So if your GERD baby is like ours and the typical 5 S'es don't work, give these modifications a try:
1. Sucking
Sucking is often last on the quieting list, but I am placing it first. It is of utmost importance for GERD babies.
First of all, many of them have difficulty sucking and swallowing. Allowing them the opportunity to suck on an orthodontically designed pacifier in between feedings gives them almost round-the-clock practice. And as we all know, practice makes perfect.
Secondly, their failure to thrive means they need more feeding sessions than babies without GERD. With our first baby, we were told to feed her every two hours during the day and every four hours at night. We were told not to deviate from this schedule, or we would be creating an obese child who relied on food for comfort. What a joke! Unfortunately, it was not very funny, and with her rapid dehydration and weight loss, we soon learned we had to feed her a little bit every 30-60 minutes during the day and every 90-120 minutes at night to keep her nourished and comfortable.
Sucking may not calm the GERD babies instantly--but it does have longterm benefits by providing them with the skills and nourishment they need to thrive.
2. Side vs. Stomach Position
Skip the infant side position and place the baby on her stomach, resting on your forearm. It's called the "colic hold" for a reason. We were taught to hold the baby's head in our hand and rest her bottom in the crook of our elbow. Reversing her position so her head was nestled on our forearm and her tummy was in our hand allowed us to apply gentle pressure to her tummy, which helped. We were also able to lower our hand to a natural position so that her head could still be elevated to aid with the reflux. Putting her on her tummy on the floor or bassinet during waking hours helped as well, particularly if a small burp cloth was rolled and placed under her tummy. I used to tell my husband that when our girls were older and didn't require so much round-the-clock care, I would design a stomach-positioner for GERD babies much like the head-positioner for premature babies. Of course, now there are stomach-positioners on the market! (More on those in another post.) How I wish we had some when our girls were infants!
3. "Shh-shh--shh" vs. The Darth Vader "Shhhhhhhhh"
I don't know why our nurse encouraged us to bounce the baby vigorously while breathing a fast-paced "Shh-shh-shh-shh." Not only does this quick-paced pattern not calm a GERD baby, it also makes you so dizzy you feel like you're going to pass out. I don't know anyone who would be calmed by this motion and noise. Newborns have the amazing potential to read our emotions, and since GERD babies are irritable and anxious to begin with, they don't need any extra tension to aggravate them.
Instead, think of Darth Vader. While holding your baby and gently patting her back, take a deep relaxing breath in...then let out a long "Shhhhhhhhhhh." Follow that repetition for as long as it takes. Deep breath. Darth Vader "Shhhhhhhhhh." Deep breath. Darth Vader "Shhhhhhhhhh."
It won't work instantly, but it will prevent you from passing out, and it will help to keep you calm and relaxed, which is essential for soothing a GERD baby.
4. The Swing vs. The Shoulder Snuggle
Everyone loves the mechanical swing. Parents can set the baby down, turn it on, and walk away. Instantly, the baby is soothed to sleep and the parents can do what they need to do, right? Not necessarily. The problem with the mechanical swing--and the car seat, for that matter--is that they create one of the worst positions for an acid reflux baby. Ever hear the stories of the colicky babies who were charmed by car rides, and if you could just keep your baby in the car seat all day long he would be happy? Ever wonder why your baby screams and cries in the car, so that even a five-minute drive across town becomes a harrowing nightmare, an accident waiting to happen for you, the driver?
Forcing the GERD baby into the seated position through car seats and mechanical swings creates pressure on the stomach and the lower esophageal sphincter, resulting in reflux. For this reason, one of the best places for a GERD baby to be is snuggled on someone's shoulder, for both physical and emotional reasons. Gently patting the baby's back or swaying from side to side may be all the vibration the baby needs. If white noise helps to calm the baby, turn on a fan or a white noise machine. One of my girls was calmed most effectively when she was snuggled over my shoulder and I was patting her in front of the dryer or the microwave vent. The pats, the position, the contact, and the noise all helped when nothing else would.
It's for this reason that a harness baby-carrier (like a Bjorn) is better for GERD babies than a shoulder sling. In the harness carrier, the baby's abdomen can be kept straight with gentle pressure from your body, whereas in a shoulder sling the baby's abdomen is scrunched up tight.
5. Swaddles vs. Stomach Bands
Swaddling is great until the reflux starts and your baby starts arching her back. Then her whole body goes rigid and she breaks out of the swaddle like a baby Hulk breaking out of restraining bands. The best advice here is just to clothe or wrap your baby in whatever seems most comfortable to her. Usually, warmth and gentle pressure to the tummy are most effective. I am impressed by the new "stomach bands" that are on the market now designed especially for GERD babies. These stomach bands look very much like the hernia belt or the belly-band for pregnant women. Some include warming devices that can be microwaved. I would be a little hesitant to use the warming device on the baby, though. I will take a closer look at the stomach bands in a future post, but for now, know that they are out there and talk with your pediatrician to see if they might be of benefit to you.
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