Reflux In Babies: What Parents Need To Know
It is no secret that the arrival of a new-born turns a parent’s life upside down. Before a child comes into your world, life is full of freedom, and you are free to do whatever suits you. Your own needs come first, and you only have the responsibility of looking after yourself. However, as new parents, you must prepare to set aside your own needs for many years to come.
Although the feeling of being a parent is fantastic, some parents struggle with their new identity, as the parenting role sometimes feels hard, frustrating and extremely exhausting.
This especially applies when your baby seems unwell or gets sick. Since babies do not have the ability to verbalise their needs, it is your responsibility to ensure that your child’s needs are being met. Research cannot remedy all baby-related problems, but if you know the most common challenges of early parenthood, you will remain calmer when those challenges arise.
Reflux is among the most common ailments in young children. Below, you can find out more about what reflux in babies is, how it is diagnosed and what you can do to minimise the risk to your baby.
What is reflux in babies?
Reflux is also known as gastroesophageal reflux disease (GERD). Reflux occurs when stomach acid repeatedly flows back into the tube connecting the mouth and the stomach (oesophagus). This backwash (acid reflux) can irritate the lining of your oesophagus and mouth. Reflux is a completely natural process that both children and adults experience from time to time. However, severe reflux is most common among babies.
When your baby has severe reflux, it is vital to be attentive to any signs of discomfort and distress, and you must keep a careful watch on their well-being. If the condition is not treated, your child can experience pain and discomfort in the chest and stomach region, acid damage in the oesophagus, etching teeth, sleep difficulties and frequent infections in the throat, ears and lungs. Many babies experience reflux as a rather unpleasant condition, but fortunately, in the vast majority of cases, it is not dangerous.
Causes of acid reflux in infants
Babies have a laxer or more immature sphincter between the oesophagus and stomach compared to older children and adults. Whilst the mucous membrane in the stomach easily tolerates stomach acid, the mucous membrane in the oesophagus is not as suited to strong substances, and therefore the recurring acid often leads to a burning and stinging sensation in the throat. All people are at risk of developing reflux, and you are more likely to develop the condition if you have a high intake of alcohol and cigarettes or suffer from a diaphragmatic hernia. Severe reflux is hereditary, which means that your child is likely to be affected by the condition if you had problems with reflux during childhood or adulthood.
Difference between reflux and silent reflux
There are two basic types of reflux in babies.
- The most common form of reflux in babies manifests itself as visible acid reflux. This condition is relatively easy to spot.
- The other form of reflux is better known as silent reflux.
The name silent reflux is slightly misleading because a child with silent reflux will usually whine and cry at least as much as a child suffering from normal reflux. The name comes from the fact that silent reflux can be easily overlooked. This type is significantly more difficult to deal with and is where the stomach contents flow up into the oesophagus in the same way as normal reflux, but instead of coming out of the mouth as gulps or thick saliva, the contents runs back down into the stomach. Since silent reflex is easily overlooked, many babies do not get the help they need.
There can be many reasons why your baby seems unwell from time to time. The most common is that the child is tired or needs something to eat. But if the child is well rested, has been fed and still seems uncomfortable, restless, and in pain, there is a good chance that the child is suffering from silent reflux.
What are the symptoms of reflux?
Apart from the nature of acid reflux, the symptoms are very similar between the two. We have listed the various symptoms and elaborated on them further down:
- Vomiting/retching – Possibly blood
- Higher irritability/more fidgety
- Sleep problems – Sleeping with their neck bent backwards
- Difficulty burping or reluctance to burp
- “Wet” burps and more drooling
- Redness around the eyes
- Bad breath/sour-smelling breath
- Constant coughing, hoarseness or laboured breathing
Recognising reflux in babies
- If your child has reflux, you will often be able to hear the child’s stomach contents sloshing up and down between the stomach and oesophagus. In addition, you can also pay attention to whether they are showing signs of pain. A child with reflux will usually whine, cry, seem irrationally irritable and resist when you try to put them down.
- If your child eats too much or too little, it can be a sign of reflux.
- Reflux in babies disturbs both the throat and the stomach. Therefore it can be difficult for the child to feel hunger or over-fullness when the condition persists.
- Keep an eye on whether the baby’s eyes appear abnormal, if there is a sour smell coming from the mouth, or if they are showing a generally increased level of restlessness.
- Coughing, hoarseness, wheezing, apnoea, frequent breathing and sleep problems are all symptoms of reflux in babies.
As mentioned earlier, not all reflux cases are easily noticeable. However, if you know the most common symptoms, you will most likely be able to recognise the condition before your baby suffers painful discomfort.
