I find that more and more people are aware of the importance of a balanced gut microbiome these days. The good bugs in your gut influence things like your immune system, hormone detoxification, metabolism, nutrient absorption, mood, skin health, levels of inflammation, reaction to food, oxidative stress, and more.

But did you know that antibiotics aren’t the only medication that can affect the bacteria in your gut, and in fact aren’t the biggest culprit for upsetting the balance.

I have gone knees deep in a research paper to find for you what medications will influence your very important microbiome. There are several commonly used medications which will potentially have a negative impact.

The main ones that were found to have an impact are:

• Proton pump inhibitors (PPIs) were one of the most notable drugs that influenced the bacteria, influencing multiple pathways, especially increasing the Streptococcus parasanguinis bacteria and affecting many pathways of bacteria’s ability to help our digestion of carbohydrates and fat
• Metformin seems to correlate with an increase of Escherichia coli, but also appeared to show an increase in the metabolic function of the microbiome, which may contribute to its effect.
• Antibiotics decreased overall Bifidobacterium levels
• Laxatives also affected multiple bacteria but were correlated with higher levels of  Alistipes and Bacteroides bacteria groups and a decrease in bacteria that digest starches

And to a lesser degree:

• SSRI antidepressants
• Oral steroids increased Methanobrevibacter smithii in those with inflammatory bowel disease. This is a bacteria which influences metabolism which could potentially explain the weight gain frequently observed in oral steroid users.
• Anti-androgen oral contraceptives
• Vitamin D and calcium supplements
• Levothyroxine use was associated with an increase of Actinomyces group

The analysis explored a multiple of different papers which examined the different microbiome associated with different medication use and found these patterns. In many instances it was thought that the microbiome changes are a result of the medications, however it is possible that when certain over growth or undergrowth of certain bacteria was present that this could be responsible for the condition that prompted that medications prescription in the first place. Given the majority of the conditions included things like constipation, reflux, inflammation and mood disorders, it makes sense as these conditions can be affected by an imbalance in your gut bacteria.

Overview of the number of associated microbial features.

Reducing the damage

While some of these correlations may not be the fault of the medication but just a reflection of the nature of the disease, it is still notable that many medications to disrupt our microbiome. In some instances, there are important reasons for taking medications, in which case you need to take steps to ensure you’re supporting your gut microbiome.

Feeding your good bacteria is one of the most important steps, and this is achieved by eating foods rich in prebiotics. Plant foods are the most notable source of this, and the bigger variety you can have, the better.

Including fermented food such as saurkraut, kimchi, kefir and kombucha and yoghurts can introduce some bacteria, but it isn’t always guaranteed that they will bring the type of bacteria you need to replace. If you tolerate these foods (people with histamine intolerance or SIBO may find them problematic) then it’s certainly beneficial to include them.

Probiotic supplementation can be very valuable, however the important thing to remember is that you need to choose a strain of probiotics that meets your aims.

Nutrients that support gut health lining include glutamine, n-acetyl-glucosamine, lysine, glycine and proline.

In some cases, it may be worthwhile discussing with your health practitioner whether there are alternatives to these medications. While natural medicines will not be as powerful as conventional medicines, in some conditions they can provide a very satisfying effect, reducing the need for medications.

Photo by Adam Nieścioruk on Unsplash

Herbs for the Gut

Herbal medicines can soothe the digestive system beautifully, and for conditions such as GORD (reflux) they can reduce the requirements for these medications.

For reflux: consider herbs such as Marshmallow root, Ribwort, Meadowsweet, Licorice (avoid if you have high blood pressure) and Dandelion root.

For reducing inflammation in the gut: A tablet containing herbs such as Boswellia and Turmeric can be particularly beneficial.

For sluggish bowels: a regular brew of Dandelion root, Ginger, Licorice, Yellow Dock and Cinnamon can help to get things moving.

