Reflux and Pumping

[mommy101]

hello
My 2 month suffers from reflux. She is growing beautifully and is feeding often but she spits up a lot. I will be going back to work in a couple months when reflux is supposed to hit its peak and am a little concerned about how much milk to express. I know the formula to work it out but with her spitting up so much I dont know if this would affect it at all.
Does anyone else have a baby with reflux and pumps? What works best?
Any suggestions would be greatly appreciated. Thank you in advance.
http://firsttimemoms101.blogspot.com

[stys82]

Hello

Was your baby diagnosed with reflux? The reason I ask is because when my son was around 2 mos he would also spit up a TON. I was so worried but after a while, probably a few weeks later, he suddenly spit up a lot less. I had tried keeping him upright and not too active after each feeding to help reduce the spitting up, I think that helped some but mostly it was just waiting out a tough period. If your baby is growing well and happy, it may just be normal.

I hope this helps, and best of luck to you and your baby!

[Shaunsmom]

I wondered too if the baby was diagnosed with reflux.

Our DD spit up tons in the early couple of months. She didn't have reflux and was a very spitty baby. Eventually she outgrew it by about 4 months or so but wow, the amounts that came back up looked crazy!

Sorry I don't have much advice. Hang in there and hopefully an expert like Amy G will come along and post here for you:)

[Amy_G_]

expert?
far from it.

Reflux really should have very little effect on pumping. Pumping long enough to get foremilk and hindmilk both will help baby to grow at their natural curve. Pump as many times at work as you would normally breastfeed, if possible. If that isn't possible, aim for pumping every 3-4 hours. Pump until after the milk stops flowing, for an extra 5-10 minutes if possible, but not to the point of pain.

Check out kellymom for info on bottlefeeding a breastfed baby while at work. http://www.kellymom.com/bf/pumping/bottle-feeding.html
as well as how MUCH to put in the bottle for a breastfed baby. Breastfed babies do not increase their ounces needed exponentially like formula fed babies do.

As for reflux, is it diagnosed reflux? If so, what is your treatment plan as of now? If it's meds, you'd stay on the same rate, increasing amount per doctor's instructions based on baby's weight.

If your treatment is to maintain baby upright after feeds, then you'd continue to do the same. If you thicken feeds, I'll suggest that you consider meds to lower acid production, instead of thickening feeds which doesn't lower acid, just makes the food weigh more by adding unnecessary fillers and early introduction of solids is linked to obesity, diabetes and other lifelong ills.

If reflux is not diagnosed and being treated medically, Is baby gaining weight at a reasonable rate? Are they extremely fussy and miserable at a certain time of day or after every feeding? Spit up by itself is not a sign of reflux, as babies are born with an immature digestive system, and if they get an air bubble trapped, when the air bubble comes up it tends to bring up some of what they ate. And it may look like a huge amount, but if actually measured, it's probably tablespoons, not large # of ounces.

[mommy101]

She was diagnosed at the baby clinic where I took her for her immunisations and the nurses did not seem worried about it. She is growing very well thanks to all the time I have to feed her and the large volume of milk I make. I do not like the idea of putting her on medicine as she is not bothered by it so I keep her upright as much as possible.
I just have one more questin regarding your statement to pump for 20 min after the milk stops flowing. My breasts are never empty. I can pump for 45 min and there is still milk coming out. Is this going to be a problem?
Thank you again for all the advice!

[Amy_G_]

Usually you pump for 20 minutes,
and then maybe for a few more minutes, maybe 5 or 10 for the milk to stop flowing.

However, from what you've said, sounds like you have OVERSUPPLY,n and in that instance, you'd pump what you have time to pump (most women do that anyway) whether the milk stops flowing or not.

If you have oversupply maybe baby doesn't have reflux after all, maybe baby is spitting up cause baby is getting too much foremilk? do you feed on both breasts at every feeding?

[mommy101]

That could very well be. What is the best way to remedy that? I only feed on one breast per feeding so she gets the hindmilk. I also have a forceful let down (it may go hand in hand with the oversupply) so I have to express so she doesnt choke. I express as much as I can but she gets pretty crabby very quickly when she's hungry and I dont like letting her cry too long. I also dont want to express too much because I may end up making even more milk.
Thanks you for your time in helping me with this. I'm not sure what to do about my milk supply. I love breast feeding and am worried if I do anything, I may decrease my supply too much.

[stys82]

I also have an oversupply and forceful letdown so when DS was younger I would have him latch on and once I felt the letdown begin I would unlatch (finger between boob and his gums) and catch the excess milk in a cloth. As soon as the letdown was over I would let him latch on again. I liked this method because it didn't require me to pump or hand express before he started to nurse and also because I wasn't removing too much milk, I didn't worry about accidentaly increasing my supply. Now that DS is older he can stay latched on during my letdown and he has no problems.

Oh yeah, you may also want to try block feeding to help with oversupply. I did two feedings on one side before switching which really helped me out. (I didn't look at the rest of the posts but in case this link has not already been given: http://www.kellymom.com/bf/supply/fast-letdown.html

[mommy101]

Thank you very much.
Do you let him cry then while you wait for your let down to slow? My baby screams and screams when I take her off the breast to express. Is it better for me to leave her to scream or to try and express as much as I can befoe she gets too upset and put her on again?

[Amy_G_]

It's better to work to lower your supply just a bit so that baby doesn't have to scream, get flooded with overactive let down, or get overfull on hindmilk and then spit up a lot.

Once you go back to work, your supply will probably settle down quite a bit, as a pump is not very good at emptying the breast, and milk left in the breasts signals your body to turn down the supply a bit.

so in the meantime, Feed off of one side per feeding. If this doesn't help, then feed off of one side for 2 feedings in a row, then switch to the other side for the next 2 feedings in a row. Do this for at least several days before trying to determine if it helps. Feed baby in a more upright position, so gravity isn't adding anything by way of making the let down more forceful.

Try NOT to express or pump any or you'll be telling your body you really do need all that extra milk. just pull baby off and let extra spray into a towel and then relatch once that slows.

of course, don't be militant in all of this, as baby will head into a 3 month growth spurt shortly, return to work will throw a monkey wrench into any best laid plans. Kind of go with the flow. ;)

[stys82]

Thank you very much.
Do you let him cry then while you wait for your let down to slow? My baby screams and screams when I take her off the breast to express. Is it better for me to leave her to scream or to try and express as much as I can befoe she gets too upset and put her on again?

For the 20 seconds or so that my letdown occurs, he would cry sometimes. I knew that he would wind up choking if I let him stay latched on so I did allow him to cry. While we were waiting, I would just comfort (rub his back, talk to him) him as much as I could. I noticed however that If I fed him before he was too hungry he would not be as upset.

[StillSingingMom]

I thought my first baby had reflux. So did the doctor. She wanted to put him on a medication.

However, in hindsight it is pretty clear that what we all thought was reflux was, in fact, oversupply.

Your baby may actually have reflux. I don't know. But it sounds like you have a very generous supply, so it certainly is possible that you have oversupply and nobody has reflux. Which is (whew!) a good thing, right?

Block nursing should help settle your supply down to a manageable level for baby within a few days. Very few women have oversupply to the point where block feeding DOESN'T settle it down- but if that turns out to be you, come back and we'll help with that.