The Boob Group
Reflux GERD Breastfeeding

Robin Kaplan: Gassy, fussy, grumpy babies. What is a mom to do to help sooth her baby’s aching tummy and what is the difference between normal infant gas versus reflux or GERD. Today I'm thrilled to introduce our expert Catherin Watson Jenna, an International Board Certified Lactation Consultant in private practice in New York City. She is also the author of multiple lactation books and a popular speaker on infant sucking skills.

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Robin Kaplan: Welcome to The Boob Group, Broadcasting from the Birth Education Centre of San Diego. The Boob Group is your weekly online on-the-go support group for all things related to breastfeeding. I am your host Robin Kaplan. I am also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Centre. Thanks to all of our loyal listeners who have joined The Boob Group Club, our members get all of our archived episodes, bonus content after each new show plus special giveaways and discounts. Subscribe to our monthly newsletter for a chance to win a membership to our club each month. Another way for you to stay connected is by downloading our free App available in the Android and iTunes market place. So today we are joined in the studio by two lovely panelists, ladies will you please introduce yourselves?

Jenna Jordan Ikuta: Hi my name is Jenna Jordan Ikuta and I am 24. I work with Children with Special Needs here in the San Diego area as a Needy contractor. I have one daughter and her name is Scarlett and she’s four months old.

Liz Hampton: Hi I am Liz Hampton. I'm 36 years old. I'm a stay-at-home mom to two daughters, two little girls and age is 3 and six months.

Robin Kaplan: Wonderful and we also have our brand new producer MJ in the studio as well. So MJ would you like to introduce yourself as well?

MJ: Yes, my name is MJ – Fisher actually last name and I am a mom of a two year old boy Jason. Just starting to work with you girls here doing lots of social media so if you all want to join our conversation here we’re Facebooking and you can ask questions or we’re Tweeting and you’re welcome to ask any questions you can be a part of this topic.

Robin Kaplan: Well thanks MJ. Alright we’ll be right back.

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Robin Kaplan: So we’re here with Jacqueline Lawrence, the creator of ColicCalm and TummyCalm. So welcome to our show Jacqueline.

Jacqueline Lawrence: Oh, thank you.

Robin Kaplan: Yeah so can you tell us a little bit about your company? When did ColicCalm first go in the market and what inspired you to create this product?

Jacqueline Lawrence: I’d love to! Yes, it was 10 years ago that my first born came into this world screaming and pretty much didn’t stop for four months. So our pediatrician called it the worst case of colic which included some reflux that he’d ever seen or heard and it certainly seemed like a curse at the time. It was just terribly devastating to watch him suffer and really not have anything to help him. So I went on a very driven mission to find a solution and the result was a huge silver lining. It was serendipity really that this wondrous combination of what I call Mother Nature’s gift came together and it’s now known as the product ColicCalm.

Robin Kaplan: What is ColicCalm exactly and how does it help settle baby’s digestive issues and upset tummies?

Jacqueline Lawrence: Sure. It’s a synergistic blend of nine aged old homeopathic remedies, very important to me as a holistic mom to start with the natural things like chamomile, aloe, ginger are better known for soothing abilities and it’s the combination that’s so unique and so affective and easily calms digestive systems and even the nervous system in a minutes and it does taste good too which is an added really for everyone.

Robin Kaplan: And what is TummyCalm? This is a new product that you all have correct?

Jacqueline Lawrence: That’s true. Yes, while ColicCalm is perfect for the common new born discomfort including colic upset stomach, hiccups, teething TummyCalm our newest product is targeted to quickly relieve primarily gas and bloating in children of all ages.

Robin Kaplan: Okay.

Jacqueline Lawrence: It just makes sense to develop the second product as our own children started getting older and it’s equally amazing for tummy troubles caused by anything from food sensitivities to over indulgence in junk foods and even stomach problems caused by nerves these days, it’s pretty tough being a kid, huh?

Robin Kaplan: Yeah, no kidding.