References

Vich Vila A, Collij V, Sanna S, Sinha T, Imhann F, Bourgonje AR, Mujagic Z, Jonkers DMAE, Masclee AAM, Fu J, Kurilshikov A, Wijmenga C, Zhernakova A, Weersma RK. Impact of commonly used drugs on the composition and metabolic function of the gut microbiota. Nat Commun. 2020 Jan 17;11(1):362. doi: 10.1038/s41467-019-14177-z. PMID: 31953381

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As I move on to breastfeed my second child my love and admiration of breast milk continues to grow. I am always in awe of the amazing benefits that breastfeeding provides, both for mother and baby.

In the same breath I also think of the challenges it can face, how hard some mothers have to fight to be able to breastfeed and how devastating it can be for mothers who want to, but for one reason or another cannot breastfeed their child. I also acknowledge that formula feeding can be challenging as well (such as sterilising bottles and the cost of formula), and that while I will dedicate this article to the benefits of breastfeeding, I want you to know that if you weren’t breastfed or you can’t breastfeed your babe, it will still be okay.

I want to share some of the benefits of breastfeeding with you, as well as some information about your nutritional requirements during breastfeeding, and things which your diet can and cannot change about your breastmilk.

In fairness, I also discuss some of the less awesome things about breastfeeding (mostly from personal experience) and share some breastfeeding resources.

Some awesome benefits of breastfeeding.

Better bone health for Mum

While your calcium stores might drop down in the first few months of breastfeeding, as you continue to breastfeed your bone density is actually strengthened.

Prebiotics

I know I’m repeating myself but I can’t help it, I just love the amazing prebiotic goodness of breastmilk for babies tummy. There are a vast amount of prebiotic sugars and fibres in breastmilk which encourages the growth of the good bacteria in the digestive system, and thus improves their immune system, skin health, digestion, behaviour, sleep and more. Having had to have a c-section for my first son I felt very reassured that I was doing wonders for his tummy by breastfeeding (which I have continued to do so).

Improves babies iron stores

There is a protein called lactoferrin in breastmilk which improves iron absorption, but also inhibits the growth of harmful micro-organisms which can steal iron for their own growth (such as E. coli, Candida spp. and Staphylococcus spp.). As young babies receive minimal iron from breastmilk this is a very handy feature, and it also means that when they do start receiving solids in addition to breastmilk it is better absorbed and utilised.

Protects against cancer in mothers

A study published in The Lancet in 2016 found that breastfeeding mothers had greater protection against breast cancer, as well as possibly ovarian cancer and type 2 diabetes. The authors estimated that is breastfeeding was more universally established it could 20 000 annual deaths from breast cancer.

Individualised immune support

Whenever the mother is exposed to a pathogen of some form, she will start making protective antibodies which she will then transfer to the baby via her breastmilk. And what if the baby was exposed to these pathogens before mum? Baby will send some of these into the breast via a backwash mechanism, which then allows the mother to start making antibodies against. So baby gets the benefit of an experienced adult immune system to help them fight against infections, via breastmilk.

The same study mentioned above predicted that universally established breastfeeding could prevent 823 000 annual deaths in children younger than 5 years.

Better development of sleep-wake cycles.

Babies don’t have a natural day-night hormonal until a few months of age, but breastmilk actually delivers different hormones in the day and night that teaches baby when it’s time to be awake, or to sleep.

Better reaction to vaccinations for babies

Babies who are exclusively breastfed, and to a certain degree partially breastfed, have been shown to have less of a negative reaction to vaccinations. They are less likely to get a high fever or discomfort after the vaccinations, and breastfeeding during or immediately after the vaccination can also reduce the discomfort of the process.

The immune response to the vaccination is also better for a breastfed baby, making the vaccination more effective.

There is also a better metabolism of the less positive components of vaccines, in particular ethylmercury. Because of the prebiotic effect of breastfeeding, better gut flora can also protect against other negative effects of vaccinations and improves the immune response.

Breastfeeding burns calories.

Exclusive breastfeeding burns approximately 500 additional calories for the mother per day. It is thought that the fat stores from the thighs are what are used for this source first, however not all mothers notice a dramatic difference in their body shape or weight from breastfeeding.

Your nutritional requirements while breastfeeding.

