Reflux – how it affects your baby.

Reflux is one of those terms that gets bandied around a lot when you have an unsettled baby. It’s also one of those perplexing things that new parents face; does your baby have reflux or are they just unsettled.

Reflux can be awful, for your baby and for you. Some babies will have obvious symptoms of crying/screaming, vomiting, not gaining weight, and others will have more subtle symptoms, like being unable to sleep for long periods etc, but either way it can be very frustrating and exhausting.

Do all babies have reflux?

When babies are born, the opening to the stomach is very loose. This means that milk can flow back up through the opening quite easily. Most babies will have some degree of regurgitation, but it is when the milk, along with the stomach acid, flow back up into the oesophagus, or even the mouth, that it can cause problems.

Reflux tends to get worse around six weeks as this is when the gastric acid starts to be produced. It will then usually peak around three to four months and start to improve – sometimes resolving itself – around five months.

If you suspect your baby has reflux some of the signs and symptoms can be:

  • Coughing.
  • Being unsettled during or after feeding.
  • Arching their back or throwing their head back when feeding or sleeping.
  • Refusal to feed or others may comfort feed and be unhappy.
  • Slow weight gain in some cases.
  • Gagging or frequent swallowing after the feed.
  • Frequent hiccups.
  • Irritability which may include screaming, whingeing, fussiness, and can be inconsolable at times due to pain.
  • Restlessness or jerkiness.
  • Tossing of head from side to side.
  • Catnapping for 45 minutes or less and inability to resettle.
  • Spilling or vomiting (may be projectile, and may vomit through their nose).
  • Husky voice.
  • Wheezing.
  • Wanting to be held upright and being unhappy as soon as they lie down.

If your baby has reflux and is not being medicated then it is advisable to seek the opinion of your doctor as medication may help enormously. It is worth talking to your doctor about feed thickeners and over the counter medications as well as prescription medications. Don’t be afraid to ask lots of questions and see what is right for your baby. Some people feel like it is a big step to put their baby on medication and some feel comfortable with it right away – find a doctor who you trust and talk to them about your concerns.

Caring for a baby with reflux can be difficult, as they may not sleep well. And this may not get better until they have grown out of it or they are treated effectively with medication. However, even when on medication, a baby’s sleep may not be perfect. There are degrees of reflux and some babies will respond well to a few changes in the way they are fed or slept, and some babies will need medication.

Some practical things you can do for babies with reflux are:

Feed baby in a more upright way.
When breast or bottle feeding, ensure the baby is on an angle where their feet are lower than their head. If you have a fast flow, then lean backwards so that the baby is not having to gulp too much when feeding. If on the bottle, use a slower teat for a bit longer to assist with your baby not taking in too much air when feeding.

Raise the head of the cot so baby is on an angle.
Sleeping your baby with their head higher than their tummy can help. It is safer to put some books or blocks under the feet of the cot or basinet rather than something under the mattress.

Burp frequently throughout the feed.
Take the baby off the feed about every 50mls or every 5 minutes and hold them upright to burp. Even if they don’t burp, giving them this break, and holding them upright can help with wind and reflux.

Keep upright for 15 minutes after the feed.
After each feed, even overnight, keep your baby upright, either on you or in a rocker/capsule, after every feed. If your baby is asleep after the feed, it is still advisable to do this. Also, try and get at least one burp out of them during this time.

Watch your diet.
If you are breastfeeding, what you eat can affect your baby and sometimes exacerbate the reflux. Reducing dairy, soy, wheat and/or food high in acid may help but it depends on your baby. You need to give it about two weeks of eliminating these things from your diet before you can properly assess whether it is helping