We all expect our newborn babies to feed well, burp and then sleep for hours. But in reality this is not the case for a lot of newborn babies. It can be heart breaking for parents to see their baby so uncomfortable and reflux may be the cause of this.
So what is Reflux?
Babies are notorious for spilling and this is because the ring of muscle between the oesophagus and the stomach is not yet fully mature. This allows the stomach contents to flow backward. Eventually the lower oesophageal sphincter (LED) will open only when your baby swallows and the contents of the babies stomach will remain where they belong.
Most babies spill because of the liquid only diet, but also due to the fact that they are on their backs most of the day.
How common is Reflux?
It is estimated that more than half of all infants experience acid reflux to some degree. The condition usually peaks at 4 months and goes away on its own by the age of 18 months (www.healthline.com).
Babies who are born prematurely are at a higher risk of acid reflux due to their immature development.
What are the signs of reflux?
Diagnosing reflux can be difficult in some occasions, especially with silent reflux. With silent reflux, the baby may not spill, however they still suffer from the acid burn. Babies who spill often and scream with the burning feeling from acid reflux are more obvious and easier to diagnose.
Arching their back
Spitting up or vomiting
Fussiness at the breast
Gagging or choking
Failure to gain weight
Excessive feeding to keep acid down
Frequent coughing and sneezing
Wet hiccups or burps
Occasionally, infant reflux can be caused by more serious conditions, such as:
GERD - The reflux has enough acid to irritate and damage the lining of the oesophagus.
Pyloric Stenosis - A valve between the stomach and the small intestine is narrowed, preventing stomach contents from emptying into the small intestine.
Food Intolerance - A protein in cow’s milk is the most common trigger.
Eosinophilic Esophagitis - A certain type of white blood cell (eosinophil) builds up and injures the lining of the oesophagus. (mayoclinic.org).
What can you do to help?
As a parent it is awful to see your baby screaming in pain as the acid reflux creeps up, but there are a few things that you can do to help. All of my babies have had acid reflux so from experience I know that you can minimise the effects of reflux.
Breastfeed your baby if possible
Feed in an upright position
Feed small and often
Hold your baby in an upright position for 20-30 minutes after a feed
Delay playtime after a feed
Elevate the head of the cot slightly
If bottle feeding, add a thickener prescribed from your doctor
Change the type of formula
Avoid tight nappies and clothing
Breastfeeding will help your baby with acid reflux due to the fact that it is easily digested, so if possible breast feed your baby until at least 6 months. From my experience some doctors will advise you to switch to formula, due to the fact that it sits heavier in the babies tummy. However I feel that this can cause more problems in the long run.
It can be hard having a baby with reflux as feeds can be very time consuming. You may notice that your baby comes on/off the breast/bottle a lot because of the burning sensation. Due to the fact that your baby is needing to be held a lot it can cause sleep problems that will need to be addressed at a later date. It is only a short phase in your babies life but it can feel like a lifetime as a parent.
There are agencies and volunteer groups out there who will help with day to day jobs around the house. This will enable you to focus on caring for your baby and for you to get some sleep. We have specialist maternity nurses who have experience in reflux, please get in touch www.maternitymum.co.uk
If you notice that your baby is still struggling even though you are following all of the steps above then it is advisable to seek help from your local doctor. They will ask for your babies history and diagnose as necessary. Doctors are sometimes reluctant to prescribe medication as reflux is so common and the research shows that medication may not actually help in the long run, especially for uncomplicated reflux. These medications can prevent absorption of calcium and iron, and increase the risk of certain intestinal and respiratory infections.
There are several medications that can help which include:
If you get to the stage where your baby needs medication, then your doctor may refer you to a paediatric doctor who specialises in reflux. There are several investigations available if needed to confirm reflux or a more serious form.
If you are going through this difficult time with your little one then make sure that you have support around you. The days and nights will feel endless and can be quite isolating, so remember to look after yourself too.
Reflux can also be very common with babies who have a tongue and/or lip tie, so it is worth having that investigated too.