Just as you did while you were pregnant, it’s important to make sure that you’re eating well so that you look after both yourself and baby. Even women (and men) who are formula feeding their baby need to look after themselves, as it’s very important for parents to take care of their health.

Breastfeeding mothers who aren’t able to access quality food can still provide excellent breastmilk to their babies, however it is often depleting their own nutritional reserves, which can result in fatigue, mood swings, hormonal imbalances, and also reduces the nutrient stores for future babes (which can be built back up, but may be an issue if the mother conceives again quickly).

The nutritional composition of breastmilk

Breastmilk is largely made up of carbohydrates in the form of lactose. It also contains a significant amount of fats and protein. It is the carbohydrates within the breastmilk that provide some of it’s wonderful benefits in boosting babies immune system, these are the prebiotic, the fuel which feeds the good bacteria in babies digestive tract. The growth of this bacteria is vital for their immune health in particular, but has a big role in almost every other facet of health including digestion, metabolism and impacts on future mental and hormonal health.

When infant formula was first created in the early 19^th century scientists worked hard to make it as close as possible to the composition of breast milk, however babies were not thriving on it. Over time it was discovered that the key to this different was the prebiotics, in particular the oligo-saccharides (of which breast milk contains >200 different forms), and various forms of prebiotics are now often added to many brands of infant formulas in the attempt to provide this benefit. Unfortunately the ability to replicate this diversity of prebiotics is still lacking and so there is still a discrepancy between the gut flora of breast fed and infant fed formulas (but much less so than in the past before the addition of prebiotics to formula).

There is a small amount of protein in breast milk, and a substantial amount of fat, which makes it very energy dense. The protein content increases as the child ages, and is often made up of more specific immune boosting proteins.

Our breasts cleverly change the composition of breast milk over various stages of babies life.

Initially we produce colostrum, which is much lower in the carbohydrates but richer in the protein and fat to boost immune health.

After the placenta is passed our progesterone levels decrease dramatically, causing our milk to ‘come in’. As part of this, levels of lactose increase. (This is why things such as a retained placenta or use of progesterone medications i.e. the mini pill, can impact on the milk supply as progesterone essentially ‘holds the milk at bay’.)

Eventually the hormones have less of a role and our breasts will respond to ‘supply and demand’ – the more they are emptied they more they will fill. (Many women worry that their breasts feel softer during this time and that this means their supply is dropping – don’t worry, for most women it means your breasts are actually getting smarter at feeding).

If you are still breastfeeding your child into their second year there is an increase of protein (specially the immunoglobulins), which means that while your toddler is getting less milk quantity they are getting just as much of the immune boosting properties.

The milk will often change in composition during a feed as well, and the more the breast is drained the higher the fat content.

Your Diet and Breastmilk

As a general rule your breasts will keep the composition of breastmilk the same regardless of diet, for as long as possible (the repercussions of a bad diet fall onto the mother more so than the baby). But there are ways that your diet can impact on breast milk.

I see many mothers who cause themselves a great deal of stress about the potential of their diet harming baby, and I feel that it is important to remember that even with a sub-par diet, you are providing a wondrous array of benefits with breast milk. But if possible, eating well will provide many additional benefits to mother and baby.

Things that your diet CANNOT change

Lactose content

Your breasts will carefully regulate the amount of lactose in the milk and if you have been told that your baby many be lactose intolerant (an unfortunately common and incorrect piece of advice) your breasts will maintain lactose levels regardless. Lactose overload is more commonly the issue, rather than lactose overload, and this is likely due to insufficient drainage of the breast.

Things that your diet CAN change

The quality of the fat.

The omega fatty acid balance of your diet will have an impact on the milk, with women who consume more DHA have higher levels in the breastmilk. Women who have more DHA in the third trimester of pregnancy have higher fat levels in their breastmilk later on. For women who are vegan or do not consume omega fatty acids it may be worth considering to take a DHA supplement, as this is an important nutrient for brain and nervous system health, however dietary sources are better utilised than supplements.

Trans fats, which are predominately from junk food can also pass into breastmilk, so avoiding junk food is advisable.

