Infant reflux affected around half of the babies I would see in my private practice. Admittedly, I specialised in more fussy of babies so it stands to reason that half of my little patients had been diagnosed with and/or were being treated for reflux. To put this in perspective and offer some advice, lets look at what we know about reflux.
Infant reflux: What is it?
‘Reflux’ is short for Gastro-oesophageal reflux – which is basically regurgitation of stomach contents. Lots of babies have ‘reflux’ – which in most cases is spit up or “posset” and is characterised by bringing up milk curds and stomach acid. It’s one of the reasons that spit up cloths are so important in early infancy. It is, for the most part, normal and nothing to worry about. In fact, so many babies regurgitate small amounts of milk curds that we could almost consider it ‘normal.’ The vast majority of these babies continue to gain weight and thrive, even though they are bringing up a portion of each feed.
For other babies, the ‘reflux’ is a medical condition called GERD or GastroEsophageal Reflux Disease, which does require intervention. These babies are not thriving and are very unwell. Many suffer from repeated lung infections and significant discomfort and pain due to the oesophagitis that develops when stomach acid burns the food pipe. These are the cut and dried cases and are very unusual.
The grey area of infant reflux
There are a number of babies who aren’t ill with the reflux but are irritable and fussy. In these little ones, it is hard to know if they are simply irritable (or highly sensitive) babies or if the reflux is causing so much discomfort that it needs to be treated. The grey area is characterised by babies who are thriving but grumpy. This scenario brings up the question about whether they should be treated medically.
Should we be medicating?
The medical treatments for reflux generally involve neutralising or blocking stomach acid production. Or thickening the milk that the baby ingests so it’s less likely to come up as easily.
Remember that in cases where babies are unwell, not thriving and have breathing problems or lung infections due to the GERD, treatment is necessary.
For all other infant reflux, in otherwise well babies, the new thinking is not to medicate these babies because the treatments that alter stomach acid may lead to other issues with digestion. If you can manage reflux conservatively in these babies, it is a way better route to go. Here are some tactic you can try:
- Give smaller feeds
- Limit the length of the feed
- Interrupt the feed to burp your baby
- Keeping baby upright for a short period of time after the feed
- Raising the head of the cot for sleep time
Infant reflux & your baby’s sensory threshold
Looking at infant reflux from a sensory perspective can be useful.
Sensory sensitive babies have a tendency to hyper respond to all sensory input. These babies are easily woken by sounds, cranky at bath time due to the change in temperature, fussy with new teats and dummies, become over stimulated in a busy setting, etc. These babies have a low threshold for all sensory input. It stands to reason that interoception (sensory input from within the body) will also cause these babies to react.
For babies with a low threshold, the mild burning or discomfort of ‘normal’ reflux makes them very irritable and they over respond to interoception from the oesophagus that another baby may not notice. Sensitive babies are more likely to over react to reflux. To determine whether your baby is a sensitive baby – do the Sensory Personality Matrix.