So your preemie has GERD. Now What?!?

November 24, 2014
One sign of GERD: Writhing as if in pain: drawing up legs, arching back

One sign of GERD: Writhing as if in pain: drawing up legs, arching back

I’m sure by now you know the sinking feeling you get when other moms come at you with the “my baby had reflux too” stories. First, I want you to know that you’re not alone. Gastroesophageal Reflux Disease (GERD) is one of the most common problems that a preemie can have. It’s often misunderstood and it’s often difficult to treat. The nights full of incessant screaming, the frustration at feeding times, and the hours spent with a baby lying upright on your chest because it’s the only position they can find relief. I know how desperation sinks in when you try time and time again to comfort your baby, but nothing ever seems to work. I’ve been there too. And I’d be lying if I told you that I’ve never had to hand my baby off to someone else, just to go outside and sit in the car crying because it was the only place I could think of to go, where I wouldn’t hear my son screaming.

You see, along with the back arching, refusing bottles, and poor weight gain; doctors fail to give you the “proper” descriptions of GERD symptoms. So, let me give you a better look at a couple “real life” symptoms the doctor fails to truly describe.…

  • “Your infant may become irritable” Seriously? No. Irritability is when I forget to turn the dryer on and find a glob of wet clothes when I go to switch loads. This, my friend, equates to my child screaming for hours on end while staring me in the eye, managing to give me the look of desperation and daggers at the same time. All that’s missing is the head spinning, because it brings me to number two.
  • “Your infant may spit up more than normal” <— Yet another blatant understatement. What it should really say is that at some point or another, you’re going to wonder what the Guinness Book of World Record lists as the furthest spit-up distance. Trust me – I’ve Googled it. You’ll go through bibs and burp rags as if they were one-ply toilet paper. And I hope you like the smell of battery acid because they completely forget to tell you about the metallic-based scent that comes along with it.

But you already know the symptoms. You’re already there and trying desperately to find a solution. Your doctor may have already prescribed medications that are beginning to relieve GERD symptoms, or maybe they worked for a while, but seem to be losing their effect. I want to focus on some tips and tricks that will hopefully help you find the perfect combination to make this hard, yet most likely temporary, phase a little easier. Please keep in mind that you should always check with your child’s pediatrician and/or specialists before trying anything new with your baby.


GERD is often associated with feeding intolerances. For those who are breastfeeding, eliminating certain foods from the mother’s diet, such as dairy, can help. For those who formula feed, some babies may need to use a formula that is specially broken down to make digestion easier. And if there’s still an issue, your pediatrician may have you use an amino-based formula, which is allergen free and more easily tolerated.


Infant massage is a great way to soothe your preemie and help with digestion. There are plenty of calming massages that can be found on the Internet. YouTube is a great resource that can help guide you, step by step, through the process. It’s not only helpful for your preemie, but it gives you nice, quiet time together.


Try giving your baby a cold bottle. GERD is caused by the abnormal flow of gastric acid from the stomach entering the esophagus, often leading to the esophagus becoming raw and inflamed. As if it wasn’t already hard enough to keep their food down, it can also physically hurt them to swallow. Mixing cold water and formula can sometimes be tricky but one tip is to add an ice cube before shaking. The ice cube not only cools the contents, but it also acts as an agitator to help mix things around. Another tip is to make a pitcher of formula and keep it in the fridge. The formula has more time to break down so it can be easily mixed and it becomes pretty handy to have it on hand as you need it.

        More Feeding TipsSeth Feeding Time

  • Feed small amounts with time to digest in-between. For example: my son did best when he was fed 1 ounce, was given a 15 minute break with gentle burping, and then repeat.
  • Gas drops and simethicone should be discussed with your doctor before use, but could cut down on your preemie’s discomfort. I always felt like a crazy scientist while trying making bottles, coming up with the exact formulation of what helped our son’s symptoms.
  • If your pediatrician advises you to add rice cereal to the bottle:
    • Add little by little until you find what consistency works best for you.
    • Cut a small X in the nipple hole to allow better flow
    • Hold the bottle at a 45 degree angle
    • Gently shake the bottle side to side, allowing gentle agitation of the rice cereal to keep it from settling and clogging the nipple.
    • Make sure there is always has milk/formula in the nipple, avoiding air pockets that could cause added burping time and additional stomach upset.


Keeping your preemie in an upright position is one of the things you’ll come to know very well. If you’re able to, change your preemie’s diaper before feedings instead of afterwards. Try not to lift their legs up too high during changes – rolling them to the side instead. Keeping your preemie upright for 15-30 minutes after a feeding will help with keeping everything down.



Carrying your preemie in a baby carrier or wrap can help to gain back some of the precious freedoms you might miss because you’ve spent hour after hour sitting with an infant lying on your chest. Freedoms such as walking, going to the bathroom, and using both of your hands again. Even napping becomes easier when you use a carrier. Your baby stays in the upright angle and you don’t have to constantly worry about dozing off and the baby falling.

Some other positioning devices that help with GERD are the RockaByeBaby as well as a Rescue Wedge. They help keep your preemie at an upright position. A Tucker Sling and mattress wedge are devices to help keep your preemie positioned comfortably when in a crib. Talk to your Early Intervention Specialist, as they might be able to help provide some of these items.


Remember that you are not failing your preemie. I know it feels that way sometimes when there isn’t an instant fix to solve your baby’s ailments, but this is just another stepping stone on the path of everything preemie and you will get through it. You need to take breaks to regain your composure. If you’re alone, place your baby in a safe place and take a few minutes to collect yourself. Crying doesn’t hurt anyone – including the baby. Having a preemie with GERD can be tiring and frustrating. It takes time and patience to find what works and what doesn’t. Often, it can take up to a week after trying something new to take effect. Don’t give up. You will find your answers; even if takes trial and error to get there.

* This information is not intended to be a substitute for professional medical advice