Sleep is one of the most important things that a Baby needs. At best, a sleepless baby can be irritable and fussy during the day; at worst, their health can be negatively affected. On top of that, you, the parent, will end up getting less sleep as well!

You can try to give your baby the best sleeping environment, ensuring that their room is cool, quiet, and dark. However, there may be a more subtle issue keeping your baby up at night: infant Reflux.

What is Reflux in Babies?

Reflux is that feeling when a bit of Food comes up and presses at the back of your throat. This often happens when we’ve had too much to eat, when we become nauseous after a heavy meal, or when we’ve eaten something that our stomach does not agree with. Babies, too, can have reflux. Like with adults, at best, it’s a little uncomfortable. At worst, it’s very painful.

Unlike adults, however, they do not have the words to tell their parents what is going on. Instead, they cry. Often times, reflux isn’t the first thing that comes to mind when parents assess their crying baby. Because reflux symptoms can sometimes be very subtle, it can go unnoticed.

Usually, reflux in babies isn’t a serious issue. However, when left untreated for long periods of time, it can lead to complications, like damage to the esophagus. In rare cases, reflux itself is a symptom for more serious, underlying conditions.

Reflux Symptoms

Does your baby have reflux? Here are signs to note when determining whether or not your baby suffers from reflux.

• Too much crying; more fussy than usual.
• Spitting or vomiting more often than usual.
• Pulling legs up.
• Constant hiccups.
• Wakes up suddenly during sleep.

When looking for reflux symptoms, remember: it’s normal for babies to spit out milk while feeding, as well as to vomit every now and then. It should only be a problem if your baby seems fussy or unhappy especially after feeding, and often.

Otherwise, reflux should go away after 18 months of age.

Causes

What causes reflux?

The main cause of reflux is an underdeveloped digestive system. This means a baby has a lesser ability to digest food, as well as to keep it down in their stomach. This, by itself, can be the cause for reflux, although there are issues that exacerbate the situation.

Here are some possible reasons for infant reflux.

Hyperlactation

If you notice your baby regularly spitting out milk, this may have a simple answer: they are drinking too fast to properly swallow. This is often caused by hyper-lactation, which describes the condition of a breastfeeding woman creating too much milk – more than their baby needs. As such, the milk comes out too fast for them to actually swallow; this can also be painful for the woman.

It should be noted that hyperlactation doesn’t necessarily cause reflux, but, rather, cause reflux-like symptoms. In this way, hyperlactation may results in a misdiagnosis of reflux in babies.

Overfeeding or Slow Digestive System

Alongside hyperlactation, overfeeding can also cause reflux. The lower esophageal sphincter, or the LES, is responsible for keeping food inside the stomach. If the stomach is full of food, pressure is put on the LES to stay closed. When feeding, the LES opens up to accommodate the new food; if the stomach is full, the undigested or partially digested food can come right back up the esophagus, causing reflux. This can also be a cause of reflux in adults, but is more common in babies, due to their smaller stomach and undeveloped digestive system.

On the other hand, your baby may just have a slow digestive system. This, in itself, isn’t an issue and may go away as your baby grows.

Weak or Immature LES

Aside from overfeeding or having slow digestion, reflux may also be caused by an issue with the LES itself. If your baby’s LES is weak or undeveloped, it will have a hard time keeping food down and inside the stomach.

When to See a Doctor

Due to their undeveloped digestive systems, spitting out food and having an excess of gas is common in babies. Generally speaking, reflux isn’t something that warrants a visit to the doctor and it often disappears on its own.

However, reflux can also be a symptom of a bigger medical problem, like allergies, serious digestive problems, or GERD. How do you know when it’s time to visit the doctor? Here are symptoms to look for:

• Baby isn’t gaining weight.
• Your baby spits up green or yellow fluid.
• Your baby spits out blood, or something that looks like coffee grounds.
• Constantly refuses food.
• Has blood in their stool.
• Chronic cough.
• Difficulty breathing.
• Begins having reflux symptoms after six months of age.

Possible Issues

What are the more serious issues that can cause reflux? Let’s take a look:

• Food intolerance: While not as serious as the rest of the conditions on this list, food intolerance should be taken seriously. When left unattended, food intolerance can worsen overtime. It can be the direct cause of reflux, and continued reflux may result in problems with the stomach and esophagus.
• Pyloric stenosis: This condition often affects babies that are less than six months old. It impacts the pylorus, which is found in the lower part of the stomach. With this condition, the pylorus becomes enlarged, creating a blockage between the stomach and the intestine. Since food has nowhere else to go, food then has to be vomited back up through the mouth. Symptoms of pyloric stenosis include vomiting, weight loss, dehydration, and, of course, reflux.
• Eosinophilic esophagitis: This condition causes a chronic inflammation of the esophagus. It results from the build-up of a type of white blood cell in the esophagus lining. This build-up can lead to inflammation or injury of the esophagus, which, in turn, leads to trouble swallowing food and liquids.
• GERD: GERD is a complication that arises from reflux. Someone can develop GERD when their stomach acid is unusually acidic and they experience reflux very often. This leads to irritation (and eventually damage) in the esophagus’ lining, which is the tube that connects the throat to the stomach.

