The diagnosis of baby acid reflux appears to be on the rise. We talk to many parents each week and a good number will have babies with reflux. Although it seems to be diagnosed more now, babies having reflux is actually not new and very common. This article will talk about your baby’s spit up, infant reflux, and how it may affect your baby’s sleep.
What is baby acid reflux?
First, what is reflux? The medical name is Gastroesophageal Reflux and some know it by GER. All this means is that stomach contents come back up the esophagus. The definition of “reflux” is “a flowing back.” When put that way, it shows you just how common it is. Babies are known to spit up a lot and I’m sure many of us can relate to how cute newborn clothes are, but they are only on your baby for a couple hours at a time and you’re doing laundry daily due to spit up!
And, why do babies spit up?
Your baby spits up or has reflux due to an immature digestive tract. As your baby grows, the tract will mature and less stomach contents will be regurgitated. The ring of muscle where the esophagus meets the stomach is soft in a baby and becomes firmer as your baby grows. Most babies outgrow spitting up and reflux by 12-18 months old.
What are the signs and symptoms of reflux?
The biggest symptom, of course, is spitting up (usually after a feeding, but not always), but if your baby has “silent reflux” he can be uncomfortable without the spit up, too. Your baby may also be fussy during a feeding and some even cry while you’re feeding them. 🙁 You might hear gurgling sounds during or after a feeding. If your baby cries a lot when laid on his back after a feeding, he may be experiencing discomfort from the food traveling back up. If your baby eats smaller, frequent meals, refusing to eat larger bottles compared to other babies his age (within reason), he may be experiencing reflux.
Do you have to worry about your baby’s spit up and reflux?
For most babies, some spit up is normal and it does not bother them too much. Some even call them “happy spitters.” If your baby is having enough wet diapers, is gaining weight appropriately, and otherwise happy and content, your doctor will most likely not prescribe any medication for the reflux. Some babies will feel uncomfortable immediately after spit up or a feeding, but otherwise may be okay, and those babies won’t usually get medication, either. For more severe cases of reflux, your baby may not eat enough or spit up too much, and can have weight gain issues. Others are simply miserable much of the day and have more frequent night-waking. For these babies, your doctor may prescribe medication, which we have begun to hear more and more about lately. If you are concerned about your baby’s spit up and suspect she may have a more severe case of acid reflux or a more serious condition, please do talk to your baby’s doctor.
How does your baby’s reflux affect sleep?
Babies with reflux typically need to eat smaller, more frequent meals. This avoids their tummy being too full, which can increase the likelihood that food will come back up. Your doctor will also likely tell you to feed your baby upright and to keep your baby upright for a period of time after eating (usually ~20-30 minutes), before laying him down on his back. A baby with reflux will then need special sleep strategies. Here are some tips:
- Consider raising up one side of the crib mattress such that the baby is sleeping with an incline. Of course, you have to be cognizant about a mobile baby rolling too far down to the other end of the crib. You can consider something like the Baby Stay Asleep for your baby to keep her from moving around too much.
- Have appropriate expectations. Can you get your baby with reflux who wakes every hour to sleep 12 hours straight? Maybe, Maybe not. It doesn’t mean you can’t improve your baby’s sleep and I do encourage parents to try using a No-Cry or Limited-Crying Sleep Training Method, because too much crying can aggravate the reflux.
- For severe cases of GERD, I recommend getting the reflux under control prior to helping your baby learn to sleep better. If you’re just starting medication, allow for some time to see if the medication is working before starting to teach baby new sleep habits. If you are wondering if baby is uncomfortable because of reflux, then this will likely lead to too much inconsistency and more frustration for all of you.
- If you are sleep training, make sure you move the feeding earlier in the bedtime routine. If you have to hold your baby for an additional 20-30 minutes after a feeding, it increases the likelihood that she will fall asleep being held. This is NOT a problem UNLESS she then wants to be held all night and is no longer a newborn. We learned that sleep associations play an integral part in your baby’s sleep.
- You may have to night wean your baby LATER than average or other babies her age. Your baby’s health is the #1 priority and although sleep is important for her growth and development, too, making sure your baby is eating enough is a higher priority.
