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Reflux Disease
(or GERD)

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  • Breastfeeding a Baby with Special Health Concerns
  • Reflux Disease (or GERD)

Reflux Disease (or GERD)

Some babies have a condition called gastroesophageal reflux disease (GERD).

GERD happens when the stomach muscle opens at the wrong times. When this happens, it allows milk and food to come back up into the tube in the throat.

Some symptoms of GERD include:

  • Severe spitting up after every feeding or hours after eating
  • Vomiting (the milk shoots out of the mouth)
  • Fussiness and crying as if in pain
  • Arching of the back as if in severe pain
  • Refusal to eat or pulling away from the breast during feeding
  • Slow weight gain
  • Gagging, choking, or having problems swallowing
  • Breathing problems (like a wheezing cough)

See your baby’s healthcare provider if your baby spits up after every feeding and has any of the other symptoms of GERD. More severe cases of GERD may need to be treated with medicine.

If your baby has GERD, it is important to continue breastfeeding. Human milk is usually easier to digest than formula for babies with GERD.

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    Two abstract figures with interlocking hands and circles.

    HAND EXPRESSION

    How it works

    Use your hand to gently massage and compress your breast to remove milk.

    What’s Involved

    • Requires practice, skill, and coordination.
    • Gets easier with practice and can be as fast as pumping.
    • Good if you are not often away from your baby or you need an option that is always with you. All moms should know how to hand express, in case they need to do it unexpectedly.

    Average Cost

    Free

    Illustration of diverse fruits and vegetables forming colorful patterns.

    Side-Lying Hold

    1. For the right breast, lie on your right side with your baby facing you.
    2. Pull your baby close. Your baby’s mouth should be level with your nipple.
    3. In this position, you can cradle your baby’s back with your left arm and support yourself with your right arm and/or pillows.
    4. Keep loose clothing and bedding away from your baby.
    5. Reverse for the left breast.

    This hold is useful when:

    • You had a C-section
    • You want to rest while baby feeds
    • You are breastfeeding in the middle of the night
    • You and your baby are comfortable in this position
    Owl with outstretched wings soaring gracefully in flight.

    Cross-Cradle Hold

    1. For the right breast, use your left arm to hold your baby’s head at your right breast and baby’s body toward your left side. A pillow across your lap can help support your left arm.
    2. Gently place your left hand behind your baby’s ears and neck, with your thumb and index finger behind each ear and your palm between baby’s shoulder blades. Turn your baby’s body toward yours so your tummies are touching.
    3. Hold your breast as if you are squeezing a sandwich. To protect your back, avoid leaning down to your baby. Instead, bring your baby to you.
    4. As your baby’s mouth opens, push gently with your left palm on baby’s head to help them latch on. Make sure you keep your fingers out of the way.
    5. Reverse for the left breast.

    This hold is useful when:

    • Your baby is premature
    • Your baby has a weak suck
    • Your baby needs help to stay latched
    • Your baby needs extra head support
    • You and your baby are comfortable in this position
    "Happy cartoon family holding hands, smiling together."

    Clutch or “Football” Hold

    1. For the right breast, hold your baby level, facing up, at your right side.
    2. Put your baby’s head near your right nipple and support their back and legs under your right arm.
    3. Hold the base of your baby’s head with your right palm. A pillow underneath your right arm can help support your baby’s weight.
    4. To protect your back, avoid leaning down to your baby. Bring baby to you instead.
    5. Reverse for the left breast.

    This hold is useful when:

    • You had a C-section
    • You have large breasts
    • You have flat or inverted nipples
    • You have a strong milk let-down
    • You are breastfeeding twins
    • Your baby likes to feed in an upright position
    • Your baby has reflux
    • You and your baby are comfortable in this position
    Stylized abstract shapes forming an intricate pattern.

    Cradle Hold

    1. For the right breast, cradle your baby with your right arm. Your baby will be on their left side across your lap, facing you at nipple level.
    2. Your baby’s head will rest on your right forearm with your baby’s back along your inner arm and palm.
    3. Turn your baby’s tummy toward your tummy. Your left hand is free to support your breast, if needed. Pillows can help support your arm and elbow.
    4. To protect your back, avoid leaning down to your baby. Instead, bring your baby to you.
    5. Reverse for the left breast.

    This hold is useful when:

    • Your baby needs help latching on
    • You and your baby are comfortable in this position
    "Abstract pattern of colorful overlapping shapes and circles."

    Laid-Back Hold

    1. Lean back on a pillow with your baby’s tummy touching yours and their head at breast level. Some moms find that sitting up nearly straight works well. Others prefer to lean back and lie almost flat.
    2. You can place your baby’s cheek near your breast, or you may want to use one hand to hold your breast near your baby. It’s up to you and what you think feels best.
    3. Your baby will naturally find your nipple, latch, and begin to suckle.

    This hold is useful when:

    • Your baby is placed on your chest right after birth
    • You have a strong milk let-down
    • You have large breasts
    • You and your baby are comfortable in this position