Herbie Murray
Reflux in newborns, also known as gastroesophageal reflux (GER) or acid reflux, can be a common concern for parents trying to help their baby sleep. Reflux occurs when a baby brings up milk or is sick during or after feeding, and it is usually due to the immaturity of their food pipe (oesophagus). While reflux is typically not a cause for concern, it can make falling and staying asleep challenging for babies due to discomfort and irritability. This article will discuss ways to help your newborn with reflux sleep better and provide tips for managing their symptoms.
| Characteristics | Values |
|---|---|
| Safe sleep position | On their back |
| Sleeping surface | Separate from parents but in the same room |
| Feeding | Burp them and wait 20-30 minutes before lying them down |
| Feeding | Avoid car seats and swings for 20-30 minutes after feeding |
| Feeding | Reduce spicy or acidic foods in the mother's diet |
| Feeding | Switch their bottle |
| Feeding | Thicken formula with powder |
| Feeding | Change formula |
| Medication | Medicines to stop the stomach from producing as much acid |
| Surgery | To strengthen the muscles to stop food or milk from travelling back up |
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What You'll Learn
Safe sleeping positions for newborns with reflux
As a new parent, you might be concerned about your newborn's reflux and how it affects their sleep. Reflux, or gastroesophageal reflux (GER), occurs when a baby's stomach contents return to their oesophagus, which can be uncomfortable and make it harder for them to sleep. While it's natural to want to try different sleeping positions to ease their reflux, your baby's safety should always come first.
The safest sleeping position for newborns with reflux, according to the American Academy of Pediatrics (AAP), is on their back on a firm, flat surface without any crib bumpers, bedding, or stuffed animals. This recommendation is based on the fact that the human gag reflex will cause your baby to automatically swallow or cough up any fluid they spit up, preventing choking. Additionally, the risk of choking is actually higher when babies sleep on their stomachs due to the alignment of the trachea and oesophagus.
Contrary to popular belief, placing your baby on their back does not increase the risk of choking, and it significantly reduces the risk of sudden infant death syndrome (SIDS). On the other hand, the prone position (sleeping on the stomach) has been associated with a higher risk of SIDS, especially when used with soft mattresses or fluffy bedding. This position can also worsen reflux symptoms, so it should only be considered under medical supervision and after exploring other treatment options.
It's important to avoid products that claim to reduce reflux by elevating your baby's head, such as wedges or sleep positioners, as these are not recommended by the AAP. Swings, reclined bouncy seats, and rocking sleepers are also not approved for safe sleep. Instead of relying on these products, focus on addressing any physical concerns and managing your baby's reflux pain with the help of a healthcare professional.
Remember, every baby is unique, and it's always best to consult your paediatrician for personalised advice and to ensure your baby is healthy and growing as they should be.
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How to soothe a newborn with reflux
Reflux in newborns, also known as gastroesophageal reflux (GER) or acid reflux, occurs when a baby's stomach contents return to their oesophagus, the tube connecting the mouth and stomach. This can cause discomfort and make it harder for them to sleep. Here are some ways to soothe a newborn with reflux and help them sleep better:
Safe Sleep Positions:
It is recommended to always put newborns and babies under one to sleep on their back, even with reflux. Sleeping on their back will not increase the risk of choking as the gag reflex will force the baby to cough or swallow any fluid. Keeping the baby upright for 20-30 minutes after feeding can also help reduce reflux. Certain positions like in a swing or car seat should be avoided as they can cause pressure on the stomach and worsen reflux symptoms.
Burping and Feeding:
Burp your baby after feeding and wait at least 30 minutes before lying them down for a nap or bedtime. This helps ensure proper digestion and can prevent acid reflux, which typically occurs after meals.
Comfort and Soothing:
Newborns with reflux prefer to be held upright and may be fussy both day and night due to discomfort. Rocking your baby upright until they are drowsy can help soothe them and lessen reflux symptoms. Pacifiers may also help with reflux by increasing saliva flow, aiding in getting fluids back into the stomach.
Dietary Considerations:
For breastfeeding mothers, it is recommended to reduce spicy or acidic foods from their diet as this can impact the baby and cause reflux. In some older infants, reflux may be due to food allergies or lactose intolerance.
Medical Advice:
While reflux is common and usually improves by the time a baby is one year old, it is important to speak with your paediatrician or GP if you have concerns. They can provide expert advice, recommend treatments, and suggest ways to help your baby sleep better. In some cases, medication, a change in formula, or surgery may be necessary.
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How to establish a consistent bedtime routine for newborns with reflux
Establishing a consistent bedtime routine for newborns with reflux is important to ensure your baby gets the sleep they need to grow and develop. Here are some tips to help you establish a soothing and consistent bedtime routine:
Understand Reflux and its Causes:
Reflux occurs when a baby brings up milk or becomes sick during or after feeding. This happens because a baby's food pipe (oesophagus) has not fully developed, allowing milk or food to come back up easily. Reflux usually starts before a baby is 8 weeks old and tends to improve by the time they are one year old. Understanding reflux and its causes can help you better manage your newborn's condition and implement effective strategies to reduce its impact on their sleep.
Safe Sleep Positions:
Always put your newborn to sleep on their back, even if they are experiencing reflux. Contrary to concerns about choking, this position is safe as the gag reflex will cause the baby to cough or swallow any fluid. Avoid placing your baby in a car seat or swing right after feeding, as these positions can cause pressure on the stomach and worsen reflux symptoms. Instead, keep them upright for 20-30 minutes after feeding to aid digestion and reduce reflux.
