Infant Reflux – solutions for you!

I wouldn’t wish infant reflux on anybody…particularly silent reflux. We got talking about it recently during Baby Massage classes and unfortunately many of the mums had pretty negative personal experiences in receiving constructive solutions for reflux. The mums I come into daily contact with share their experiences with me and other mums. In general, when it comes to reflux, mums seem to feel they either aren’t listened to properly or that it is not diagnosed correctly when they seek out help, as the majority of babies with reflux are still putting on weight and appear to be thriving. Many mums felt that the condition is sometimes bundled in with colic or something that the baby will ‘grow out of’.   This is an amazingly frustrating place to be for a desolate parent witnessing their baby screaming crying on a daily basis for weeks or even months on end.  But mums cannot bear to see their tiny baby in such discomfort and need immediate solutions. I wanted to write this piece to try to offer you some solutions, using my own knowledge and experience, but also giving you direct advice from two wonderful experts, and other mums who have come out the other side of reflux.

What is reflux?

GER (Gastro Oesophageal Reflux, a.k.a. Acid reflux) in infants and babies is very common and is typically due to an immature digestive system. The muscular ring or ‘sphincter’ at the top of the stomach is not fully grown and so milk returns up the oesophagus and out the mouth. Other times it opens and regurgitates food back up, but doesn’t reach the mouth (silent reflux).

According to Craniosacral and Physical Therapist, Colette Trout, GER is common in approximately 65% of healthy infants and peaks between the ages of 1-4 months. GER usually resolves itself by 6-12 months. She says “Reflux and particularly the condition of Silent Reflux is on the rise; I’m seeing it daily in the clinic now and usually presents after a difficult labour/ quick labour/a prolonged breech positioning/ use of forceps or vacuum.  CranioSacral Therapy works to balance the diaphragm, and nerve supply to the sphincters and also relieves pressure and strain elsewhere in the spine and head that could be triggering the reflux”. Normally babies require 3 treatments, or sometimes up to 5 in severe cases.

It is crucial to have reflux diagnosed early and correctly, so therefore going to a specialist in this area is imperative. An experienced dietitian or paediatrician will be able to do this, or a GP with specific experience with reflux and other infant gastrointestinal illnesses.
Once diagnosed, what can you do?  Experienced Dietitian Emer Delaney, states “Positioning is so important during feeding; if your baby is suffering from reflux, it’s best to aim for at least a 45 degree angle during feeding. Thickening feeds with a thickening agent may also help. Your dietitian or paediatrician will be able to help you with this. If you’re breast feeding, keep feeding, but you can thicken your expressed milk”.
Further advice:
  • Burp/wind baby gently on your shoulder (swaying movement), or sit baby upright on your leg, leaning baby slightly forward. Ensure their back is straight, cupping their chin with your hand.  Do not bounce the baby at all or tap their back, as this causes the stomach contents to come back up ie. reflux.
  • Continue to hold on shoulder up to 30 minutes – or as long as needed. This helps reduce anxiety of winding.
  • Add a thickening agent to baby’s milk, under the guidance of a dietitian.
  • Depending on baby’s age, introducing solids can help. The guidelines are to wait until baby is 6 months to do this, but some mothers feel that baby-led weaning is a help at an earlier age.
  • Some mums recommend having the baby’s cot tilted up gently to encourage milk to stay down in the stomach.
  • On bad days, use a sling around the house so that baby is right next to you feeling as calm as possible, and they are also in an upright position.
  • If you are breastfeeding, some exclusion diets may improve the reflux, but should not be done without professional guidance of a dietitian.
  • You may wish to join the SURVIVING REFLUX Ireland Facebook page which gives access to a very empathetic group of mums whose babies currently have reflux or have had it in the past https://www.facebook.com/groups/RefluxIreland/
  • NOTE: If your baby shows signs of inadequate weight gain, failure to thrive, feeding or oral aversions, respiratory difficulties or oesophagitis please seek medical advice.

It is likely that baby will be prescribed some form of medication from your GP or paediatrician. In general, they will be varying forms of acid-reducing medication. A mild antacid like Gaviscon will most likely be initially suggested. If you don’t see any improvement, your baby may be prescribed Zantac or similar drug, and as a last resort Proton Pump Inhibitors (PPIs), which can take up to 3 weeks to work. Your GP or paediatrician will guide you along this path if required.

For details on finding a local dietitian and craniosacral therapist in your area, search www.indi.ie/find-a-dietitian.html and http://www.iacst.ie.
I hope this was of some help. Mums, you are doing an awesome job. Keep asking questions, keep believing in yourselves.
Big love ,

Helen
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