This is something I experienced with both my boys to differing degrees. Knox had reflux – he had pain when he fed and would also spit up a lot too, but thankfully was able to feed without medications by about 4 months of age. Tate on the other hand had severe silent reflux (stomach acid burning his throat but not spitting up) and wasn’t able to feed without medication until almost his 12 month birthday. He would also grow out of his reflux dose often and we’d then have massive flare ups in his pain and comfort level.
So I’m here to tell you that I get it, I’ve been there and struggled with it. I’ve seen the effects that it can have on your baby’s sleep.
What causes a baby to have reflux?
Reflux usually happens because the ring of muscle at the lower esophageal sphincter does not completely close or relaxes, so breast milk or formula can come back up a baby’s throat easily. The good news is that the vast majority of babies will stop having reflux symptoms by about 6 months of age. Babies showing more severe symptoms could potential take longer, like Tate.
What are the common reflux symptoms?
There are a wide variety of symptoms of reflux. You may see some, but not all in your baby.
- Arching of their back during or right after eating
- Coughing, gagging or pulling away during feedings
- Gulping to swallow fluid coming up the throat.
- Poor weight gain (especially if spitting up)
- Poor appetite or refusing to eat
- Spit up beyond what is normal for happy spitters
- Sour smelling breath
- Feeling uncomfortable when placed on their back
If you think your baby is showing signs of reflux, don’t hesitate to talk to your pediatrician or other medical professional so that you can receive their advice and support.
The best ways to handle reflux so it doesn’t affect your baby’s sleep.
- Medication. Now I know this isn’t for everyone, but for my boys they would have struggled to feed enough if they weren’t medicated. Especially Tate. He just couldn’t sustain a feed for more than a few seconds because he was in so much pain. I want to cry now even thinking about how hard it was for him, and me. After reflux was suggested by my midwife I went to the doctor for a diagnosis of reflux. She then prescribed medication and his symptoms quickly improved. If you are weary of medication, the good news is that many baby’s come off it by about 6 months of age.
- Making sure he had good burps after finishing feeding on each breast. For a bottle fed baby you will want to make sure they burp well at the end of the bottle, and potentially halfway through.
- Holding them in an upright position for up for 5-7 minutes post feed. Many pediatrician’s medical advice is that you hold baby upright a lot longer, which then impacts on sleep more, but honestly I never found this length of time necessary, especially if he’d been a burp master!
- Some professionals will suggest smaller, more frequent feedings. This did not help my babies with their reflux symptoms, but may with yours.
- Do what you can to promote a healthy sleep foundation and if you are still struggling with your baby’s sleep contact me. I can help!
And just for safety, I DO NOT recommend inclined surfaces like a crib wedge or sleep positioners. Some parents ask me about them after their pediatrician recommends them but honestly according to the American Academy of Pediatrics they aren’t safe. The AAP says: This strategy is ineffective in reducing GER, and it is not recommended to relieve symptoms of an upper respiratory infection, regardless of symptom severity.”
You maybe thinking, but what about bouncy seats or a car seat? They are fine for awake times, when you are supervising. But they are much like an infant sleep positioner and are not considered safe due to the risk of suffocation and strangulation. The positions they put babies in can place pressure on a baby’s belly and can make a baby’s reflux worse. The safest sleep position is to always put your baby to sleep on their back on a firm sleeping surface, with a fitted sheet, and free of any oft items and bedding in the first year of life.
To be honest, I did try one for Tate when he was first diagnosed because I didn’t know it could contribute to the risk of SIDS. After finding him having slid all the way down the bottom of his bassinet I quickly took it away. Such a scary, unsafe position to find him in.
What about sleep training?
This is completely up to you. If you feel comfortable giving sleep training a go, and your pediatrician has given approval to work on your baby’s independent sleep skills then you can get started. My expert advice is to pick a method that suits you and your baby and keeps the reflux issues in mind. You and your baby deserve better sleep if you are struggling.
I hope this list helps you handle reflux with your baby. Should you decide that working with a Child Sleep and Behavior Consultant might help you please feel free to check out my packages. I offer many different packages to suit all needs and budget from a sleep strategy session to a virtual package with a consultation, sleep plan, and 2 weeks of support. I’d love to help you with your little one’s sleep! Contact me today.