Tuesday, November 30, 2010

Oversupply Reflux in a Breastfed Baby

Many medical professionals believe that you cannot over feed a breast fed baby....Hogwash.  When I used to hold open clinics I could almost draw a line down the room of fussy babies.  Half would be skinny, grumpy looking old man bubbies and half would be gynormous Buddha babies.  The skinny ones were crying because they were not getting enough milk.  The Buddha's were crying because there guts were full to bursting and they had sequential Christmas dinners for the past 4-8 weeks.  There is only so much a newborn esophageal sphincter can take (the muscle ring that keeps the food inside....quite undeveloped in most newborns...which is why they spill a lot).  Some theories also believe that the mums who have too much milk also have high amounts of foremilk which is high in lactose.  The baby only has so much Lactase the enzyme which breaks down the lactose and so the excess undigested lactose then causes gastric cramping as it shoots through the gut.   Basically a recipe for a really grumpy little bubby.

Symptoms of Oversupply Reflux:

In Baby:

First thing is get help from a professional that has experience in dealing with Oversupply Reflux, Lactation Consultants usually have experience with treating this challenge and when working in conjunction with a supportive GP or Paediatrician usually can fix the issue in a week or two.

Some things that have worked for my clients in the past are as follows:

  • The primary treatment is aimed at reducing the speed and amount of milk the baby takes in.
  • Expressing off the first let down into a cloth and then latching baby after the lactose rich foremilk has passed can sometimes help.
  • Feed on one side only  for a 3-6 hour block, this enables the baby to get less volume and higher fat content.
  • Feed until baby begins to pop off or fight at the breast, then pick up and cuddle on shoulder for about 5-20 minutes.  You can offer small top ups after this on the same side only (this seems to settle babies and may be related to washing down a burning silent reflux)
  • Nipple shields can help baby control the flow.
  • Feed baby in an upright position with his bottom much lower than his head.
  • These babies tend to do better being held by a family member while they are in pain.  Holding the baby upright and gently moving tends to help baby cope with the discomfort.
  • Raise the head of the babies sleeping area by 40 degrees.
  • Reflux medication can help in many cases where baby is in a lot of pain.
    • Most parents seem to prefer Ranitidine to Gaviscon for ease of use and effectiveness with a baby.
  • You can express your breast only to comfort not to empty, as that would stimulate more milk production..
  • Leaving a baby to cry it out that is in pain is not developmentally appropriate.  They do not yet have the ability to soothe themselves and need help.  So lots and lots of cuddles for baby as well as parents until baby comes right.  
  • Cabbage leaves can help with engorgement and help reduce supply in heavy breasts (cut the hard stem out and roll the leaves with a rolling pin then place them on the breasts in the bra, when they wilt replace them with fresh ones.  I would recommend using an organic cabbage so as not to potentially).   put pesticides near the breasts).  Use in moderation because these can be more powerful than you would suspect.
  • If the milk supply is just over the top and will not be tamed by the above measures then you can try using an herbal tincture called Galactagone (try healthfood stores).  But be very careful as it will kill a large supply almost overnight.  I only use in extreme circumstances.

1 comment:

  1. thanks for the post. my 14 week old spills a lot on some days, gets agitated and pops off the breast very quickly, usually in the afternoon. she'll be calm by night. i am sometimes guilty of quickly putting her to my breast to soothe her cries, maybe even when she's already have a full stomach. i don't feel i have an oversupply at the moment but will be more mindful from now.