Jacqueline Lawrence: All the pressures!

Robin Kaplan: Is it a different combination of homeopathic remedies then in there?

Jacqueline Lawrence: Exactly, exactly.

Robin Kaplan: Okay and I know some lactation consultants don't recommend gripe waters specifically just because they’ve added sugar and kind of junk stuff in there that aren’t good for the baby’s gut so what makes ColicCalm different than these other gripe waters on the market and gas drops I should say?

Jacqueline Lawrence: Good point. Yes, ColicCalm and TummyCalm are very different. First of all they are FDA regulated over the counter medicines and they are manufactured under the strictest standards superiority and efficacy here in the US. And like all homeopathic medicines, they encourage the body to self heal as opposed to merely suppressing symptoms. And in addition our products are free, as you mentioned, of sugar, baking soda, synthetic Simethicone, artificial flavors and colors. The anti spasmodic properties, I believe are beyond comparing relaxing the digestive systems and relieving upward pressure too. So if reflux is the problem, a great natural place to start before resorting to pharmaceutical drugs.

Robin Kaplan: That’s so wonderful. I know I was checking out your website and I love the little videos about how the digestive system works that’s very informative.
Jacqueline Lawrence: I hope so, that’s our goal.

Robin Kaplan: Yeah, it’s great.
Jacqueline Lawrence: Thank you.

Robin Kaplan: Well, I do want to mention that if our listeners go to tummycalm.com that they can find a $3 off coupon for the TummyCalm. That’s really exciting, they can go try it out and I love that you have the money back guarantee as well so that way if for some reason it doesn’t work, but I know I recommend it a lot as well, our parents seem to have a lot of good feedback for your company.

Jacqueline Lawrence: Thank you so much.

Robin Kaplan: Yeah, so thank you so much. We really appreciate you being on our show.

Jacqueline Lawrence: Lovely to be here. Thank you for spreading the word, so appreciated.

Robin Kaplan: Thank you so much. Well, have a wonderful day.

Jacqueline Lawrence: You too!

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Robin Kaplan: So today on The Boob Group we’re discussing reflux and GERD in the breast fed baby. Our expert Catherine Watson Genna is an International Board Certified Lactation Consultant in private practice in New York City. She’s also the author of the books, Supporting Sucking Skills in Breast Feeding Infants and Selecting and Using Breast Feeding Tools as well as a wildly popular presenter at Lactation conferences around the world. She’s also one of my favorite experts in the field of lactation so I'm super excited to have her on the show. So thanks so much for joining us Catherine and welcome.

Catherine Watson Genna: Thank you for having me Robin. Hi everybody else.

Liz Hampton: Hello.

Robin Kaplan: So Catherine, let’s talk normal infant behavior first. What does typical fussiness and gassiness look like for a new born baby?

Catherine Watson Genna: Okay well fussiness and gassiness and reflux are two different things – are three different things. A lot of babies get fussy when they are over tired or overly hungry or over stimulated and then usually nursing them will bring them back to being relaxed or going to sleep or whatever they need. And all babies pass gas sometimes. As long as they don't seem to be unduly uncomfortable we don't worry about that either. And babies spit up sometimes too and they think that from recent studies that about three or four times a day that your average baby will bring up some milk and it’s effortless and it doesn’t seem to hurt them, it doesn’t fly across the room so that’s what seems to be normal for babies.

Robin Kaplan: Okay and Tiffany from Facebook wanted to know how can you tell the difference between normal infant gassiness and spitting up as well, I guess, versus reflux? What are common symptoms and how are these and are the symptoms different for silent reflux?

Catherine Watson Genna: Okay, well normal reflux is normal. Reflux is just effortless spitting up of milk, the milk comes up effortlessly. The little valve at the top of the esophagus, it’s called the lower esophageal sphincter – sorry at the top of the stomach, is looser in babies than it is when they grow up. And babies also spend a lot of time lying down or sitting up so several times an hour actually a little bit of milk comes up from the stomach into the esophagus and three or four times in a day it will make it all the way up into the baby’s mouth and the baby will spit it out. That’s normal. What isn’t normal is a baby who is projectile vomiting, whose vomit is very smelly or it feels slimy like egg whites, that’s not normal and that’s gastro esophageal reflux disease and that’s a different thing.