To ensure you’ve got plenty of good fat, try to consume 2-3 serves of low mercury seafood per week, such as small fish like sardines. Vegan mothers may choose to supplement with algal DHA, (they may also benefit from supplementing with zinc, vitamin B12 and choline).

These micronutrients

Vitamin A, C and E, and B vitamins (except folate), Iodine, Selenium, B12, Vitamin D and Choline

Nutrients not in this list are still important for you, but your breast will closely regulate levels of regardless of intake.

Intolerance reactions

Some foods may potentially cause a reaction to baby. The protein within dairy, wheat and soy, chilli, and some cruciferous vegetables are common examples. I have provided a list of these foods here.

If you suspect that baby is intolerant to a food you are eating try eliminating one food at a time and then rechallenging. It is important to do this as thoroughly as possible tog et the best results. I don’t recommend taking a lot of foods out of your diet at once while breastfeeding as it is a time of increased energy requirements and you are often struggling to prepare good food at the best of times, so do it slowly and gradually. Speak to a health care practitioner for guidance if you’re struggling.

Medications and breastfeeding

Have you ever been told that you need to stop breastfeeding due to medication use?

There is a large difference in what medications are safe during pregnancy and breastfeeding, and some people are unfortunately told to stop breastfeeding when this might not be necessary, or decide by themselves to “pump and dump”. Doing this unnecessarily can reduce the amount of amazing breastmilk that your baby gets, and is also very stressful, and hard work, for the mother.

There can also be natural medicines that may be safe and effective as an alternative whilst breastfeeding, talk to your natural therapist about this if this is something you might consider.

Some things which aren’t so great about breastfeeding

Of course there are some downsides. I don’t believe they outweigh out the benefits, however I feel that in fairness I should mention them, mostly just so that other mother’s don’t feel like they’re alone if they experience these things too.

• It can hurt. Breastfeeding in the early days can be painful while your nipples get used to the process. If baby has a poor latch (perhaps due to tongue tie or an incorrect technique) this can also cause pain, contributing to nipple damage, which lengthens the duration of pain. If baby does not take enough nipple into their mouth it can rub against the hard palette, and this can really hurt. It is important to establish good technique from the start to reduce this, and getting consistent advice from a lactation consultant is a great way to do this.
• Breasts can leak. Oh boy, can they. The amount of breast pads I went through was ridiculous, and I still don’t understand why there aren’t more pattern breastfeeding friendly shirts available (because solid colours show the stains so much more). Thankfully the leakage situation does settle down – for me it took about 8 months.
• You can get ‘over-touched’, where you feel like all you want to do is sit by yourself and have no-one touch you for a while. Newborns like to nurse a lot. And the more you feed them, the better your supply, and the more a baby is held and carried the more settled they are, so of course we indulge them. And as baby ages, they can get a bit handsy. Mothers who have continued to feed their toddlers are likely well aware of the ‘twiddling’ that toddlers love to do, which for many mothers can drive them a little crazy.
• Many mothers notice a significant lack of libido whilst breastfeeding, at least until their period returns. This can be combined with vaginal dryness due to the hormone changes involved, meaning that even if you do want to have sex it can potentially be painful.
• It can be stressful. There are so many doubts that breastfeeding mothers can experience – ‘is my baby receiving enough milk’, ‘is my milk good enough’, ‘did something I eat/drink affect my baby’ and this can cause a mother significant stress and worry. There are so many benefits to breastfeeding that it would be a real shame if a mother were to stop feeding unnecessarily, without getting quality advice from a lactation consultant first.
• It can be embarrassing. A newborn baby will have no concept of when or where is an appropriate place to feed, and so mothers often will feed their baby is situations that might be a little awkward. I remember the feeling of ‘everyone is looking at me’ from the early days of feeding that can be very off-putting for some Mums. I have realised in retrospect that nah, most people are just looking at your cute baby and anyone else that is looking at you with judgement can bugger off.
• Mastitis. This is an infection of a milk duct in the breast. It doesn’t happen to all mothers but for those who do experience it, it’s pretty damn awful. A blocked duct can lead to infection, resulting in fever, chills, pain and lethargy. The whole thing can be incredibly painful and unpleasant. Thankfully there are natural methods to prevent and/or treat it, so if you are prone to this, see a naturopath for support.
• Juggling work and breastfeeding can be difficult. While women are within their rights to ask for allowances in the workplace to express, this can be easier said than done. It is also not always easy to express enough milk to maintain supply and provide a good feed for baby. Many mothers can produce bountiful amounts of milk when their baby is feeding, but expressing produces little to none. Even if they do manage to express, the storage and handling of the expressed milk can be a nuisance.