How is acid reflux diagnosed?
It is always a good idea to contact your doctor if you suspect that your baby is suffering from reflux. The diagnosis of reflux in babies usually has two components. First, the doctor will carry out an initial examination of the child and ask you a series of questions surrounding their medical history. In this phase of the diagnosis, the doctor or nurse will often focus on visible things such as the child’s weight, sleep patterns and overall development.
If the symptoms are unclear, your doctor may recommend medical tests and refer you to a gastroenterologist to diagnose and treat the condition. The gastroenterologist may perform a gastroscopy, a procedure in which a doctor uses an endoscope and a thin probe to assess acid reflux and see the muscle function of the oesophagus. If the case of reflux is more serious, the doctor will usually recommend a minor operation.
In minor cases, the doctor will usually just write a medical prescription for the child. In the vast majority of cases, it will be unnecessary to perform surgery as long as the parents help the child to alleviate the condition.
How is reflux in babies treated?
Medical treatment via prescription is the most common treatment for reflux in babies. Most babies who receive medical treatment are provided with a proton pump inhibitor.
The proton pump inhibitor reduces the child's production of stomach acid so that the levels gradually decreases. In most cases, the inhibitors alleviate both the child's symptoms and pain, and in addition, will significantly reduce the risk of acid damage in the oesophagus.
Medical treatment does not necessarily result in your baby crying less than before, but the medicine will reduce the level of stomach acid and, in turn, cause less pain and discomfort.
In a few cases, the child’s reflux is caused by an abbreviated tongue-tie. If this is the case, the medicine will not solve the problem, and instead, the doctor will have to cut the abbreviated tongue-tie. The procedure will result in the tongue having more mobility and function.
When you have the initial talk with your doctor, you may ask whether a chiropractor, an osteopath or a Craniosacral therapist can remedy the reflux to avoid operations and medical treatment.
How to relieve reflux in your baby
The cases requiring surgery and medical treatment are quite rare, as thankfully, there are several things you can do to help your baby recover from the condition.
The most effective home remedy for reflux is elevating the head position when your baby is in bed. Babies spend a large part of their lives sleeping, and when you raise the baby’s head so that it is slightly higher than the stomach, gravity will assist in keeping the stomach contents in place.
For most babies, rocking movements will have a calming effect, meaning a sling cradle with a motor can be a great help. However, you should make sure that your baby has the opportunity to turn their head in the swing cradle in case of the need to regurgitate or to get rid of drool. You can do this by placing a stiffening mattress in the sling cradle.
Once your baby’s sleeping position has been rearranged, it is a good idea to make sure that their diapers are not too tight and that they are not only wearing pants. Pants and nappies tighten around the stomach, which can worsen the reflux condition.
When feeding, it is essential that you do this with your child in an upright position. It is also recommended that you keep them in the same position for at least twenty minutes after feeding.
It is important that you ensure your baby burps regularly, and you should not play with them immediately after mealtime.
If your baby is still breastfeeding, it may be recommended that the mother refrains from consuming caffeine and cow's milk as these can trigger further irritation. You can replace your cow's milk with oat milk as a possible gentler alternative.
What are the consequences for babies with reflux?
Untreated reflux has consequences for your baby and for the well-being of the rest of the family. When a baby suffers from severe reflux, it will generally behave restlessly and require far more energy from the parents. As new parents, you are probably used to reduced sleep levels, but with a child affected by reflux, you may find yourself unable to sleep whilst the condition persists.
Reflux is, of course, primarily uncomfortable for the child, but since it affects the whole family, it is crucial that you do something about it as soon as possible.
Consult with other parents
Doctors can be used for many things. However, a visit to the doctor will not solve all the problems that characterise the life of new parents. The reason is that every doctor approaches their patients clinically and objectively, which will no doubt help, but if your child is struggling with reflux and neither parent has slept properly for several weeks, sometimes the most helpful thing to do is to talk with somebody who has been in a similar situation.
If you and your partner do not have any friends with small children, it may be a good idea for you to join a parenting group. Alternatively, there is the Reflux Association, which can provide plenty of help and support.
At the parents' group, you will meet people who can relate to your situation and maybe even give you some good advice on dealing with the difficult periods that can seem particularly unbearable.
Hang in there – It will get better
Reflux can almost make time stand still. When your child is unwell, you probably also feel unwell, and you may even convince yourself that the condition is permanent and will never go away. During such periods, it is important that you persevere and remember that even the worst case of reflux in a child does not last forever.
Parenthood is fraught with many complications, but thankfully the hard times are rewarded by all the good times you will have with your child in years to come.