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Let’s talk about REFLUX…..
If you are in the thick of it with a reflux baby, you have my sympathies, I’ve been there, lived it and felt like a complete failure!! Yes, I knew what I was doing but it was awful not being able wave a magic wand to fix things instantly. On reflection, I should have accepted more help, I felt I needed to do it alone but truth is, I struggled!! I do, however, feel this has helped me to help my clients with this issue and I hope the information below, helps you too.
What is Reflux??
Reflux is a word meaning "wrong way." Reflux happens to us all, some of us know about it, some of us don't and this is the same with babies too. More than likely you will know if your baby is experiencing reflux if your baby is uncomfortable, doesn't settle well and is distressed often. Your baby may experience frequent episodes of hiccups, sneezing & irritability often, they may also have waxy ears, sound mucousy with a cough, your baby may arch their back too. There are many other symptoms of reflux but know it can be exceedingly painful and exceedingly stressful & upsetting for you too.
A baby who suffers from reflux, in simple terms means that the milk baby has ingested, goes down but then comes back...the wrong way!! Typically, milk goes down the oesophagus into the stomach and the gastro-oesophageal valve normally ensures milk remains in the stomach, however, in the case of a baby experiencing reflux, the valve may not have matured sufficiently and milk can come back up.
This is sometimes in the form of vomit or sometimes just a small amount of fluid into the throat causing a burning sensation as the milk is mixed with stomach acids. It is commonly known as silent reflux when nothing visible comes out of your baby's mouth, but you may notice a metallically acidic smell on their breath. As a result of reflux many babies experience sleep issues.
Both my children experienced silent reflux, along with other health issues. It was an emotional journey for us all and consumed our every minute of most days, until finding what worked for each of our children brought relief to the situation.
Babies who have underlying health issues including food intolerances, or babies who are born prematurely can often experience reflux due to immature physiology. The help and advice given below is for an otherwise medically well infant.
There are many things you can do for reflux but firstly...if you feel you need some support then please please please shout out to somebody, either contact me or ask for help from a family member or friend.
Tips and Suggestions
Look at the position you feed your baby in, whether this is from a bottle or a breast, if a baby is reclined it may be encouraging the stomach valve to force the milk back into the oesophagus. Keep baby upright even during the feed.
Consider how your baby is being held after a feed. Many years ago, an infant would not have been left on a play mat or placed in a little seat!! They would have been carried most of the day in order to keep them from possible harm and as a result, gravity was an amazing tool. I'm not suggesting your baby isn't safe being laid down, but you will have experienced the level of discomfort if you have been out for a large meal and gone to bed thereafter. Keep baby in an upright position after all feeds by using a sling, in your arm or finding a friend who will walk with baby like this, if you cannot.
Make a note either on paper (best option) or in your head, as to how much your baby has had per feed if fed from a bottle, or how long baby fed from the breast per feed. Jot down the effects afterwards, you may discover your baby overfed at a certain time due to being sleepy and was then in more discomfort as a result. Please know, this method has been key to many of my clients but not all. I never remembered to jot this information down but I knew one of my children use to feed heavily late afternoon and we would have an awful situation thereafter. Sometimes little and often will be the fix for your baby.
Sleeping positions...this is topical!! NHS Guidelines & The Lullaby Trust advise all babies should sleep on their back to prevent SIDS. The campaign set years ago absolutely reduced death rates amongst babies massively, however, there are a number of factors that need to be considered such as temperature of the environment, air quality, mattress quality, babies birth weight & potentially any underlying health issue.
I am NOT suggesting you lay your baby on their tummy to sleep having read this. I am however suggesting IF your baby is struggling with reflux and is unable to sleep on their back, look into ways of allowing your baby to sleep SAFELY on their front, with the use of a sleeping mat/apnea monitor. The are many mats on the market now, some monitor only movement, some monitor oxygen levels & heart rates. In my opinion, buy the best one you can.
A monitor should be used at EVERY SLEEP whether a baby sleeps on their front or their back. Babies sadly still die whilst on their backs in their cots, having a mat can prevent any cot death happening.
Some babies are able to sleep on their back with their crib/cot tilted through 'raisers.' This enables the milk to stay down in their stomachs.
I personally used the "Cocoonababy nest" for my most recent baby, which certainly helped him sleeping on his back BUT I do have to mention at this point, these sleep aids are not advised by the NHS or The Lullaby Trust. You need to be fully aware of safe sleeping, so read up on it. The NHS offers guidelines regarding SIDS & Reducing the risk of SIDS. The Lullaby Trust also has information on safer sleeping and SIDS. I strongly believe we are set guidelines to inform us of possible risks but we can all make our own decisions with informed choices.
Eliminate any excess wind your baby may also have. Winding a baby may seem simple, place baby on your knee, hold upright and pat, right.....?? No, our anatomy isn't quite as straightforward as this!! Our stomach does not sit in alignment with our head and the valve is off at an angle too!! Therefore by placing baby over your right shoulder at an angle as this should help release any build up of wind. Removing this issue won't stop reflux from happening, but it can reduce discomfort.
Think about giving your baby a probiotic, acid reflux destroys gut flora, probiotics should be able to replenish and heel the gut. Not all evidence agrees with their effectiveness so I would suggest you read reviews and make a decision based on your findings. I found them to be very useful amongst the stress that reflux brings.
Decide whether you feel your babys' symptoms need to be seen by your GP to discuss medication for this issue . There is medication available, typically an antacid, but it comes with possible side effects therefore it is a personal choice as to whether you feel your baby could benefit from something or not. Sometimes tweaking the diet alone, means you don't always need to consider medication.
You could review with your GP/HV whether it is an option to give baby a thickened formula, which literally does what it says on the tin...increasing the density of the milk helps it to stay down. If you are breastfeeding, a thickening agent can be given prior to a breastfeed.
It is important to communicate if there is a family history of allergies such as a cow milk protein allergy (CMPA) or a lactose intolerance (LA) issue with your GP/HV. If there is allergy history, your baby is more likely have the same predisposed issues too. If therefore, you are breast feeding, you may want to note if your baby is more uncomfortable after you have had foods containing the above triggers. I know my second son reacted heavily to me eating dairy but also caffeine appeared to affect him too. Be open to trialling other options!! If you are formula feeding, you may want to discuss this with you GP/HV, who can either refer you to a paediatric consultant or a paediatric dietician to discuss different formulas that are made without the trigger ingredients.
Please try to remember, hard though it is, the gastro-oesophageal valve will mature and hopefully end all mild reflux issues. If however, the reflux is caused by other means, finding the answers are key, but know what you are experiencing now, will not be forever. Please seek help, accept help and know you are doing your very best. Know also...you are NEVER EVER alone.
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