GP told me to breastfeed less and switch to anti-reflux formula??

[Emilia35]

I have a 3 week old who cannot sleep on their back at all. They either start throwing up milk or grunting making gagging noises until it turns to full blown crying. They can only sleep on their stomach and usually on top of me.

This means neither of us are getting much sleep and I've had to resort to unsafe sleeping as I cannot stay up 24 hrs a day and my husband has now returned to work.

Called GP today and was told I should switch to anti reflux formula before asking for any prescriptions?! I said I wanted to continue exclusively breastfeeding, and he said the guidelines for this are to first try anti reflux formula...

My instinct is telling me this isn't right.

But I do have a very strong let down reflux which could be making things worse and my baby wants the boob when they're in discomfort so could be overfeeding. They won't take a dummy for comfort though.

Any advice?

I am not an expert but I would question that advice and find a second opinion. Do you have any breastfeeding support groups near you? They are sometimes very knowledgeable. Sorry, this sounds stressful, hope you are all able to get some sleep soon.

Here are the NICE treatment guidelines for infant reflux cks.nice.org.uk/topics/gord-in-children/
It clearly states for breastfed babies the first steps are management, then gaviscon. You absolutely don't need to stop breastfeeding

Health Visitors are far more knowledgeable than GPs on stuff like this. Having said that, I think you should follow your own instincts and continue to fully BF.

I’m a GP and that sounds like frankly crap advice from the history you’ve given. GPs get very little training in breastfeeding issues, and they may be trying to poorly follow a guideline they’re not familiar with.
I’d look into getting a second opinion if there’s another doctor at the practice (appreciate this isn’t always possible) about medications. In the meantime keep breastfeeding, call the breastfeeding network / la Leche league or a local helpline. Do you have a breastfeeding cafe near you or any midwife support with feeding?
If finances allow, a session with a lactation consultant might be really worthwhile.
Regarding unsafe sleep - obviously the lullaby trust guidelines are the safest and gold standard, but breastfeeding is a protective factor if you can continue. I had a lot of nights (weeks) with my second child sleeping on me, I eventually persuaded him onto his side next to me / under my arm which felt like a step in the right direction.

Take a look on IG - babyrefluxlady & rockabye_hub. My first was a reflux baby and was caused by a TT. Questioning whether my 2 week old is or just very small and therefore poor latch / excessive air intake.

can you try and express off the letdown before feeding to try and control it? Don’t need to stop BF though just need to find the cause, reflux is a symptom of something underlying.

I was just going to find the guidelines @Whentwobecomesthree posted - I’m not sure how your GP has made their conclusion to stop BF. Take a copy of those on your phone if you see another GP.

Thank you all for the very helpful replies! Looking at the guidelines it seems the GP followed the ones for formula fed infants, even telling me to reduce the volume of each feed (which was quite confusing as I don't know how much baby is taking!)

I saw a breastfeeding consultant last week who confirmed the initial latch is very good, but as the feed goes on baby gets lazy and loses the latch. I was told there almost definitely isn't a TT, though baby's dad and older sister both have one (with sister it was very clear).

I asked for baby gaviscon and the GP reluctantly prescribed it, so will try that and as a PP suggested, will also try expressing a small amount before feeds to reduce the strong let down.

Thank you all!!

We had exactly the same issues with DD1. Baby Gaviscon mixed into a small amount of expressed breastmilk made a good difference for us. Look into how to safely tilt the head of your crib to help the milk settle.

I have the same issue with an oversupply and a fast letdown. When you have latched on, get as close to lying down as you can. Gravity will slow the flow of milk making it easier for your baby to keep up and helping them swallow less air. It's a very comforting position for baby to feed in so will relax you both.

Look at safe bed sharing. It's totally possible. Sharing sleep on a sofa is never safe. Can you prop baby up for some sleeps? Just a bit? Books under three front legs of a cot for example. Baby may want to feed little and often if they have reflux as the milk going down keeps the acid reflux down. Many very young (& very old) have a floppy 'lid' at the top of the stomach that means acid leaks into the throat. It gets better as baby gets older and starts to sit up, so around 6 months.

If the over supply / fast let down continues to be a problem once your moon is established (6 weeks ago) I’d look into block feeding under the guidance of a specialist / infant feeding team. It’s helped me to reduce the oversupply that made things really difficult with my DD, things are much easier to manage this time around.
Please don’t google it and jump straight in without guidance though as you don’t want your supply to drop too much or risk mastitis.

Hi all, just updating on our progress :)

The gaviscon worked really well but I think it gave baby a tummy ache as they were unsettled for hours afterwards kicking legs and going red in the face. Things are much better with reflux now though! I think the breastfeeding lying down and pulling baby away from the breast while the strong let down happens is really helping her! We managed 2 nights with quite a few hours in her crib and some naps during the day too :)

Now how do I know if baby has emptied my breasts? They feel soft/less heavy after a feed but if I squeeze milk still comes out. I'm asking as we're now struggling with colic so wondering if she's not getting to the fatty hind milk and is getting too much of the high-lactose milk that comes out first.

Thank you all!!

Hi just came to the thread and so glad to read your story that you kept BF and ignored that gp's bad advice.

There is only a tiny proportional difference in fat content between foremilk and hindmilk so I wouldn't ever worry about that if I were you.

Your breasts will always leak a bit if you squeeze them - they produce on demand (squeezing) and so they're always empty and never empty if that makes sense. As long as, when you stroke them all around, there are no firm parts, then you know you aren't risking engorgement. If there's a firm part then feed baby to empty it even if baby hasn't really asked.

This has probably been mentioned above but rather than reflux, have you considered trapped/gulped wind which also fits those symptoms - are you winding baby very thoroughly after every feed? Not just tapping the back but swaying the top half of the body etc. Also try different positions that help prevent gulping air while feeding, I found side lying the best.