Breastfeeding resources

Australian Breastfeeding Association

ABA provides a free 24 hour hotline to answer questions about breastfeeding issues or provide support. This service doesn’t require you to be a member.

There are regular talks held on various topics by local groups. You can attend 3 without joining as a member. They also hold playgroups and catchups occasionally.

I attended ABA meetings for the first year of feeding Ash until work commitments stopped me from going, and they were an enjoyable and valuable experience. You can find local groups by contacting ABA directly or searching on facebook.
1800 686 2 686 / 1800 mum 2 mum
http://www.breastfeeding.asn.au/

La Leche

Facebook: https://www.facebook.com/LLLSydney
Email: sydneylll@outlook.com
Website: http://www.llli.org

Find a lactation consultant

https://www.lcanz.org

www.ilca.org

Information on attachment:

Watch this video before baby is born:       

How to increase milk supply:

More links on breastfeeding attachment:

ABA – Attachment to the Breast

Biological Nurturing

Baby Led Attachment – How to Awaken your Babys Breastfeeding Instincts

Baby Led Attachment – Renee Kam

Some great resources to check medications:

LactMed: http://toxnet.nlm.nih.gov

Medications and Mothers Milk Online: http://www.medsmilk.com

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It is estimated that one-fifth of the population believe that they have a food intolerance. If you’re reading this article, you’re probably one of them. If you can’t quite put you finger on what food isn’t agreeing with you, then it’s time to get clued up.

In this article you can read about the difference between food intolerances and food allergies, plus 5 common causes that you can investigate, and practical tips to help manage your allergy or intolerance.

Want to learn more? You can read the full article here: http://casadekarma.com.au/the-ultimate-guide-to-food-allergies-intolerances/

The post The Ultimate Guide to Food Allergies and Intolerances appeared first on Alison Mitchell Naturopath.

Health & Wellbeing Podcast #3

If you have been following me for a while you probably know that I love to talk about digestive health and the importance of gut health for overall wellbeing. I was very excited to have the opportunity to talk about all things digestion (and of course poo) with my fellow naturopath, the beautiful Hayley Stockbridge.

Hayley practices at Manly on Sydney’s Northern Beaches and in Stanmore in Sydney’s Inner West. Her major focus is always educating her patients to live healthier and happier lives. She treats women, men and children of all ages and a wide variety of health issues such as weight loss, digestive problems, anxiety/stress, fertility, hormone imbalances, food intolerances and headaches.

You can also connect with Hayley on Facebook and Instagram.

We answered a few digestion questions in this podcast which was lots of fun, I would love for people to keep submitting questions for future podcasts. You can submit them in the comments section below, on my facebook page or via the contact form.

Want to subscribe to get podcasts automatically? You can do that here: https://itunes.apple.com/au/podcast/health-wellbeing-podcast/id1006574743

Podcast Breakdown

3:57 What is a normal bowel movement?

6:50 Question 1: I’ve had GORD ever since I can remember, I’m on Nexium and I take metamucil. I still get the occasional bit of reflux but mostly it’s controlled with the medication. I don’t want to stay on it because I don’t want to rely of a medication. I also get diarrhoea every week or so that’s watery, explosive and smelly and really urgent and uncomfortable, and I’m frequently bloated. Is any of this connected and what do you suggest I do about it?

9:05 Diet for reflux, food intolerances.

9:40 The importance of easing of PPI medications slowly.

11:00 Reflux often due to a structural/mechanical issue, but this doesn’t mean you’re doomed.

