Jeannette, I hope "the tape" you have is from Susan Boekel, RD, IBCLC's
excellent presentation on GER at the July 2000 ILCA conference. It is not
my "specialty," either, but after attending that session, I think it could
be! Your pair display some of the classic symptoms she described (pain and
crying after nursing, vomiting, weight loss as baby vomits AND self-limits,
etc.)
Boekel suggests, in cases of suspected or confirmed GER, that parents try
some easy, can't-hurt, physical changes:
(1) Positioning. ALWAYS keep the baby's head above the stomach -- not just
after a nursing! Baby's head above tummy during nursing ... during play ...
during diaper changes (put a prop under the pad to keep baby's head up. And
don't lift the legs and scrunch up that tummy when wiping! Roll baby to
side to clean) ... and during sleep. The last suggestion may be considered
controversial (because supine sleeping is promoted to prevent SIDS), but
prone sleeping definitely is more soothing to the GER baby. At least, she
suggests, use the prone/pushing-up-on-arms position for play with baby in
the day.
(2) Wear the baby in a sling.
(3) Favor a left-side-lateral position for the baby.
(3) Use car seats and bouncy seats when baby must be put down. This keeps
head up. Roll up a receiving blanket and place it under baby's knees, to
prevent that "slide and slump."
She also said that babies with GER will often have high sucking needs. GER
babies may produce extra saliva ... and, the physical action of sucking
helps baby re-swallow the troublesome refluxate that keeps bubbling up from
below, and traumatizing the tender esophagus. Often moms will mistake
baby's mouthing and swallowing as a feeding cue, when it really is a
"sucking cue." Boekel recognizes that using a pacifier for this purpose may
be considered controversial, but parents could use a finger as well if they
feel their baby is "done feeding, but not done swallowing."
I won't repeat here Boekel's thorough discussion of medications/ treatment
options. These physical changes may provide some relief to both your mom
and baby. Good luck to them.
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