Robin Kaplan: Okay and so you had mentioned all babies have some sort of degree of reflex due to the way their digestive system is supposed to work at that time so how long does it take for an infant’s digestive system to fully develop?

Catherine Watson Genna: Well by about eight or nine months depending on whether the baby’s exclusively breastfed or not. Exclusively breastfed babies seem to grow out of refluxing a little earlier around seven to eight months and babies that are mixed fed stop refluxing somewhere around eight, nine months, up to about 18 months or so.

Robin Kaplan: Okay.

Catherine Watson Genna: Doctors recommend that if babies are still spitting up numerous times a day by 18 months to two years they should get checked for allergies and gastro esophageal reflux disease or GERD for short.

Robin Kaplan: Okay. So ladies in our studio, how old was your baby when – I guess they’re both little girls in here, so when she started to get this kind of really fussy and gassy and what was it that actually concerned you? Jenna?

Jenna Jordan Ikuta: I think she was probably anywhere from two to three weeks when we really started to kind of worry about it. She was extremely fussy and we couldn’t figure out what the issue was, we tried everything in the book and she was really gassy in the very beginning, she ended up having more of dietary issues that I was ingesting but trying everything and just continuing to make sure that she knew we were there and calming her down was really what helped her fussiness more than anything. And the gassiness we took a few things out of our diet and the gassiness, didn’t actually go away but it became less of a painful experience for her.

Robin Kaplan: Okay. How about you Liz?

Liz Hampton: Yeah, I noticed it pretty soon. I have an elder daughter so I was trying to remember back and at some point I was thinking this is not normal new born behavior. I could never put her down. And I could hear – so my baby, I believe has silent reflux. I could hear it coming up in the throat and so I asked the pediatrician about that but she just cried all the time unless I was holding her very close. So I did a lot of baby wearing around the clock. But around six weeks was when I decided I need to do something about this, this is definitely not normal behavior and so I started making dietary changes as well. And for us that was a big factor in it but we also did have reflux after that so we ended up putting her on Zantac.

Robin Kaplan: Okay.

Liz Hampton: For six months.

Robin Kaplan: Okay.

Liz Hampton: And she just has gone off of it.

Robin Kaplan: And how is she doing now?

Liz Hampton: She’s doing great as long as I am very diligent about my diet, it’s really difficult. She’s allergic to dairy and soy specifically, we’ve figured out, so if any little bits of dairy sneaks in it’s just hours of crying and fussiness. But so unfortunately, those slip ups happen every now and again if –

Robin Kaplan: If you eat out.

Liz Hampton: If you eat out exactly.

Robin Kaplan: Yeah.

Liz Hampton: Which we’ve really – we love to cook, we have a big garden at home but it’s impossible to eat at home a 100% of the time or at least I find it.

Catherine Watson Genna: Oh, it’s so hard to have an allergic baby. And actually the research shows that babies who truly have reflux disease it’s usually because of allergies.

Robin Kaplan: That’s amazing, think about how many babies are sitting here and not necessarily in our studio but just that we see everyday who are battling this and sometimes these dietary changes can actually – as you have noticed too make a huge significant difference in them. Catherine, when does a little bit of reflux turn into something more concerning?

Catherine Watson Genna: When there’s gut damage. When babies have allergies even being on reflux medicine won’t protect their gut unless we take the allergens away. So both Liz and Jenna did really smart things with trying to examine in their diet, what was bothering the baby and taking those things out and eliminating those exposures.

Robin Kaplan: And well, definitely I want delve into the food intolerance as well in a little bit because that’s such a large component of this. What would you say Catherine are the differences between reflux and GERD?

