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10 Signs Your Reflux Baby Should See A Pediatric Feeding Therapist

June 17, 2017
Top 10 Signs Your Baby With Reflux Should See A Pediatric Feeding Specialist -

Reflux is one of the most difficult things to deal with when raising a newborn.  I can tell you, from personal experience, that it’s soooo frustrating and disheartening! That’s one of the reasons why I am a pediatric feeding therapist myself!

But I want to tell you, dear readers, that there is hope and there is help!

And I’m not just talking about medication.  If your baby truly has reflux disease (GERD) medication is necessary to prevent the continual burning and erosion of the esophagus, so don’t delay expressing your concerns to your pediatrician.  If you don’t know for sure if your baby’s fussiness is related to GERD, read this post:

“Do you have a Fussy Baby? Is it Colic, Reflux or Allergies?”

If your baby has been diagnosed, read on to be empowered with information!

There are many reasons why a baby has reflux, or GERD.  Some of them are not preventable like prematurity, unusually acidic stomach juices, or other medical issues like pyloric stenosis (when the stomach has difficulty emptying its contents into the small intestines.) But there are also preventable or treatable reasons for reflux!


But there are also preventable or treatable reasons for GERD. The most common being feeding issues and constipation! Click To Tweet


10 Signs your reflux baby needs a feeding therapist

If a baby has any of the top 10 feeding issues listed below, they may be getting too much air into their stomach, or too much food, making it more likely to come back up! Even if the acidity of the stomach juices is normal, excessive amounts of spit-up can still be very irritating to the esophagus and can cause chronic pain and inflammation with every meal.  Poor little fussy baby!


So how do I know if my baby would benefit from feeding therapy, you ask?  I’ll tell you!

Pediatric physical therapists (PT-like me!), occupational therapists (OTs, OTR/L) and speech/language pathologists (SLP) can all be trained as feeding specialists, with further coursework and certifications in the specialty beyond our graduate programs. (Physical therapists have doctorate degrees, and OTs and SLPs have master’s degrees.)

A pediatric feeding specialist can help evaluate your baby’s oral motor structures and oral motor function during feeds. If something is awry, we will teach you simple exercises or techniques you can do at home before, during, or after feeding to minimize the reflux and pain.

If you are eager to get help and information for you and your baby right away, I offer online baby consultations! Click below for more information!



Need a feeding therapist? Work with Me! "Ask the Baby Expert" at



You may or may not have already worked with a lactation consultant to get a good latch and maintain a good milk supply–among many other things related to Momma’s breasts–but pediatric feeding therapists are the experts on the baby’s side of the equation.  (P.S. If you haven’t given birth yet, be sure to INSIST on a visit from the lactation consultant while you are still in the hospital! Early feeding issues like poor latch and tongue ties can be caught and treated early before bigger problems arise later.)

Read this post to learn more about lactation consultants:


The 10 most common signs of poor feeding that can be improved with help from a pediatric feeding therapist:


  1. Sucking on just the nipple of the breast, or collapsing the nipple on the bottle

  2. Chomping on the breast

  3. Smacking during feeds

  4. Losing milk out of corners of mouth

  5. Spitting, sputtering, coughing during feed

  6. Poor suck-swallow-breathe coordination

  7. Frequent feeds of small volumes

  8. Fussing that stops the feed, while baby is still acting hungry

  9. Wet, gurgling breathing after feeds

  10. Oral aversion – refusal to take breast or bottle


Other signs or symptoms that can be assessed and treated by a feeding therapist:


  1. Poor weight gain10 Signs your reflux baby needs a feeding therapist

  2. Tongue and lip ties

  3. Torticollis, tight muscles 

  4. Low muscle tone, fatigue with feeds

  5. Poor posture, arching during feeds

  6. Difficulty starting solids — tongue protrusion, gagging, choking or refusal

  7. Oral aversions with play — not putting hands or objects in mouth or over-active gag reflex

  8. Difficulty taking a pacifier or transitioning between breast and bottle.

  9. Difficulty transitioning from bottle to cup

  10. Constipation!

Read: “What is torticollis?” and “I think my baby has torticollis, what should I do?

