Before the birth of my son, I spent hours researching various brands of products that I assumed I needed. I scoured bookstores and tried to decide which books to purchase and which philosophies made the most sense to me. One year after Max’s birth, I took inventory of the products and books that I had purchased or was given. Most of them were unused or had been a total waste of money. In the end, it was really getting back to old-fashioned basics that had benefited us the most.
Max was born with infant reflux. He rarely slept for longer than 20 minutes at a stretch unless held or carried. He spit-up or vomited frequently and was in acute physical distress for hours during the night, moaning in pain. He cried for hours inconsolably and nursed for 45-90 minutes at a time, every 2 – 2½ hours for most of the day. He refused to be laid on his back and was unhappy in his seat or swing. Although he wanted to be constantly held, he hated the sling and only tolerated the front carrier, preferring instead to be held in arms in an upright position.
Modern Products and Advice Helpful? Not Always…
Luckily for Max, he has the type of personality that demands things. He was able to communicate in no uncertain terms what he did NOT want. It was a long list that covered many modern baby-raising practices such as:
• Scheduled feedings
• Formula and bottles
• Flat nursing pillows
• Play yards, swings and infant seats
• Modern slings or carriers that put pressure on the tummy
• Sleep training
Don’t get me wrong, I am a huge advocate for products or advice that make the baby or the parent more comfortable, and above all assist in sleeping. However, I think that Max would have been better off if I had NOT read so many books or researched so many products and instead just listened to Max.
Old Fashioned Basics
Max wanted very few things really. He wanted things that babies in less developed countries get automatically, without the benefit of parenting books or expensive products. He wanted:
• On demand breastfeeding in an upright position
• Constant carrying in an upright but supported position, as with a Moby Wrap, Baby Cuddler, or Mai Tei
• Sleeping in physical contact with parents
Once we established what he did want, our lives changed dramatically.
Frequent Connection Between Fussiness, Colic, and Reflux
It is now commonly believed that fussiness and colic are often caused by undiagnosed baby reflux, or GER. It is also estimated that between 40 and 60% of all babies suffer from some degree of reflux in the early months due to an under-developed lower esophagus sphincter (LES). That means that half of all babies may experience physical distress due to gas or acid in the esophagus. It is important to realize that a baby need not spit up in order to be refluxing. This is called silent reflux. This does not necessarily mean these babies need medication. They may require or benefit from some simple lifestyle changes.
How Products, Advice and Schedules Can Aggravate the Problem
Many of the things you are currently using or doing may be making the problem worse.
• Choose breastmilk over formula. Human breastmilk is the most developmentally appropriate and easily digestible food source for a human baby. Formulas contain many ingredients that can cause intolerances. You may consider eliminating from your diet dairy or other foods that can cause intolerances to see if they are also aggravating your baby’s system. Food intolerances can aggravate reflux and increase gas.
• Choose breastfeeding over bottle feeding. The act of the tongue against the roof of the mouth improves disgestion by creating waves that push food through the digestive tract. This happens when a baby sucks on a breast and does not happen as effectively when a baby sucks on a bottle.
• Do not schedule or time feedings. Your baby knows how much milk he/she needs and will feed appropriately in order to establish the correct milk supply for you both. By timing, scheduling, or withholding feeds you are inhibiting your baby’s efforts. The correct frequency and number of feeds will be unique to every mother and baby team and should not be advised by a book. Overfeeding can aggravate reflux and increase gas.
• Finish the first breast before switching sides. Many books will tell you to offer both breasts at one feeding. Follow your baby’s lead. Leave your baby on one breast until you feel he/she is actively seeking more milk rather than just comfort nursing. You will very quickly be able to tell the difference by the intensity of your baby’s sucks and other more unique cues your baby will give you. This will help with oversupply and overactive letdown as well as foremilk/hindmilk imbalance. All of these conditions can aggravate reflux and increase gas.
• Stop stressing over insufficient milk supply. If your baby is gaining weight and has the appropriate number of wet or soiled diapers in a 24-hour period, then your supply is more than likely just fine. Do not try to gauge your supply by the amount of milk you get when pumping. Stress over supply is a very common reason to begin supplementing with formula and may lead to the end of your nursing relationship.
• Feed your baby in an appropriate feeding position. The natural nursing position is with baby on his/her side with the body on an angle so that the head is higher than the rest of the body. Preferably the angle will be about 30 degrees, although some babies will benefit from an even greater angle. The head and spine should be well supported and in a straight line. This will facilitate digestion. You can achieve this through the use of a nursing wedge or by propping FIRM pillows.
• Keep your baby in an upright position with no pressure on the tummy. This is especially important during and for 30-60 minutes after feeds. Reflux happens most frequently when a baby is laid flat on his/her back, such as in a play yard or on the floor on a play mat. In addition, deep seat “wells” where the seat bottom and back meet in many bouncy seats or swings can put baby in a position that puts pressure on the tummy. The strapping mechanisms can also increase tummy pressure. Some slings can curl baby in a position that puts pressure on the tummy. Some modern carriers also do not hold the baby in tight enough so that the baby slumps slightly, putting pressure on the tummy. Asian-style baby carriers like Mai Teis and Podegis keep the baby in an upright position close to you so the baby does not slump or slouch. Moby Wraps and Baby Cuddlers can also be adjusted so that the baby is very upright and close to you.
These lifestyle changes are simple to implement and any baby will benefit from them, especially babies who are fussy, colicky or have reflux. They require very little money and, in fact, may save you money in desperation purchases you might make in order to calm and quiet a baby made uncomfortable by following inappropriate advice. Now if I could only return all these unused baby products.