So many parents and carers get in touch with me because their babies have reflux and they are at the end of their tether. Many exhausted parents don’t know who to turn to or how to resolve it, and often even when they do raise it with a professional, no one takes it seriously. If this is your experience, this article should hopefully answer some of your key questions and give you the confidence to find a solution.
What is reflux?
Reflux is when a baby brings up milk, or is sick, during or shortly after feeding. For some babies this can be painful, causing distress, whilst for others it is not painful at all – ‘sicky’ but happy babies. Other babies aren’t sick with reflux because they swallow the regurgitation liquid instead. This is silent reflux, and is harder to spot.
What causes reflux?
In some babies, the valve between the oesophagus and the stomach isn’t fully developed or working effectively. This means the contents of the stomach can be pushed into the oesophagus, which can cause vomiting. Often reflux happens simply because of your babies age – it usually starts before they are 8 weeks. As they grow and the oesophagus increases in length and strength, and therefore work more efficiently, the reflux will naturally ease.
Large feeds can also cause or exacerbate reflux. Babies obviously have small stomachs and if they are too full, milk can be pushed back up the oesophagus. Babies lie down the majority of the time and his position allows milk to come back up easily. Allergies can also cause the digestive system to work slowly and this can cause reflux.
What are the signs to look out for?
- Frequent, long periods of upset where they cannot be settled;
- Weight loss – often the case for babies who vomit a lot but not the case for silent reflux, they will gain weight;
- Fussy during and following feeds;
- Wheezing or snuffly;
- Difficult or disrupted sleep; and/or
- Reluctance to feed.
How to help ease reflux:
These tips won’t work for everyone, but they are a good place to start when your baby first starts to struggle.
- For very young babies, try small frequent feeds rather than big feeds until the stomach grows and can tolerate larger feeds;
- Hold your baby upright in arms, bouncy chairs or on a cushion for 15 mins after a feed. I do this for all babies (day and night) in the first 12 weeks. Gravity will help the food to stay down;
- If you are bottle feeding, don’t up the teat size too soon. Fast feeds will cause an overfull little tummy;
- If you are breastfeeding and you have a very fast flow, bring the baby off for a few moments to all the flow to slow down; and
- offer a dummy – sucking can ease the pain and push food back down.
So, if that doesn’t work, what next?
It’s time to go to the doctor if your baby:
- is not improving after 2 weeks of trying things to ease reflux;
- gets reflux for the first time after they’re 6 months old;
- is older than 1 and still has reflux.
How do I get the doctor to take it seriously?
The sad truth is that reflux babies are often thought of as “spirited” or “high needs” when actually they are uncomfortable or in pain. This can be the attitude of friends, family and even professionals, and it’s hugely challenging. The number of women who tell me they have been fobbed off with statements like ‘babies just cry’ or ‘this is normal for a baby of this age’ with undertones of judgement that they are being over the top or aren’t coping with motherhood (I mean who is anyway?!). These tips should help you get the support you need:
- Book a long appointment and be prepared. Try to stay calm and give a full account of the symptoms. Doctors are keen to not over diagnose reflux. I suggest taking the following with you:
- A list of symptoms;
- Film of a feed. Babies with a cows milk allergy tend to be very noisy sleepers often grunting and continuously waking. Film this too;
- A detailed diary – feed times, amounts and a description of the during and after the feed;
- A diary of sleep times – babies frequently wake at 30 minute ,45 minute and one and half hour marks of sleep. If they are often waking around this time it gives me an indication something is bothering them.
- One of the most helpful tools I have found are the NICE guidelines that doctors have to adhere to for treatment of reflux in babies. Have a read of the guidance and note down the questions they suggest you ask – it might give you more confidence and ensure the doctors listen to your concerns.
- Don’t be fobbed off! I have seen many a parent be seen as tired, depressed or too keen to get a reflux diagnosis. Don’t be scared to seek a second opinion.
When you go in, don’t forget – Trust your gut. Reflux is REAL. Just because your baby isn’t sick doesn’t mean it’s not reflux. Weight gain does not mean your baby doesn’t have reflux.
What might the doctor be able to do to help you?
If appropriate the doctor may prescribe:
- feed thickeners;
- reflux medication such as omprezole;
- If a cows milk protein allergy is suspected they may suggest a dairy free milk or an elimination diet for breast feeding mothers.
Can working on sleep help babies with reflux?
Due to babies being in pain their sleep is often more difficult. Over 80% of my clients babies have had reflux issues in the past. This can lead you (understandably) to develop coping mechanisms so everyone can get some sleep, which can sometimes lead to challenges later down the line.
Once the pain is under control it is an ideal time to start working on some of the remaining sleep issues. Visit my services page for details of my packages.