Reflux sucks, no doubt about it!
Infant reflux, also known as gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD), can be a distressing condition for both babies and their parents. While infant reflux is common and usually resolves on its own by the time your baby is 12 months old, it can be unsettling and quite frankly, exhausting for parents to witness their little ones in discomfort. In this blog post, we will explore five ways to help a baby with reflux while adhering to the American Academy of Pediatrics (AAP) safe sleep guidelines.
Understanding Infant Reflux
Before jumping into the strategies to help babies with reflux, it's good to understand the condition. Inside our tummies, there's food and special acids for digestion. There's a tiny muscle on top of our tummy that keeps stomach contents from flowing back up. But if that muscle isn't strong or isn't doing its job properly because it isn't developed enough yet, stuff is regurgitated into our esophagus, and then into the mouth. Many babies spit up on occasion, this is normal. However, some babies feel a burning or painful sensation in the esophagus. Those babies should see a doctor to find out what's going on and get the right help if it is in fact reflux.
Here are some signs your baby could be struggling with reflux:
fussing/crying and arching their back during feedings
experiencing an increase in frequency or intensity of spit-up (i.e., forceful)
raspy during sleep
difficult or disrupted sleep
wheezing or coughing off a lot
refuses to eat
experiencing poor weight gain
Reflux sucks! While most infants outgrow reflux by their first birthday, it can be a trying time for parents. The discomfort and pain that infants experience can lead to sleepless nights and increased anxiety. However, there are several strategies to help alleviate these symptoms and make life a little more comfortable for both the baby and parents while adhering to the AAP's safe sleep guidelines.
Modify Feedings
One of the most effective ways to help infants with reflux is to modify their feedings. Feeding adjustments can significantly reduce the frequency and severity of reflux episodes. Here are some tips:
Smaller, More Frequent Feedings: Instead of larger meals, feed your baby smaller amounts more frequently. This can help prevent the stomach from becoming overly full, reducing the likelihood of reflux. Paced-bottle feeding is a good technique to learn for all babies but is especially helpful with babies struggling with reflux.
Hold the Baby Upright: After each feeding, hold your baby in an upright position for 20-30 minutes. This allows gravity to help keep stomach contents down and minimizes the chances of reflux.
Burp Frequently: Burping your baby during and after feedings can help release any gas that might contribute to reflux. Learn a variety of burping techniques that will help with hard-to-burp babies. How often should you burp? That depends on your baby. A newborn can typically be burped after every .5 ounce from a bottle or halfway through a nursing session. Some babies may need more burping at the breast while others do not. If your baby is content with you trying to get a burp, I would do that. If your baby is pissed off when you unlatch them or is actively and aggressively sucking then I may wait another moment or two before unlatching them.
Likewise if you are breastfeeding and you have a strong letdown, relieve some of that pressure by first either hand expressing into a burp cloth or using a simple device like the Haaka just to relieve some of the pressure before attempting to let your baby latch on can help reduce the air intake from gulping.
Use an Anti-Reflux Formula: Some specially designed infant formulas are thicker and can help reduce reflux. Consult your pediatrician to see if switching to an anti-reflux formula is appropriate for your baby.
Consider Breastfeeding Techniques: If you're breastfeeding, pay attention to your diet. Some foods may exacerbate reflux symptoms, but I wouldn't do an elimination diet until you have been seen and evaluated by a CLC or even better, an IBCLC (expert in breastfeeding). Then if an elimination diet is recommended talk with your own doctor first. Additionally, try different breastfeeding positions that promote safe sleep guidelines, such as laid-back breastfeeding, which can be more comfortable for reflux-prone babies.
Introduce a Good Probiotic
Talk to your baby's pediatrician doctor about the use of a good probiotic. Some families have seen mild improvements with the use of pre and probiotics. There is a study out there, and I can't find it at the moment, but it showed it resulted in less spitting up and shorter crying periods.
See a Chiropractor You Trust Who Works with Babies Regularly
Chiropractic care may help with infant reflux by addressing spinal misalignments, particularly in the upper cervical region, which can interfere with the proper functioning of the nervous system and digestive processes. Gentle chiropractic adjustments aim to restore alignment and improve nerve communication between the spine and digestive organs, potentially alleviating symptoms of reflux by promoting better digestion and reducing the frequency of regurgitation.
Additionally, chiropractic care may relieve tension in the muscles surrounding the diaphragm and stomach, which can contribute to reflux. By improving overall body function and reducing physical stress on these areas, chiropractic treatment can help support the body's natural ability to manage and reduce the symptoms of infant reflux.
I Know Reflux Sucks, But Always Follow the AAP Safe Sleep Recommendations
The AAP says, “Elevating the head of the infant’s crib is not effective in reducing reflux. It may result in the infant sliding to the foot of the crib into a position that may compromise respiration and therefore is not recommended.” As someone who works with newborns, I can confidently tell you following the safe sleep recommendations set forth by the AAP despite what you may hear from other people, is the way to keep your baby as safe as they can be while sleeping. Furthermore, the AAP goes on to say that, “Sleep position does not increase the risk of choking and aspiration in infants, even with GERD/reflux because infants have airway anatomy and mechanisms that protect against aspiration.” (see video below)
Here's a free printable we created with Updated 2022 AAP Safe Sleep Guidelines and quotes by the AAP about reflux and safe sleep!
Authored by Elizabeth Luke
Elizabeth is the founder and CEO of The Jacksonville Baby Company. Elizabeth and her husband and best friend, Richard are parents to four children. With certifications in Postpartum and Infant Care Support, Childbirth and Newborn Care Education, Lactation Support, and Infant Sleep, Elizabeth is a wealth of knowledge and has a heart for helping parents live their best lives while also ensuring their children are safe, happy, and leading their healthiest lives possible! Elizabeth and her team provide day, overnight, live-in, and travel support!
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