Read: “How to know when your baby is ready to start solids” 


Take home messages:


  • Talk to your doctor as soon as you detect difficulty with feeds or signs of reflux. Even if you don’t want to give your child medication for reflux, or your doctor doesn’t diagnose reflux, at least you are getting a head start on recognizing the problems and advocating for getting help for your baby!

  • There is no harm in seeking a pediatric feeding therapist to evaluate your baby. The worst thing that can happen is you get information about what’s going on and you get help! The best thing that can happen is the therapist says everything looks good and you two are doing a great job!  I don’t see a downside to this, do you?

  • Don’t question your mommy instincts! If you feel like something is wrong, or your baby is really in a lot of pain, speak up! Go back to the doctor or ask for a referral to a specialist or feeding therapist if you aren’t satisfied with the answer you got the first time!

  • Keep a journal of your baby’s feeds and diapers: ie Time of feed, how long feed lasted, fussiness, trouble burping, pain afterward, how much spit up, how many wet diapers and how many bowel movements (if any of your baby’s BMs are hard or your baby has to strain and fuss to pass stool, please bring that up to your pediatrician!)

  • Schedule a call with me if you have any questions or concerns.  The first call is always free! We can sort out your concerns together and I will help you get the help your baby needs!


Ask the Baby Expert! Free 30min consult with Wendy Rohin, pediatric PT at


I hope this post has empowered you with information and resources to advocate for you and your baby!

Let me know what you think in the comments below! 


Does your baby have reflux? What can you do about it besides medicate? Top 10 Signs Your Baby With Reflux Should See A Pediatric Feeding Specialist -

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  • Reply mspyanov June 17, 2017 at 1:46 pm

    Great info. What are your thoughts on difficulty transitioning to solids? I know you listed at the end.
    We have no issues with breast, bottle, paci, etc. However, with solids she struggles with spoon as well as any finger foods. I’ve been doing pouches because I don’t want feeding to become a negative experience and she’s hungry and wants the food. We do spoon and finger foods to practice and then if she gets frustrated/tired we just do the pouch (which really is similar to a bottle as far as skill). She’s shown improvement but even last week she vomited twice with spoon feeding. She’s slowly getting used to so I’m not worried but is it common with preemies to struggle with solids even once otherwise ready to eat?

    I’ve mostly done baby led weaning so I’ve never had this problem lol. She’s hungry but not quite coordinated enough for blw.

    I swear I’m not on FB all day 😂 I have to go back and forth while writing and always get distracted and post 😂

    • Reply June 18, 2017 at 11:39 am

      Thank you so much for commenting! I think babies definitely need to have good head control in supported sitting before you try anything solid or on a spoon. Also, I would say preemies have a harder time with solids and spoons likely because of immature or uninhibited reflexes (like the startle and plantar reflex), but with feeding it would be the gag reflex and tongue protrusion reflex. There is an oral motor assessment we do to test what the tongue does with stimulus that helps us determine why they struggle with objects and solid foods in their mouths. Also, untreated tongue ties can affect their tongue movements with solids. Read this post, too and let me know if it helps answer your questions!


      • Reply mspyanov June 18, 2017 at 11:43 am

        Thanks for the response. She met the criteria for starting based on your article and per GI we were told to definitely start offering. She loves eating, but she does struggle sometimes. I’ll catch a video of our next session. She does do some of the “started too soon signs” however. She started grabbing my food to eat though and opens to eat. She does not close her mouth around the spoon at all though.

  • Reply Emily August 13, 2017 at 7:34 pm

    Great posts! My sister is an SLP and I respect that field so much. It’s definitely not worth giving up breastfeeding for if baby is having a little trouble.

    • Reply Wendy Rohin, PT August 14, 2017 at 12:41 pm

      Thanks so much for your comment, Emily! I hope-very soon-moms will be presented with BOTH resources from the beginning, lactation services and pediatric feeding therapy. PS I love your website, I pin and share a lot of your stuff! Let me know if you want to join my group pinterest board that’s for evidence based information only!

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