Crying baby, sleepless nights – could your baby have reflux?

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Your baby is irritable, grizzly, hates lying on his back, spits up or vomits often, has hiccups constantly and he is a nightmare to feed: he starts to feed voraciously, then he wriggles, squirms and ‘throws’ himself off the breast or when he isn’t doing this, he wants to be permanently attached to your breast. He screams after and between feeds – waking from a deep sleep suddenly screaming as though somebody has poked him with a pin!

Take heart – it’s not your fault. Your baby is unhappy because he is uncomfortable or in pain. The symptoms just listed can be a red flag that your baby may be suffering from Gastro-oesophageal Reflux or ‘reflux’ as it’s common called by mums.

At first, all babies will have ‘reflux’ to some degree, because their digestive systems are immature. At the bottom of the oesophagus (the swallowing tube), there is a ring of muscle that helps keep contents in the stomach. In babies, this sphincter cannot squeeze shut as effectively as it can in a child or adult, and it relaxes randomly, quite frequently. As well as letting swallowed wind be released, these relaxations allow food (milk) to flow back into the oesophagus. For some babies – the ‘happy chuckers’ – this will just mean a few spills that don’t seem to affect their wellbeing. At the other end of the spectrum, it can cause heart-burn like pain, abdominal pain, and/or frequent vomiting and can result in some of the symptoms just listed. Of course, as babies are all individuals, symptoms will vary from one baby to another. For instance, constantly wanting to feed may be comforting because the natural antacid effects of breast milk will soothe your baby’s discomfort or he may need more feeds to make up for the milk he lost when he vomited. For another baby, if their tummy hurts as they feed, they will squirm and pull off the breast and may not feed well. Babies with reflux may also be diagnosed with low weight gain or breathing problems.

According to paediatric gastroenterologist, Dr Bryan Vartabedian, from Texas Children’s Hospital, author of ‘Colic Solved’ and father of two babies with acid reflux, babies at extreme ends of this spectrum (happy chuckers or babies who are very unwell) are easily diagnosed, but the babies who are between extremes can be more challenging to treat, and even doctors can vary in their opinions as to when or how to treat baby heartburn.

What can you do?

Firstly, have your baby checked by a doctor – your GP or paediatrician or ask for a referral to a paediatric gastroenterologist (if you are ‘blown off’ remember, you know your baby best; persist until you get answers to your baby’s distress). A proper diagnosis can involve a treadmill of tests which often compounds your baby’s (and your own) distress. So, if other medical causes for your baby’s distress have been ruled out, before you embark on invasive testing, consider whether his symptoms could be caused by conditions such as lactose overload (sometimes called fore milk intolerance), food intolerance or allergy, including reactions to foods that may pass through your breast milk. Milk protein allergy can present with very similar symptoms as gastro-oesophageal reflux disease and is more likely if you have family history of allergies, asthma or excema If you are breastfeeding, these conditions can be simply addressed by eliminating offending foods from your own diet rather than weaning: a child health nurse, dietician or lactation consultant can advise you.

When considering changes to your own diet, also consider gut health as a factor in your baby’s discomfort. Consult your health care provider about an appropriate probiotic for yourself and your baby. By taking a probiotic yourself, the benefits will be passed to your baby.

Could it be tongue tie?

Another thing to have checked is, could your baby have a physical issue such as a tongue tie? This can affect your baby’s ability to latch and suck effectively so he may suck in a lot of air as he feeds, causing discomfort both while he is feeding (Because it is hard work for him to stay attached to the breast) and afterwards as his tiny tummy is distended with wind.  The baby with tongue or lip tie may need to feed frequently due to a disordered ability to coordinate sucking, swallowing and breathing. This can contribute to a temporarily overabundant milk supply with symptoms of lactose overload and/or reflux.  The good news is that if tongue tie is the cause of your baby’s ‘reflux’ symptoms, this can be corrected quite simply either surgically or be laser, depending on the treating specialist and will make feeding so much easier. Note: although tongue ties present differently (i.e. they don’t all look or feel the same on oral examination), the photo in this blog shows a baby with a tongue tie – see how the tongue cups at the sides and the centre is restricted.