Catherine Watson Genna: Well GERD, there is damage. There is damage to the gut. That’s what makes it a disease. Refluxing babies will reflux numerous times an hour, just a little bit pass their stomach and several times a day into their mouth or out of their mouth and that’s normal. It’s painless, it doesn’t do any damage to the baby’s esophagus, to the baby’s stomach but in GERD, in reflux disease the baby actually gets injury to the lining of the esophagus and even the lining of their intestines. And this is the allergy connection.

Robin Kaplan: Okay.

Catherine Watson Genna: Whatever they’re allergic to seems to set up a nasty reaction that damages their little body inside.

Robin Kaplan: Is it because of the inflammation that’s causing that damage or?

Catherine Watson Genna: Yeah sure anytime we have an allergic reaction, histamine is released and that causes a whole inflammatory cascade exactly and that can cause the gut damage.

Robin Kaplan: Okay and how is GERD diagnosed? Is it mostly diagnosed by symptoms or is it something that actually needs a diagnostic test?

Catherine Watson Genna: Well, there are several diagnostic tests and not all of them agree. So there are things like pH probe where they put a little tube down the baby’s nose or mouth into the esophagus and they can measure the pH and that’s the acidity or alkalinity of what’s coming up. pH probe only picks up acid reflux which babies don't make very much stomach acid until they are about six months old and that’s why we don't start solid till six months. And there’s also something called a multichannel impedance monitoring and that uses a different type of tube that can pick up gas coming up or acid coming up or mix reflux, that’s gasses and liquids from the stomach coming up together.

Robin Kaplan: Okay. Ladies were your babies everly formerly diagnosed with anything? Or was it just something that you knew there was some reflux going on and there also some symptoms that you just really wanted to kind of alleviate? How about you Jenna?

Jenna Jordan Ikuta: She was diagnosed with allergies more than anything. We definitely noticed the reflux or the GERD whichever she may have, we never had that diagnosed. We went to an allergist and had her tested for allergies and she is allergic to dairy, wheat and soy. So we just cut all of that out of our diet before it got any worse so.

Robin Kaplan: Okay and about what time did you do that? How old was your baby?

Jenna Jordan Ikuta: She was about six weeks I think when we had her tested.

Robin Kaplan: Okay.

Jenna Jordan Ikuta: Yeah, six to eight weeks somewhere around there and has done drastically better since we cut everything out.

Robin Kaplan: How about you, Liz?

Liz Hampton: Yeah my pediatrician just said it sounds like silent reflux from everything that I had described and I also – at the suggestion of some good friends who had gone through it read a book called Colic Solved. And that was really helpful for me in kind of figuring out what was kind of going on with her so I didn’t get a formal diagnosis but just cutting out dairy within five days it was like I had a new child. She was suddenly just calm and smiled at us for the first time. And there she’s telling us!

Robin Kaplan: We have both babies in here now Catherine.

Catherine Watson Genna: I hear they sound great.

Robin Kaplan: They are. Catherine, have you heard of that book Colic Solved before?

Catherine Watson Genna: Yes, by Dr. Bryan Vertabedian.

Robin Kaplan: Okay.

Catherine Watson Genna: He’s a good guy, yep.

Robin Kaplan: Okay fantastic. Well when we come back we will discuss with Catherine some common causes for reflux symptoms as well as helpful remedies for reflux and GERD. We’ll be right back.

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Robin Kaplan: Well welcome back to the show. We’re here with Catherine Watson Genna, an International Board Certified Lactation Consultant in private practice in New York City. So Catherine, what are some common causes for these symptoms of reflux and GERD symptoms in breastfed babies?

Catherine Watson Genna: Sure, there seem to be about three things. One thing is swallowing difficulties. Sometimes mom has a fast flow or baby has a tight tongue and those can lead the baby to have difficulty swallowing comfortably and that will make the baby cry and because the baby is upset and their nervous system is over activated that will cause more spitting up. So that’s one set of things, so feeding problems are one set of things that can cause this kind of behavior. As we talked about a few minutes ago, allergy is another big issue. With babies who are allergic often they have a rash like eczema or they have spit up that’s the consistency of egg white. It’s mucusy and doctors call that Mucus MSS. And those are two really reliable signs that the baby is having allergy difficulties. With eczema, it’s your standard type of allergy, your IgE mediated allergy and for the Mucus MSS it’s usually something newly discovered called the T cells mediated allergy.

