If your baby has reflux he/she won’t be getting much sleep. That is unless you are holding them upright or comforting them in some way – which means that you won’t be sleeping much either!
We’ve written this post as the vast majority of babies and children we see at Savvy Tot Sleep start life with reflux and/or colic. This seems to limit LO’s ability to learn to self soothe becuase they have learned they need parental intervention to return to sleep on waking.
Sound familiar? Let’s take a look at the facts.
WHAT IS REFLUX?
We all have a valve that acts like a lid keeping the contents of our stomach “in” the stomach. In some babies this valve is immature and “floppy” and let’s stomach contents escape into the oesophagus or throat. When combined with naturally occuring stomach acid this causes pain and vomiting similar to heartburn.
WHEN IS REFLUX A PROBLEM?
If your baby is thriving, gaining weight and happy in between feeds there is no medical need to do anything. Ok – it’s hard work clearing up the vomit and always smelling of sick BUT it isn’t a medical problem. Having said that we know from practice that parents of babies with reflux can be utterly exhausted and sleep deprived and that can lead to parental low mood.
SYMPTOMS OF REFLUX
!. Your baby likes to be held upright all the time. Parents will often comment “my baby will only sleep when upright on my chest”.
2. Cries a lot – particularly when placed on his/her back. But remember small babies can cry for up to 3 hours a day. This crying peaks between 4 – 6 weeks and tails off around 3 months of age.
3. Demands frequent feeds. Mum’s will say “he’s only quiet when he’s on my breast”.
4. Arches back during or after feeds (goes into a banana shape).
5. Vomiting – or maybe not! When a baby does not vomit but has the above symptoms it could be “silent reflux”. Your baby may still benefit from behavioural modification and/or medication.
6. Hiccoughs, gagging on feeds, coughing and a rasping cry – as if he/she has a sore throat.
7. Premature babies are more prone to reflux.
PRACTICAL THING YOU CAN DO TO HELP REFLUX
1. See your GP who can give your baby a full medical examination
2. Try smaller more frequent feeds.
3. Try regular winding during feeds.
4. When feeding baby put them in a vertical rather than prone position. You can do this even with a breast fed baby – gravity helps!
5. Hold baby upright (an angle of 45% is about right) for at least 30 minutes after a feed to enable them to bring up wind and keep stomach contents “in”.
6. Soothe baby quickly. Crying for prolonged periods will encourage more food including acid to be regurgitated.
7. Elevate the head of the cot to aid digestion (a couple of large, stable books under the legs at the head of the cot will do nicely).
8. Try anti-colic teats/bottles to reduce the amount of air taken in during feeding.
9. Buy a sling – at least it means you have two hands free!
10. Family history of dairy intolerance? Maybe your baby is also intolerant to cows milk protein. This is especially likely if your baby has dry skin or eczema. If you are breast feeding try cutting dairy from your diet (BUT DO TALK TO A PROFESSIONAL PERSON ABOUT SUPPLEMENTING YOUR DIET). Don’t forget that dairy is present in many foods (even your favourite bisuits) so look out for words such as casein, whey and milk protein on the ingredients list. You will need to follow a dairy free diet for at least 2 – 3 WEEKS as this is the length of time it takes for milk proteins to be eliminated from your and baby’s body. However, many babies will show a signifiacnt difference within a week.
Formula fed babies may try a cows milk protein free formula prescribed by a paediatrician
11. Try medication such as Infant Gaviscon as prescribed by your G.P or paediatrician. You need to give this a two week trial to see the full benefit.
12. Look after yourselves! A baby with reflux can be exhausting. Rally the troops to help, don’t put pressure on yourselves. Most babies outgrow reflux when they learn to sit up – although a small proportion may continue.
13. If reflux doesn’t improve with medication prescribed by your GP ask to be referred to a paediatrician.
FINALLY – REMEMBER THAT REFLUX WILL INTERFERE WITH A BABY’S ABILITY TO SELF SOOTHE! But – it’s not their fault – or yours! just something that happens. The key thing to remember is AS SOON AS you baby’s reflux is under control START SLEEP TEACHING! We know you’re tired BUT the extra mammoth effort you put into sleep teaching now will pay you in no end of peaceful nights in the future.