Burping and Digestion:
Burp your baby after feeding and wait at least 30 minutes before putting them down for a nap or bedtime. This helps ensure proper digestion and can reduce the likelihood of reflux occurring while they sleep. Rocking your baby upright until they are drowsy can also help soothe them and reduce reflux symptoms.
Consistent Bedtime Routine:
Consistency is key when it comes to establishing a bedtime routine. Develop a calming pre-sleep routine that includes activities such as reading a story, singing lullabies, or giving your baby a warm bath. A consistent routine helps signal to your baby that it's time to wind down and prepare for sleep.
Comfort and Soothing:
Newborns with reflux often prefer to be held upright and may be fussier than usual due to the discomfort of reflux. Provide extra comfort and attention before bedtime to help your baby relax. Pacifiers can also be useful for reflux since they increase saliva flow, which can aid in getting fluids back into the stomach more quickly.
Medical Advice and Support:
If you are concerned about your newborn's reflux or sleep patterns, don't hesitate to seek advice from your paediatrician or healthcare provider. They can provide expert guidance, recommend safe sleep positions, and suggest treatments or medications to help manage reflux and improve your baby's sleep.
Remember, every newborn is unique, so you may need to experiment with different strategies to find what works best for your baby. Be patient, consistent, and always prioritise your newborn's comfort and safety when establishing a bedtime routine.
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The impact of a mother's diet on reflux in newborns
Reflux in newborns, also known as gastroesophageal reflux (GER), occurs when a baby's stomach contents return to their oesophagus, causing discomfort and affecting their sleep. While reflux is a common issue, with many babies growing out of it, it can be distressing for both parents and infants.
A mother's diet is directly related to the diet of her breastfeeding baby, as the food she consumes can influence the nutrition, composition, and taste of her breast milk. For example, eating spicy foods can irritate the stomach lining, triggering acid reflux in babies. Similarly, caffeine consumption can lead to reflux and caffeine stimulation symptoms like irritability in infants. Breastfeeding mothers are advised to limit their caffeine intake to 750 ml per day (equivalent to 5 cups of coffee). High-fat foods should also be consumed in moderation, as they can cause the lower oesophageal sphincter to remain open, resulting in stomach content reflux.
To address reflux in newborns, it is recommended to adopt an elimination diet, where certain foods are restricted for a few days and then gradually reintroduced to identify any triggers. This approach can help determine which foods are causing reflux episodes in the baby. Additionally, holistic nutrition focuses on providing nutrient-dense foods that promote optimal health for both mother and child, reducing the likelihood of reflux.
While it is important to address the physical concerns related to reflux, ensuring a safe sleep position for newborns with reflux is crucial. It is recommended that babies with reflux sleep on their backs, despite concerns about spitting up and choking. Positions like sleeping in a swing or car seat should be avoided as they can put pressure on the stomach and exacerbate reflux symptoms.
By combining dietary modifications with safe sleep practices, mothers can effectively manage reflux in newborns, improving their sleep and overall well-being.
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When to seek medical advice for a newborn with reflux
Reflux in newborns, also known as gastroesophageal reflux (GER) or acid reflux, is a common condition where the stomach contents return to the oesophagus, leading to spitting up or vomiting. While reflux is typically harmless and resolves as the baby's digestive tract matures, it can be a concern for parents, especially when it disrupts their sleep.
Spitting Up or Vomiting Patterns
- Spitting up or vomiting that starts after six months of age.
- Vomiting that persists beyond 12 months.
- Persistent and forceful vomiting.
- Nighttime-only vomiting.
- Blood in the vomit, which may appear as coffee grounds.
- Green or bright yellow vomit, indicating the presence of bile and a potential medical emergency.
Other Symptoms
- Chronic diarrhoea.
- Rectal bleeding or blood in the stool.
- Swollen belly.
- Poor weight gain or weight loss.
- Excessive sleepiness or drowsiness.
- Chronic coughing.
Severe Reflux
Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is a more severe form of reflux that requires medical attention. It is characterised by chronic acid reflux that affects a person's quality of life and can damage the oesophagus. Symptoms of GERD or GORD may include frequent vomiting, blood in the vomit, poor weight gain, and other symptoms like a swollen belly or chronic coughing.
Persistent Sleep Disturbances
If reflux is severely impacting your newborn's sleep, causing them to wake up frequently or struggle to sleep through the night, it may be advisable to seek medical advice. A paediatrician can provide guidance and recommend safe sleep positions to manage reflux symptoms while ensuring your baby's safety.
Concerning Behaviour
Trust your instincts as a parent. If you are concerned about the frequency or amount of spitting up, vomiting, or other symptoms, don't hesitate to contact your healthcare provider. They can assess your baby's symptoms, rule out other medical conditions, and provide appropriate advice or treatment options.
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Frequently asked questions
Reflux occurs when a baby brings up milk or is sick during or shortly after feeding. It usually starts before a baby is 8 weeks old and gets better by the time they are 1. It is very common and usually gets better on its own.
It is recommended that newborns and babies under one are put to sleep on their back even if they have reflux. You can also try to keep your baby upright for 20-30 minutes after feeding to help reduce reflux.
Avoid putting your baby to bed immediately after feeding. Instead, burp them and wait 30 minutes before lying them down. Also, avoid placing your baby on their back or in a car seat right after feeding as this can lead to more spitting up and discomfort.
Speak to your paediatrician or GP about your concerns. They can recommend ways to help your baby sleep and may suggest medication, a change in formula or, in rare cases, surgery.