Robin Kaplan: Is that something that you can test for?

Catherine Watson Genna: Yes, doctors can test for it. The easiest way to test for it is an elimination challenge --

Robin Kaplan: Diet.

Catherine Watson Genna: Just what Liz and Jenna were talking about take away the things that you think might be bothering your baby. Cow milk is a really big allergen, soy is another thing especially in moms who are vegetarians and need a lot of soy, that’s a big potential allergen. If you take away the biggest allergen and your baby is suddenly happy a day or two or three or four or five later and then you add it back a few weeks later and the baby is upset again or sick again or crying again that’s a pretty good sign that that’s what your baby is having difficulty with. And if it’s harder to pin down, if there are more things the baby is allergic to or if the baby is seriously ill like refusing to eat and losing weight then there are medical tests that can be done as well.

Robin Kaplan: Okay, something we did with our son too. He was a little bit older but we did some muscle testing with an osteopath in San Diego and that helped us kind of pin point a few things to try to eliminate first and then before we started adding them back into his diet to see how he reacted to it.
Okay, so what are some measures that mothers can take when they – for example the two moms in the studio, they eliminated foods from their diet, their babies did significantly better but they were still having some, some significant fussy periods. What are you favorite measures Catherine for helping sooth these symptoms?

Catherine Watson Genna: Well one thing you can do is Dr. Keener Smiley’s new trick. If baby seem to be a little bit fussy especially for moms who seem to be milk goddesses and make lots of milk, she calls it doing the breast milk shake. What you do is you kind of shake and massage the breast for a few seconds before nursing, to knock these fats off of the blocked twaddles and put it back into the milk so the baby gets a good balance of fat and sugar in their milk and that’s one trick that can be really cool.
As you said the elimination diet, but remember to challenge. Dr. Arvalo, who is a researcher in Italy, studied babies with blood in the stool as one of the signs of an irritated gut and they recommended very strongly that mother’s challenge because only about 18% of the babies turned out to have cow milk allergy, the rest just had some sort of low level infection. And they actually did cultures and they were able to identify the germ the baby was just barely sick with and that was causing the little bit of fussiness or the little bit of blood in the stool which often goes along with reflux too.

Robin Kaplan: Okay, how about things like Gripe Water and stuff like that? Do you know much about those?

Catherine Watson Genna: Yes, it’s way better not to give babies any of those things. Most Gripe Water and things contain sugars and the sugar in mom’s milk is special. It’s lactose and it’s a really great fuel for the brain but it’s also a really great fuel for healthy bacteria in the baby’s gut. When we give them different kinds of sugars bacteria that are not so good can grow in their belly and make them feel even worse. In fact some of the other studies have shown that babies that are cranky or babies that seem to have GI problems don't have as many good bacteria in their gut so exclusive, exclusive breast feeding is really helpful so that babies have those normal healthy germs in their belly.

Robin Kaplan: Okay, how about probiotics?

Catherine Watson Genna: Yeah, that’s what we’re talking about. Now the probiotics that are sold are just like one bacteria, one strain whereas breast milk causes hundreds of different good things to grow in the baby’s tummy. The best evidence for a strain called Lactobacillus Reuteri, but I understand that they’ve stopped making the infant powder and that’s just something that I read yesterday.

Robin Kaplan: Oh no!

Catherine Watson Genna: Yeah, so there are just pills and liquids that have other things that we really don't want to be giving babies.

Robin Kaplan: Okay. Ladies, besides removing dairy and soy and gluten, Jenna for you, what other measures have you tried to remedy your baby’s reflux symptoms and what do you feel has worked the best? Jenna, how about you first?