12:50 Testing and avenues to look at for assessing causes of reflux, most common food triggers of reflux.

14:15 Question 2: I feel bloated and grumpy whenever I eat bread, but my GP said I’m not celiac so I can eat as much wheat as I want. I don’t get it though, why am I getting these feelings if I’m ok with bread?

15:00 Non celiac gluten intolerance including fructose mal-absorption

18:34 The general overconsumption of wheat and gluten containing foods and the issues with processing of wheat

22:40 It’s advisable to rule out celiac disease, as knowing this will determine how much gluten you can tolerate.

24:00 Sourdough may be an option for people sensitive to wheat as the fermentation breaks down some of the gluten and gliadin

25:45 Gluten free products are not always better for you

26:45 Experiment to find out what foods work best for you

27:55 Question 3: Help for constipation please! I have been taking movicol for about 5 yrs now. I go to the toilet once a day, but if i don’t take movicol I go once a week. I don’t like relying on it, but I don’t know what else I can do. Hayley and I discuss some common approaches to supporting constipation and diet for good bowel movements.

30:29 Papaya vs Pawpaw

33:00 Probiotics

34:40 Apple cider vinegar benefits

36:00 Dandelion coffee/tea

37:00 Manual work for constipation

37:25 The importance of exercise for healthy bowel movements

38:57 Toilet time – make time each morning to train your bowels to go at that time, and don’t suppress the urge to go when you need to.

39:50 Our yoga efforts.

41:00 Question 4: My 4 year old daughter frequently complains of stomach pains, I’m always at the doctors with her trying to find out what it is but they can’t find anything. It can be really upsetting for her, and sometimes she’s doubled up and crying with the pain. We eat well, but she always has a runny nose and this stomach pain is very concerning. She started preschool last year and seems to get sick all the time, I’m worried about how she’ll go at school with this stomach pain. She used to go to the toilet every 3-4 days, and even though this is considered normal the doctors gave her parachoc to try and help in case this is causing the pain, now she does go to the toilet easily (although it’s very lose) . Is there anything else I can do for her?

46:00 Infant massage for stomach pain

47:15 Our favourite digestion herbs

The post Digestion Podcast appeared first on Alison Mitchell Naturopath.

It can be extremely upsetting for parents to realise their babies are experiencing reflux, and they are often left feeling helpless. Sometimes it can be difficult to get assistance or advice, but luckily there are plenty of options.

Gastro-oesophageal reflux (or simply ‘reflux’) is when contents from the stomach — including stomach acid — are spontaneously passed into the oesophagus, causing a lot of discomfort. You can tell if your baby is suffering from reflux through symptoms such as regurgitation, possetting and projectile vomiting, but a child can experience reflux without any of these symptoms presenting as well.

It can be helpful to remember that as the infants digestive system is not adequately developed until they start eating solids (not that this should be rushed into) almost all babies will experience some form of reflux. It is not always a problem, as often the pH of the contents of a babies stomach is not acidic enough to cause damage, but it can be frustrating when an entire feed is lost and baby is then hungry again.

Most babies will grow out of reflux by the 3rd or 4th month however in some cases it doesn’t just go away; instead, it ends up causing far worse complications. This is more common when issues such as pyloric stenosis is present.

Common treatment for reflux in babies include the prescription of medications which reduce stomach acid production. While this can provide symptomatic relief it should not be used long term as it can result in deficiencies of magnesium, iron, vitamin B12, can affect kidney function and cause imbalances in the important microbiome. Coming off these medications cannot be done quickly, as the stomach acid can rebound and worsen symptoms.

Unfortunately there is limited research on the use of these medications, but as many parents and doctors feel the pressure to do something to help, they are very commonly prescribed. In some instances the baby grows out of reflux not long after the use of these medications is started, and parents associate the improvements with the medication and are then afraid to stop it.

I have compiled some information on factors that can be considered to support reflux, but it is advisable to consult with a health professional to obtain individualised advice.

