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Q&A: How can I help baby?

The doctor thinks my baby has GER. What can I do to help her?

Re: The doctor thinks my baby has GER. What can I do to help her?

The Bump Expert

It depends what the baby's symptoms are. Gastroesophageal reflux is being diagnosed now as the new answer to “colic” in the baby. It’s good for everyone (except the mother and baby) because the doctor has a reason for the baby’s colic and difficulty breastfeeding and the pharmaceutical company sells a lot of ranitidine (Zantac). There is such a thing as GER, to be sure, but it is being overdiagnosed to the extreme. So what symptoms are being attributed to GER?

• Spitting up. If the baby is content and gaining weight well, then spitting up is a laundry problem only. In fact, because breast milk is loaded with immune factors (not just antibodies, but many others substances too) that protect the lining of the baby’s intestines, when the baby spits up, these substances get another chance to line the upper gut (the esophagus), the nose, the throat, the Eustachian tubes (which lead to the ear), and the trachea.

• Colic. The treatment for colic may be as simple as getting the baby to latch on better. And there are other approaches as well. See the information sheet on colic at the website NBCI.ca.

• Pulling at the breast. Babies most often pull at the breast because the flow of milk is slow. Occasionally they pull because it’s too fast for them to handle, or it could be both too fast at first or too slow later. The answer is to follow the protocol to manage breast milk intake (see the website) and use the video clips at that website to help use the protocol.

As for treating GER -- and colic, spitting up, and fussiness -- we encourage mothers to “finish” one breast before offering the other. How do you know the baby is “finished”? When she stops drinking (see the video clips at the website). If the baby then wants the other side, let her fall asleep on the other side. If she doesn’t pull off and sucks, very little milk will go down while the stomach empties.

Often what’s thought to be “colic” is actually hunger -- even if the baby is gaining weight well. The solution: Don’t limit feedings, and make sure your baby is drinking well from the breast (see website).

Jack Newman, MD, FRCPC