Although it’s been said that breastfed babies spit up less, both my boys spit up and I breastfed for their first year. My youngest spit up a TON!! He was, thankfully, a “happy spitter” though and we never had serious reflux issues. We used cloth diapers as burp cloths and rarely picked him up without one on our shoulder. We’d go through many outfits and cloth diapers every day. I have many clients with babies with reflux, and once they have the reflux under control, either by medication or by changing routines, babies with reflux can go on to be good sleepers just like the rest of us.
If you’re looking for ways to get your baby or toddler into a healthy sleeping routine, please be sure to pick up your FREE copy of 5 Ways to Help Your Child Sleep Through the Night, our e-Book with tear-free tips to help your baby sleep better. For those persistent nighttime struggles, check out The 3-Step System to Help Your Baby Sleep (babies) or The 5-Step System to Better Toddler Sleep (toddlers). Using a unique approach and practical tools for success, our e-books help you and your baby sleep through the night and nap better. For those looking for a more customized solution for your unique situation with support along the way, please consider one-on-one baby and toddler sleep consultations, where you will receive a Personalized Sleep Plan® you can feel good about! Sometimes it’s not that you can’t make a plan. Sometimes you’re just too tired to.
How did your baby’s reflux affect sleep? Was it severe?
Sources:
Journal of Human Lactation – http://jhl.sagepub.com/content/25/2/237.citation
The Mayo Clinic – http://www.mayoclinic.com/health/infant-acid-reflux/DS00787
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Molly says
I’m so scared my boy has reflux and he is so unsettled all the time when feeding he will choke/cough his milk up and he also arches his back all the time. Night time is the worst I finally get him to sleep then he will cough then choke and cry and pukes up clear yellowish fluid . I quickly hear him and jump up and grab him but I’m scared hes going to do it and choke and stop breathing on his own sick. Please help.
Neosha says
@Molly – Thank you for reading and sharing with us. Spitting up and reflux in babies can be quite terrifying, we know. Reflux often rears its head at meal times and when your baby is lying down causing those muscles in his throat and digestive system to relax. If you suspect your little guy has reflux and it’s interfering with his feeding and sleep, you should consider reaching out to his healthcare provider for further evaluation and treatment. Both of you hang in there, Molly!
Amber says
Get well soon. Don’t panic, I believe you’il get over it if you’re interested. Maybe it’s not reflux?
I suggest you read the following site that has a useful article on this topic.
https://www.kidschildrenshealth.com/foaming-at-mouth-of-baby/
Debbye says
@ Marilyn- Thank yo so much for sharing your story! It is unfortunate that caring for our babies should lead to any guilt or confusion, and I am so happy that you guys are on the right track now! I hope things continue to improve!!!
@ Darcy- Thank you for writing! You can feed smaller more frequent meals and avoiding citrus fruits is a good plan, as they are hard for young babies to handle. Follow your Doctor’s recommendations and follow up if you have any concerns. You may be able to find some more helpful information here: http://www.babycenter.com/0_gastroesophageal-reflux-gerd_10900.bc
Good luck!
Molly says
My boy is 4 months old
Darcy says
Thanks for the article! My baby shows signs of acid reflux but when I went to my doctor he told that it would go away soon. Can I support this by avoiding some kinds of food like citrus fruits?
Marilyn says
*Sigh* Thanks SO much for this article. I was starting to feel pressure to get my daughter on a schedule and sleep through the night, etc. but she hasn’t been able to yet. We also had a very rough start. She was 2 months old when it started to get bad. It took a while to diagnose her (silent reflux :() and now, at six months, she’s on meds (and I’m dairy and peanut free) and we’ve had a couple weeks of her doing much better.
My pediatrician scolded me for not having her on a eat play sleep schedule and said it should get her sleeping through the night. But whenever she tried to have “full” feedings and have that routine her reflux would get worse. Now she refuses to eat a lot at one time. She knows it makes her feel bad! Your article helped confirmed the things I was feeling and seeing in what worked for her and helped take the Dr. guilt trip off my shoulders. It’s so nice to know that I’m not alone in this because dealing with reflux in an infant can be so confusing and exhausting.
P.S. Thanks to all who make this website possible. I found it when my first was a few months old. He was the perfectly on schedule one (eat play sleep) 😉 thanks to your help. 🙂 He’s now almost 3 and still a great sleeper!