How to help a baby with reflux

mother comforting baby

by Emily Thorpe |

As a parent, you're often on high alert for anything that might be wrong with your child. If they're bringing up milk or are even sick after feeding, there's a possibility that your baby could be experiencing what's known as reflux.

What is reflux?

Reflux is when milk comes up from the stomach and into the food pipe (oesophagus). Milk can sometimes come all the way out of the mouth (regurgitation or ‘posseting’) and some babies have what is called ‘silent reflux’ where there is no posseting or vomiting but they are uncomfortable as the milk is still coming into the oesophagus.

"Reflux is extremely common in babies under one as their muscles at the top of the stomach aren’t fully developed, their diet is predominantly fluid and they spend a lot of time lying down," says Hannah Love is a Paediatric Nurse, baby sleep specialist and Ambassador for Bloomsbury Mill. "Unfortunately, this isn’t a good combination and is why reflux is far more common in babies than adults."

How can I tell if my baby has reflux?

Some symptoms that your baby might have reflux are quite obvious such as vomiting, being uncomfortable or back arching after feeding. "Some are less so and could just be that your baby is generally unsettled day and night. Reflux babies are notorious for not wanting to lie flat (including for nappy changes or playing), grunting through the night and they often wake lots," explains Hannah.

"Often the biggest ‘symptoms’ of reflux is poor sleep. As a sleep specialist, I have ‘diagnosed’ reflux when parents have contacted me for sleep issues, during the program we have realised that the sleep issues are actually caused in part by undiagnosed reflux. Addressing sleep issues often improves reflux symptoms and helping with the reflux symptoms. By separating feeding and sleep, reducing night feeds and advising simple things like holding baby upright can help the reflux symptoms."

Reflux symptoms usually start before 8 weeks and they usually get better by themselves as baby gets older, eats a more solid diet, spends more time upright and milk feeds reduce. 90 per cent of cases are completely resolved by the time the baby is one.

"It is also important to note that reflux symptoms are often the same as cow’s milk protein allergy (CMPA) symptoms and can often be confused," says Hannah.

How to help your baby with reflux

There are a few things you can do at home to help your babies reflux symptoms. Here are Hannah's tops tips:

• The first thing I would advise is separating feeding and sleeping. This is simply because you want your baby to be able to lie down to sleep and this isn’t an ideal position for a reflux baby, after being fed.

• Reducing overnight feeds is also important. Overnight you want your babies tummy to rest, not be full of milk so that they can lie down more comfortably and sleep better for you.

• In the daytime keeping your baby upright after feeding can help, as can raising the head end of the cot with a reflux pillow.

• If you have tried all of the above and baby is still struggling I would strongly advise investigating the elimination of cows milk protein, either by changing formula or dietary elimination for the mother if breastfeeding.

• If you decide that your baby is uncomfortable or needs medical help then there are many medications that can help, as well as milk thickeners which can also help some babies.

Are some babies more likely to get reflux that others?

"Reflux has been shown to be more common in babies born prematurely, or with low birth weight and in babies with any kind of muscular impairment such as cerebral palsy," Hannah explains. "It does often go hand in hand with CMPA, which is why two can often be confused and misdiagnosed."

When should you seek medical advice

Most babies' reflux can be self-managed without medical intervention. "I would always advise contacting a reflux specialist so that you can get non-invasive advice to help you and your baby," recommends Hannah. "There are lots of good support groups around too."

If your child is unwell, distressed or losing weight or you as the parent have any concerns then it is best to talk to a health professional as the child may need treatment/referral to a paediatrician.

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