Treatment and Solutions

While reflux isn’t always serious and, generally, will disappear with time, your pediatrician can still recommend some treatments to alleviate the symptoms. The doctor may diagnose your baby by performing a physical exam and asking you questions.

If you’re planning to schedule an appointment with your pediatrician, keep a log of when and how reflux symptoms in your baby manifest. This can be helpful in the initial diagnosis.

Your doctor may recommend further testing to rule out more serious issues. These tests may include ultrasounds, blood and urine tests, and an endoscopy.

If your doctor determines that your baby isn’t suffering from anything more serious than reflux, they may recommend some home treatments, as well as the following:

• If you’re breastfeeding, eliminate dairy from your diet to determine allergies.
• Switch formulas.
• Thicken formula or breastmilk.

Like some treatments, these should be done under the supervision of your pediatrician, especially the thickened formula approached.

On very rare occasions, your baby will need to undergo surgery on their lower esophageal sphincter. This surgery will tighten the LES to help it keep acid in the stomach. This procedure is only done when reflux is severe enough to be detrimental to your baby’s health.

Baby Reflux Sleep Solutions

Babies with reflux often have a hard time sleeping. A lack of sleep in infants can mean an unhealthy baby, not to mention one that is cranky, fussy, and loud during the daytime. Thankfully, there are ways to avoid reflux.

Help your baby sleep better with the following tips:

Be Aware of Hyperlactation

Hyperlactation occurs when the breasts produce more milk than a baby is able to consume. While it doesn’t necessarily cause reflux, it can cause reflux-like symptoms. If you notice your baby regularly spitting out milk while breastfeeding, it may be because of hyperlactation. Since the rush of milk is too much or too forceful, feeding babies might choke or cough. They may also be drinking too much in too short a span of time, leaving their bodies unable to digest the milk.

Hyperlactation often disappears a few weeks after giving birth. If you are hyper-lactating, it’s worth seeking out a doctor’s advice.

Opt For Small, Frequent Feedings

Because babies tend to have smaller, underdeveloped stomachs, giving them time to digest their food is a good idea. In that same vein, giving them smaller amounts of food is beneficial. Smaller amounts of food and more frequent feedings will ensure that your baby has sufficient time to digest their food, while also ensuring they’re still full and have all the nutrients they need.

Frequent Burping

Burping is an essential part of feeding an infant. It’s one of the easiest techniques to help you avoid GERD and reflux in babies, and it’s recommended by pretty much every pediatrician.

A good rule of thumb is to burp your baby every two to three ounces when bottle-feeding, and every time you switch breasts when breastfeeding. If your baby is prone to reflux or has GERD, it’s wise to burp them once every ounce when bottle feeding, and once every five minutes when breastfeeding.

Sometimes, you may find your baby waking up in the middle of sleep. Chances are that your baby woke due to pain caused by too much gas. When your baby wakes up, simply pick them up and try to make them burp. Chances are, getting rid of the gas will help your acid reflux baby sleep soundly through the rest of the night.

To learn how to properly burp your baby, check out this guide from Kids Health.

Hold Your Baby Upright Before Sleeping

In adults with GERD, one of the more common recommended techniques is keeping an upright posture after a meal. This will encourage food to stay down, remaining in the stomach until it is digested. In babies, the same principle holds true.

Since babies can’t maintain correct posture on their own, keeping them upright falls to the parents. Whether you’re holding your baby up, or keeping them up in a chair, make sure that your baby stays in a vertical position after feeding for about ten to fifteen minutes. It’s also a good idea to make them burp before putting them down to sleep.

On that note, do not let your reflux baby sleep on their tummy. Letting infants sleep on their tummy may seem like it would lessen the chances of choking with reflux, but can actually do the exact opposite. It’s incredibly dangerous to your baby’s health.

Do Not Incline Your Baby’s Crib

When looking at ways to help your reflux baby sleep, a tip you may encounter is to incline your baby. It does make sense for your baby to be inclined while sleeping, as it follows the same principle as keeping your baby in an upright position: having the upper body higher than the stomach can help avoid reflux with the aid of gravity. In fact, elevating your baby’s head and upper torso while sleeping can be effective for avoiding reflux.

The problem with this? The health concerns that come with using a baby reflux sleep positioner, inclining your baby’s crib, or adding towels or blankets to achieve an incline. The biggest of these health concerns is SIDS, or sudden infant death syndrome.

The AAP, or the American Academy of Pediatrics, has a set of guidelines when it comes to putting your baby to sleep to avoid SIDS. These guidelines include putting your infant flat on their back and removing any unnecessary objects to avoid strangulation and suffocation.

Conclusion

Reflux in babies is often nothing to be worried about. While it can be a challenge to manage for tired and sleep-deprived parents, there are many things you can do to alleviate your baby’s symptoms, giving both you and your baby a good night’s rest.