Positions to help

Until your baby’s system matures, improving the positions he lies during feeding and sleeping will be helpful to reduce his discomfort: holding your baby upright after feeds will aid digestion. However, young babies without much control of their abdominal or chest muscles tend to slump when placed in infant or car seats (reflux babies usually hate car seats). This increases pressure in their stomachs so worsens the reflux. Try using a baby carrier that supports your baby firmly in an upright position, comforting him, as well as leaving you ‘hands free’ or use an infant seat that reclines a bit.

For sleeping, try utilising gravity to aid digestion by raising the head end of the cot: place phone books under the cot legs or place a folded towel under the mattress (never use a pillow on a baby under 12 months). Placing your baby on his left side closes off the sphincter between the stomach and oesophagus and positions the sphincter above the stomach contents so that regurgitation is less likely. As a result, your baby may sleep more soundly on his left side – however as this is not advised by SIDS, please check with your health care provider and only do this when you are able to watch that your baby doesn’t roll onto his tummy while sleeping.

Meanwhile, please don’t blame yourself for your high needs baby. It’s not your fault he cries (and cries!). You are never ‘spoiling’ your baby by helping him feel safe and comfortable, and even if he cries despite your best efforts to help him, at least he will know you are there for him, through it all. This is an investment in his security and your relationship with your little one. And that will last long beyond these tough weeks and months.

For more tips to help your unsettled baby, check out Pinky’s books 100 Ways to Calm the Crying and Sleeping Like a Baby.  And if you or your baby have food sensitivities, you make like to try our Gluten and Dairy Free Boobie Bikkies.

5 COMMENTS

  1. my son who is 38 must of had reflux as a baby he had all the symptoms. it was a horrible time for all of us. nothing i could do helped him and i felt so useless. he was my second and i did know what i was doing. nothing helped. fastforward to 12 years ago my granddaughter was born. her and her mum lived with me. she was doing the same things as my son had, but she had a fantastic doctor, dr barry from childrens hospital at randwick nsw. he knew what it was straight away and helped her. what a relief for her and all of us. i wished i would have known about reflux with my boy all those years ago.

  2. my 4 weeks little girl has pretty much all the symptoms, but she only grunts not crying. She is def in a pain and has wind, she vomits each time after feed. I was told by the doctors that if she isn’t crying, she is perfectly fine! She will grow out of it. It has been 3 weeks with sleepless night with her terrible grunting noise all night long, I had enough and helpless. I have to pay over 300bucks to see a private paediatrician tomorrow. Ps: I have tried infant friend, and it made her situation worse!

    • Check out silent reflux in Google if you can before you see the paed. Silent reflux is hardly spoken about and not many people seem to know of it. There are treatments for it, usually Losec or Mylanta and the improvement in bubs condition is really fast!

  3. Is it a coincidence that this has come up on my fb today?!! Pretty certain my 4 week old daughter has it. Same time every day she starts screaming and her tummy goes rock hard! She doesn’t vomit tho…

  4. I struggled for months with my daughter, she would cry and scream for hours on end, cluster feed, didn’t sleep for long. As a new mum I sought medical help and was told (by more than one practitioner) that she would grow out of it, or it was new mum jitters or colic. It knocked my confidence as I was certain something wasn’t right. Eventually I saw a pediatrician who diagnosed her with silent reflux. She didn’t throw up after feeds but had the acid build up and sore belly. A couple of days on Losec and she was a different child! Losec eases the acid burn but Mylanta in a small dose will do the same thing. When I had my son he was also put on Losec early on as he had lower belly pain from reflux too. My paediatrician was great at explaining about the different types of reflux in babies – something the books just didn’t address.

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