Diet

Occasionally breastfed babies become colicky because of something in their mother’s diet. Some mums find that if they stop drinking cow’s milk and other dairy products, the situation improves. If you’re breastfeeding, try cutting out dairy products for a few days to see if that makes a difference. If your baby’s colic improves, you have your culprit. If not, don’t give up hope — and at least you won’t need to deprive yourself of butter.

Some breastfed babies seem to be bothered if mum indulges in a lot of spicy food, wheat products, or cruciferous vegetables. Again, to test if these foods are making your baby uncomfortable, avoid eating cabbage, broccoli, cauliflower, garlic, caffeine, alcohol, and other irritants for a few days. If your baby seems better, reintroduce the foods into your diet, one at a time, allowing a few days between reintroductions. It should be fairly easy to pinpoint which one is causing your baby problems: if he starts fussing again after a food is reintroduced, then you’ll know that’s the offending substance. You’ll have to abstain from it until your baby outgrows his sensitivity, which usually at around 3 months, but that’s a small price to pay for a happy child.

I don’t recommend eliminating too many foods at once, as this can be a stressful period at the best of times. In addition it can make it more challenging to identify foods which are the culprits when too much is eliminated at once.

 Irritating Foods in Order of commonness

1. Dairy (Dairy alternatives – Rice milk, oat milk, almond milk, quinoa milk)
2. Chilli and spicy foods
3. Wheat
4. Caffiene e.g. tea and coffee
5. Sulphur containing vegies e.g. broccoli, brussel sprouts, garlic
6. Alcohol
7. Food additives and preservatives
8. Soy
9. Mint

Digestive Health

Giving baby some probiotics can help (mix the powder in with a little breast milk or water and the herb slippery elm and squirt a little into his mouth, or ideally supplement via the mother) as this restores the microflora balance, improving their immunity and digestive health.  It’s important to give baby the good bacteria if they were caesarean born, or are not breastfed. Lactose Dairy protein intolerance is one of the biggest causes of colic/reflux, and probiotics can help their little tummies handle this a bit more.

Edit: Through personal and clinical experience I have found that lactose intolerance is over diagnosed in babies. It is actually normal for babies to have some lactose pass through their stools undigested, and the presence in stools is often used to diagnose lactose intolerance. Lactose is the key carbohydrate in breast milk, it is actually extremely rare for an infant to be truly lactose intolerant. What this may be getting confused with is lactose overload, where mothers have an oversupply of milk and are providing too much foremilk rather than the fattier hindmilk. This issue can be corrected with breastfeeding technique adjustment, but it will also improve with time. Some cases may be due to a reaction to the casein protein, which can improve if mother reduces her intake of dairy. If it is lactose intolerance it does not matter how much dairy mother has, as the breasts will regulate their own lactose production.

Always remember if they’ve have to take antibiotics to take probiotics otherwise they can get thrush.

Slippery elm is fantastic for soothing pain as well.  Mix a little of the powder with some water or breast milk and syringe it into their mouths. Start with a pinch and see how that goes.

If possible, my preference is for the mother to supplement with the probiotic LGG which passes through the breastmilk.

Natural Remedies

• Probiotics (use a strain specific to infants) or mother take the LGG strain of probiotic
• Slippery Elm powder
• Herbal tincture of herbs such Meadowsweet, Fennel, Chamomile, Parsley root and Marshmallow
• Weak, luke-warm tea of fennel seeds (crushed) and chamomile (remember to strain well and test temperature)

Breastfeeding Issues

The incidence of reflux is similar in both formula-fed and breastfed infants, but reflux episodes in breastfed infants are less frequent and shorter than those in formula-fed infants. Breastfed infants have more quiet sleep (when reflux rarely occurs). Breastmilk is also significantly less damaging than formula if aspirated (inhaled). Breastmilk is more nutritious and easily digested. It is much quicker, easier and cheaper to give an extra breastfeed than to prepare extra bottles of formula, especially when many babies with reflux are erratic feeders. Regurgitated breastmilk doesn’t smell as bad as regurgitated formula.

