Author: InfantBasicsandToddlerTraining

Emily Blewett, RN, BSN, CLC is a proud mom, NICU Nurse, Certified Moms on Call Baby & Toddler Sleep Consultant + Certified Lactation Counselor. Emily combines the expertise of a nurse, with the care and concern of a mom to partner with you on this wonderful, yet at times confusing and exhausting parenting adventure. Photo by Milana Mia Photography with Kaylee Baggerly

Many babies experience their stomach contents coming back up into their esophagus, known as reflux. If your baby is happy and gaining weight, they are known as our happy spitters and do not need to be on medication for reflux. For our unhappy spitters, they may be diagnosed with gastrointestinal reflux disease (GERD).

GERD is a condition where the contents in the stomach rise up through esophagus AND cause symptoms. Below are some signs and symptoms of GERD:

• Refusal to feed
• Crying, arching their back during feeds
• No weight gain or very slow weight gain
• Vomiting (a forceful flow that shoots out inches)
• Pain with feedings and/or vomiting

Some babies with GERD will be started on medicine, like Zantac or Prilosec. What these medicines do is decrease the acid secretions in their stomach. It is the acid that causes the pain when they spit up. This means your baby will still spit up while on these medicines, but it will be less acidic, so it won’t hurt as much.

Medicine alone will not take away the symptoms of reflux. There are some adjustments that we can make to help these reflux babies feel their best:

In my NICU and lactation experience, classic nipples work best with all babies. Like my friend Mariana says, “Classic never goes out of style.” At Moms on Call, these are the ones that we have seen work most effectively in reducing reflux symptoms, helping with difficult eaters and reducing gas in babies.

When bottle feeding, feed them in an elevated side-lying position. It allows the baby to control the flow of the feeding, which provides a positive feeding experience. With the “crook of the arm” positioning, gravity can have milk flood the baby’s mouth, which leads to gulping, coughing and choking. Studies have shown this position gives babies more feeding endurance. It also leads to increase engagement and volumes of milk.

Did you know feeding is like an aerobic exercise for babies? If feedings go over a certain time or feedings are too close together, it can cause more gas as the digestive system ramps up and also produce more acid secretions, which is what causes the pain. We want feedings under 30 minutes and feedings at least 2 ½ to 3 hours apart. This allows their digestive system to rest, reset and boot.

Do you have questions regarding reflux, gassiness, breastfeeding, bottle feeding, or anything baby or toddler related? Book a personalized consult with me through FaceTime, In-Home, or Email! Check out Personalized Consultations for more information!

Emily Blewett, RN, BSN, CLC is a proud mom, NICU Nurse, Certified Moms on Call Baby & Toddler Sleep Consultant + Certified Lactation Counselor. Emily combines the expertise of a nurse with the care and concern of a mom to partner with you on this wonderful, yet at times confusing and exhausting, parenting adventure. Photos by Milana Mia Photography with Kaylee Baggerly

I am sharing some of my tips and tricks to help your baby become a great eater with the bottle, whether exclusively breastfed, bottle fed or combination of both.

There are three keys to support your baby’s ability to become a great eater with the bottle:

• Type of bottle and nipple
• Positioning
• Time

Type of Bottle and Nipple

In my NICU and lactation experience, classic nipples work best with all babies. Like my friend Mariana says, “Classic never goes out of style.” At Moms On Call, these are the ones that we have seen work most effectively time and time again. We advise families to pick one type of bottle and stick with it. Babies thrive in consistency and familiarity.

My favorites include:

• NUK/Gerber First Essentials Bottles with Dr. Brown’s Standard Nipples
• Evenflo Bottles
• For moms who want a breastfeeding bottle, Lansinoh

Check out more of my favorite bottle feeding products!

Positioning

Did you know there is another position to feed your baby a bottle than in the “crook of the arm”? The preferred bottle feeding position with newborns until 3-4 months old is the elevated side-lying position. This is when the baby is laying on their side, as seen in the photo below. Their ear, shoulder, and hip should all be aligned. For elevated positioning, I cross my legs, but you could also use the Boppy or a pillow.

Advantages to using the elevated side-lying position:

• It allows the baby to control the flow of the feeding, which leads to a positive feeding experience. With the “crook of the arm” positioning, gravity can force milk to flood the baby’s mouth, which leads to gulping, coughing and choking.
• Studies have shown this position gives babies more feeding endurance. It also leads to increased engagement and volumes of milk.

For breastfeeding moms, this position also:

• Mimics the breastfeeding positioning
• Supports breastfeeding skills
• Provides consistency between breast and bottle feeds

For breastfeeding mothers, we want to make sure to introduce the bottle to baby at 2-3 weeks old, once a breastfeeding latch has been well established. It is important to keep the bottle part of their daily routine. When first introducing the bottle, we can use their 24-hour clock to know what time the bottle feeding is coming. If we try the same feeding time each day, they learn faster. Once they are doing well with the bottle, you can offer it anytime that is most convenient for your family. For example, the time that worked best for our family was the bedtime feeding. This allowed dad to be involved with a feeding and have time to bond with our daughter. It was such a sweet time. Plus it gave me time to take a break and made date nights much easier – no rushing home to feed the baby!

Time

Did you know feeding is like an aerobic exercise for babies? If feedings go over a certain time or feedings are too close together, it can cause a cycle of not getting a full feed, then not resting well, hungry sooner, too tired to eat great, eats a little etc. These small feeds cause more gas as their digestive system adapts and can hinder them getting those nice, big feedings. For babies under 2 weeks old, feeding times should be between 30-45 minutes. For babies over 2 weeks old, we want feedings under 30 minutes.

One final tip in laying a healthy feeding foundation with your little one, is beginning the Moms On Call Feeding Routine based on the baby’s age.  I began using them when my daughter was 6 weeks old–their schedules were a game changer for our family! It removed all the guesswork, simplified parenting a newborn, and brought me peace of mind as a new mom. Their routines laid a healthy feeding and sleeping foundation for our daughter that benefited our family (and marriage).

Do you have questions regarding breastfeeding, bottle feeding, weaning, or anything baby or toddler related? Book a personalized consult with me through FaceTime, In-Home, or Email! Check out Personalized Consultations for more information.

Reference

Seattle Children’s. (n.d.). Developmentally Supportive Feeding in the NICU. Retrieved April 2, 2020, from https://www.seattlechildrens.org/globalassets/documents/healthcare-professionals/neonatal-briefs/side-lying-feeds.pdf