Jenna Jordan Ikuta: We had her evaluated for a tongue tie and lip tie and we ended having her tongue tie clipped and we have decided not to laser or clip her lip tie. But that – just knowing that there was a structural difficulty helped a lot I think, we’ve floated her in a bath with lavender oil, we have tried the Gripe Water, we baby wear all over the place, we take away stimulations just so that she doesn’t get necessarily as worked up about whatever is causing her issues. We feed her before she cries, I've noticed that if she does cry she gets a lot more of the spit up and a lot more of the reflux that comes up into her throat because she’s so over tired and over hungry and we tried probiotics as well. Trying to think of all the different things that we’ve done.

Catherine Watson Genna: Jenna, you brought up a very important point that when babies have anything that’s causing them pain or discomfort that their nervous system tends to get ramped up and the carrying and the gentle handling all of those things help to normalize that nervous system activation again. So that’s really important stuff that you’re doing for her.

Robin Kaplan: She’s a very good mom. Liz, how about you? What worked best for you do you think?

Liz Hampton: Yeah, echoing a lot of what Jenna said, baby wearing husband life saving. I mean in the beginning she would cry unless I put her in the wrap and she would only go to sleep if I put her in the cradle position hold, I did a front wrap, cross carrying, woven her up and a cradle position hold and feeding her at an inclined breastfeeding and then she would fall right asleep within minutes. Whereas, if I try to rock her with a nursing pillow or something; she just would scream for an hour straight. But over time, trial and error that worked the best for us. We also went ahead and put her into a convertible car seat in our car pretty early so she was only eight or nine pounds and we put her in a larger car seat because it had a better incline, like more upright and definitely keeping her upright as much as possible especially after feedings and try to offer smaller, more frequent feedings.

Catherine Watson Genna: Those are the evidence based strategies. All the studies of normal reflux show that giving the baby shorter feedings, feed more frequently, hold them up right after feeding and avoid cigarette smoke exposure that’s another big reflux trigger. But no, you’re doing all the right things for her.

Liz Hampton: Thank you. It’s good to hear.

Robin Kaplan: I know it’s good to hear. Catherine, acid blocker Zantac, Liz had mentioned Prevacid, Prilosec all of these things are often a remedy recommended by pediatricians. Do you find that these help? Because the moms that I work with tend to find that they do reduce some of the symptoms but it sounds more like really looking at food allergens would probably be the wisest choice in the beginning. What are your thoughts on these medications?

Catherine Watson Genna: Yeah, the acid blockers are really unproven in babies. Anything you give a baby that tastes good maybe distracting for them and calm them temporarily so that’s why I think a lot of moms have positive experiences with things like Simethicone, the gas drop.

Robin Kaplan: Yeah, that’s what I was just going to say.

Catherine Watson Genna: That really go and do anything clinically but since they’re sugary and they have flavor they distract the baby for a bit so nursing often will do the same thing. The big problem with the Proton-pump inhibitors the brand new, really expensive reflux drug is they actually increase the number of acid pumps in the cells while you’re taking these drugs. Your body says, ‘Oh no, my acid pumps aren’t working I have to make more!’ and so when you take the baby off those medicines, well the same thing happen with adults, they have 30% to 50% more acid.

Robin Kaplan: No way!

Catherine Watson Genna: And they don't prevent the gut damage from happening.

Robin Kaplan: Okay.

Catherine Watson Genna: So they don't prevent the GERD, the disease part of reflux in babies that have allergies.

Robin Kaplan: Okay.

Catherine Watson Genna: So those are big problems.

Robin Kaplan: Okay, so what would be your biggest recommendations then? Looking for food to see if there are some sort of intolerance going on as one of your first recommendations?

Catherine Watson Genna: Yes, see a lactation consultant first and rule out the tongue tie. Tongue-tie is a big reason why many babies might have swallowing problems or may have difficulty getting enough milk, either of those things will make the baby cry a lot.

Robin Kaplan: Sure.