Positioning

Babies with reflux are often helped if fed in a more upright position than is usual – you may need to experiment with different positions. Some mothers have found that having the baby sitting facing the breast while straddled across mum’s leg or cuddled against the side of the sofa, facing the breast can be helpful. Others have found that instead of cradling their baby around their body, they can cradle the baby down the body. To do this, some mothers feed twin-style, while others feed standing up. After a feed, keep baby upright and still – many mums find putting baby on their shoulder keeps him happier.

How frequently to feed

Some babies do better with smaller, more frequent feeds. (This causes less pressure on the oesophageal sphincter.) They may not want both breasts at each feed, or may do better if offered only one side, but more frequently. Other babies have coped with being fed from one breast only, and if requiring a top-up within the hour, being given the same breast, encouraged to have a sleep, then being fed from the other breast. It is recommended that the breast is drained at each feed to ensure your baby gets both the more watery (fore)milk and the more creamy (hind)milk, and to reduce the risk of blocked ducts. Continuous or very frequent feeding is generally not recommended.

As reflux episodes are greatest within the hour or so after feeds, some babies may prefer a larger feed less often. These babies may prefer to feed from both breasts at each feed, and have a longer interval between feeds. You may like to experiment to see if any of these methods helps your baby.

Breastfeeding information obtained from: http://www.breastfeeding.asn.au/bfinfo/reflux.html

Diaper Changing Technique

Before a baby has learnt to crawl they can be prone to subluxation of their lower vertebrae, brought on by certain methods of diaper changing. When this occurs the nerve that flows to the digestive system can be affected, sometimes worsening reflux and colic.  A visit to a osteopath or chiropractor skilled in helping babies can correct this, but you can prevent it from happening by using a different diaper changing technique. When changing the diaper support their chest with one hand and roll the baby side to side to clean and change the diaper, rather than lifting their bottom up by the ankles.  It may take longer to do this however this can help to reduce colic and reflux by promoting good nerve flow to the digestive system.

Infant Massage

Massage therapy has been used for centuries to help with pain, injury and illness, and infant massage in particular has been found to benefit not only physical health, but also the emotional and psychological health of babies.

With regular massage, infants experience improved function of the respiratory and digestive systems, reduced levels of stress hormones, enhanced cognitive ability, reduced crying and better, more regular sleep. Not only that, but infant massage has also been found to help with infant reflux as well

Reflux is a direct result of the incomplete development of the muscle between the stomach and the oesophagus, and, unlike regular muscles, it can’t be helped directly with massage therapy. Instead, it is the skin stimulation from the massage that affects the nervous system, which in turn helps the muscle develop in two major ways:

Massage on any part of the body stimulates the vagus nerve, which is a nerve in the brain that controls various regions of the respiratory and digestive systems. This includes the oesophagus and the stomach.

Massage helps the nerves in the body to develop more quickly, which means they can begin to operate more effectively sooner. Since nerves control the muscle between the stomach and oesophagus, massage should help to improve its ability to function.

Infant massage instructors are trained to teach a sequence specific for the relief of colic.  Luckily, it has been found that infant massage techniques that are focused on the abdomen can help to relieve the symptoms of colic, wind and constipation in two to four weeks with regular sessions.

Infant Massage information obtained from: http://blog.babymassage.net.au/infant-massage-reflux/

Is it really reflux?

Given that babies will naturally gave some regurgitation and spit ups for the first few months, and that a distressed baby will make similar actions (pulling knees to chest, grimacing, crying) it is possible to attribute the cause of an unhappy baby to reflux. However it may be that this particular baby is wanting something else, such as more contact. Carrying baby in a supportive carrier could help to ease their discomfort whilst still allowing the parent to go about their business.

Resources

Australian Breastfeeding Association
1800 686 2 686 / 1800 mum 2 mum
http://www.breastfeeding.asn.au/

La Leche

Facebook: https://www.facebook.com/LLLSydney
Email: sydneylll@outlook.com
Website: http://www.llli.org

Tresillian
1800 637 357
http://www.tresillian.net/

Reflux Infants Support Association (RISA) Inc.
PO Box 1598, Fortitude Valley Qld 4006.
Phone: 07 3229 1090.
Website: www.reflux.org.au
Email: info@reflux.org.au

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