend feels strongly about breastfeeding that she should contact a LLL leader or a lactation consultant. There are many different things that she could try in order to help her baby. If she is getting information from her doctor that doesn't feel right to her as a mom than she should get another opinion and more information. Moms have strong instints, and she should trust herself.

1 mom found this helpful

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