Catherine Watson Genna: Or makes the baby unhappy. So we want to rule out feeding problems and once we’ve ruled out or fixed feeding problems, if the baby’s still unhappy and especially if they have rashes or if they have that mucusy egg white textured spit up then we want to get them to the doctor and find whatever they may be allergic to. And if a baby is losing weight or refusing to eat we want to use a doctor and a lactation consultant together to try to solve those problems.

Robin Kaplan: Okay, how about the spit up that curdly?

Catherine Watson Genna: That’s normal.

Robin Kaplan: And smells?

Catherine Watson Genna: That just means that it was down there getting digested. It came from a little lower in the stomach.

Robin Kaplan: Yeah, my kids were infamous for those and I was like a walking, smelly mess for months.

Liz Hampton: Yes.

Catherine Watson Genna: Gosh.

Robin Kaplan: So about spit up, you had mentioned three or four times is pretty normal. When does the spit becomes worrisome? You had mentioned the projectile for example.

Catherine Watson Genna: Right, when a baby cries or refuses to eat and when you do persuade them to eat they throw up across the room that could be that they have a condition that the lower valve in the stomach is tightening up, it’s called Pyloric Stenosis and that’s a surgical emergency. It’s very rare in babies who never got any formula.

Robin Kaplan: Okay.

Catherine Watson Genna: Another couple of research studies just show that it’s extremely rare in exclusively breastfed babies. I think having one bottle of formula increase the risk fivefold.

Robin Kaplan: Oh my goodness, that’s amazing.

Catherine Watson Genna: Yeah.

Jenna Jordan Ikuta: Wow.

Robin Kaplan: Wow, well you’ve given us such fantastic information today Catherine so thank you so, so much for sharing these incredibly invaluable resources about reflux and GERD in a breastfed baby and for out panelists for sharing their experiences, we’ve learnt so much from you as well. For all of our Boob Group Club members our conversation will continue after the end of the show as Catherine will discuss if reflux and GERD is on the rise in infants or if it’s just being over diagnosed and over treated. For more information about the Boob Group Club please visit our website at the boobgroup.com.

Catherine Watson Genna: Thanks for having me Robin.

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Robin Kaplan: Here’s a question from one of our listeners, this is from Christine Wood Schilling. ‘Dear Boob Group, I'm looking for some advice. My exclusively breastfed three month old refuses bottles. He doesn’t like pacifiers; he’s not even a thumb sucker. I’ve had others, my husband and the siblings try to bottle feed him. I've tried several different bottles and no luck. I even started using a nipple shield to get him used to the feeling of a bottle and he’s fine with that but absolutely refuses bottles. Please help.’

Andrea Blanco: Hi Christine Wood Schilling, this is Andrea Blanco, International Board Certified Lactation Consultant. Bottles can be tricky especially with such a smart baby. While there are different tricks you can employ, often times it’s just the crapshoot to see what works. Start with trying different bottle teeth and placing them in the cup of your breast milk for a few hours and then offering the bottle with the breast milk soaked teeth. Always have someone else offer the bottle whether you are or not home. Try breastfeeding right positions and if that doesn’t work try the opposite, position where baby is not at all familiar to a breastfeeding position. Sometimes the change of scenery can help before attempting bottle feeding in the backyard for instance may yield results. Lots of patience, understanding and may be just a little bit of time. About four months you may be able to introduce a sippy cup instead of a bottle and the baby may react better to that. Good luck.

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Robin Kaplan: So this wraps up our show for today. We appreciate you listening to The Boob Group. Don’t forget to check out our sister shows, Preggie Pals’ for Expecting Parents and our show Parent Savers for Moms and Dads with Newborns, Infants and Toddlers. Coming up next week we have Abby from the Badass Breast Feeder discussing how to become a badass public breast feeder. Thanks for listening to The Boob Group; Your Judgment Free Breastfeeding Resource.

[Disclaimer]
This has been a New Mommy Media production. The information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though such information in these areas are believed to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

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