• Adrienne Fenton

What is Reflux?


What is Reflux?

In simplest terms, Reflux is when baby spits their milk back up. The spit up milk is combined with stomach acid and burns the throat.


This spilt milk can also include stomach acid which can burn the esophagus and cause discomfort or pain. This is similar to heartburn or indigestion experienced by adults. You will often hear that reflux is caused by an immature esophageal sphincter. This is not usually the true cause. All babies have immature muscles and the esophageal sphincter is no different to any other muscle that has to develop. So why do some babies get reflux and others don't? Because there is an underlying cause for their reflux and their reflux is just one symptom of that bigger issue. It could be allergies, oral ties, gut health, air intake, and so on.


“I felt like it was easy to get frustrated with it all but it really isn’t for long”


What is Silent Reflux?

Silent Reflux means no/little milk comes out of baby’s mouth when milk is brought up.


Silent Reflux is where the milk is partially regurgitated up into the oesophagus but does not reach the mouth and there is no outward spilling of milk. This can cause a lot of painful heartburn-like symptoms but because there is no spilt milk, Silent Reflux is often misdiagnosed as wind or colic.


How Reflux effects Sleep

A Reflux baby is likely to be an unsettled poor sleeper due to their physical discomfort and because they often need more frequent feeds overnight. Reflux babies often prefer feeding at night when they are relaxed and/or half asleep as their relaxed body seems more able to keep the feed down. This of course results in a more disruptive night for everyone. So what do we do about it?


Sleeping Tips for Reflux Babies

  • Continue to sleep baby on their back even if they have Reflux as back sleeping dramatically reduces the risk of SIDS. People often think that if a baby sleeps on their back when they spit up, they’ll choke on the spilt milk. This is not true. Check out this video to learn more about why back sleeping is safer for Reflux babies. The AAP states that “sleep position does not increase the risk of choking and aspiration in infants, even those with Reflux, because infants have airway anatomy and mechanisms that protect against aspiration”.

  • Avoid the use of sleep wedges or elevating one end of the cot/mattress. The AAP has found that “elevating the head of the infant’s crib is not effective in reducing Reflux. It may result in the infant sliding to the foot of the crib into a position that may compromise respiration and therefore is not recommended”.

  • Avoid tight fitting clothing or blankets/sleeping bags/swaddles.

  • Offer feeds when baby wakes up, rather than before their nap/bedtime. This allows time for the feed to be digested before they lie down to sleep.

Feeding Tips for Reflux Babies

  • Offer plenty of daytime feeds in a dim calm room. This can help baby relax similar to how they are at night and encourage them to feed better.

  • Feed baby in an upright position and keep them upright after a feed for 20-30 minutes.

  • Offer small feeds more frequently and don’t force baby to eat more than they want.

  • Burp your baby for a few minutes after every feed.

  • Handle baby gently and avoid too much jiggling especially after a feed.

  • Once baby is on solid food (around 6 months), offer solids before a milk feed as having something in their tummy seems to help the milk stay down.

  • There is insufficient research to confirm if thickened milk/Formula reduces the effects of Reflux. The Royal Children’s Hospital does not recommend changing Formula or changing from breastfeeding to bottle feeding.

“Patience is certainly the key to getting through it”


Most babies with Reflux do not need any treatment for their reflux but it is a good idea to try to identify what the reflux is a symptom of. I know that is so much easier to say, than to live but unfortunately there is insufficient research to confirm if interventions such as medication or anti-acids are effective and the best approach seems to be patience. In most cases the worst of Reflux is between 4-6 months.


When should I be concerned about Reflux?

In a small number of babies Reflux can lead to GORD. If you notice any of the following symptoms, please consult your family doctor or Plunket nurse;

  • Long or frequent periods of irritability or crying

  • The Reflux action is forceful or green or dark yellow

  • You can see blood in the Reflux

  • Baby arches their back after a feed

  • Poor sleeping

  • Poor weight gain

  • Long lasting cough or wheezy breathing

  • Reflux continues after baby turns one year old

  • Any other changes that you can not explain

Links for more information

Check out @RockabyeReflux on Instagram for more great Reflux information

https://bpac.org.nz/BPJ/2011/november/infant-reflux.aspx?fbclid=IwAR2ilqqcL6qkhrzC9Omq_DHfim7rMreiDqgD70hlu1XZZypiRKHh28bGolk

https://www.cryingoverspiltmilk.co.nz/

https://www.plunket.org.nz/child-health-concerns-and-symptoms/stomach-and-gut/reflux/

https://www.youtube.com/watch?app=desktop&v=zm0YQbAsDnk&feature=youtu.be

https://rednose.org.au/article/sleeping-position-for-babies-with-gastro-oesophageal-reflux-gor

https://www.rch.org.au/kidsinfo/fact_sheets/Reflux_GOR_and_GORD

https://pediatrics.aappublications.org/content/138/5/e20162938


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