How Do You Know Your Baby Has Colic Or Reflux
A colicky baby can be easy to spot as their marathon crying fits can last for 3 hours or more at a time and occur daily, at a similar time. Colic is quite normal in newborns and generally starts when your baby is around 2 weeks old. It does tend to go away by 6 months but during that time when your baby is so unsettled, it can be stressful and difficult to know how to soothe them.
- Your baby cries a lot, and you are not sure why
- Your baby cannot be soothed, and the crying feels most common in the evenings
- Your baby looks angry and rather red in the face
- Your baby brings their knees up to their chest or arches their back when you hold them
Reflux In Breastfed Babies
Reflux can affect your baby whether theyre breast or bottle fed. Remember that if you are breastfeeding, you should continue to feed your baby as usual.
Its tempting to explore the foods to avoid when breastfeeding a baby with reflux, particularly if you suspect that your baby may have an allergy or intolerance to cows milk. However, its important not to cut anything out of your diet without first consulting your GP for advice.
Symptoms And Remedies For Silent Reflux In Babies
The signs of silent reflux in babies aren’t always obvious. Here’s how to tell if your baby is silently sufferingand how to make her feel better.
Jodi Di MennaMay 1, 2018
Any parent whose newborn has suffered from reflux knows the helplessness of trying to comfort an infant who hurts after each feeding. Babies with reflux may be irritable, spit up or refuse to eat. They arch their bodies during or after feedings, or cry when placed on their backs, especially if they just ate. But sometimes the most obvious symptoms dont show upthis is known as silent reflux. Regular reflux occurs when food and digestive acid leaks up from the stomach, causing painful irritation in the esophagus. But silent reflux in babies might not spit up at all, swallowing the regurgitated liquid instead. Some babies with regular reflux lose weight, but babies with silent reflux can gain weight normally, despite being in pain.
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Baby Reflux Management: How To Help
While reflux is usually nothing to worry about and generally resolves itself,there are plenty of things you can do to help:
- Feed your baby little and often smaller amounts of milk are more manageable for tiny tummies.
- Take your time babies with reflux dont cope well if feeding happens too quickly.
- Try to keep your baby upright during and after feeding.
- Try winding your baby before and after feeds.
- Avoid bouncing your baby up and down after a feed.
- Avoid dressing your baby in outfits that are tight around the waist.
- If youre bottle-feeding, try a slow-flowing teat to stop your baby guzzling their milk and taking in too much in one go.
- You might also want to speak with your GP or pharmacist about the special infant formulas available for babies with reflux.
What Is Reflux In Babies
So we know that reflux is common, but what causes reflux in babies? Because infants dont yet have a fully developed lower esophageal sphincter the muscle at the bottom of the esophagus that opens and closes to allow food into the stomach and keep it there food can easily slip back up the esophagus.
Acid reflux, also known as gastroesophageal reflux , is normal reflux that occurs among infants. 40-65% of infants experience this normal reflux. How do you know if a baby has acid reflux? If an infant is spitting up milk after feedings, theres a good chance that he or she has this type of reflux. As babies mature, GER usually goes away on its own with no intervention needed.
If a baby experiences complications that go beyond just spitting up small amounts milk such as difficulty feeding and discomfort he or she may have GERD. The symptoms of GERD include the following: 1
- Arched back during or after eating
- Crying more than three hours per day with no medical cause
- Poor eating or refusing to eat
- Poor weight gain or weight loss
- Trouble breathing
- Forceful or frequent vomiting
GERD usually occurs when the LES muscle becomes weak or relaxes when it shouldnt, resulting in stomach contents resurfacing into the esophagus.
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When To See A Doctor
Toddlers with occasional symptoms of acid reflux who are otherwise happy, healthy and growing normally are generally not at risk of harm and will likely outgrow their symptoms. However, if your child has any of the more serious symptoms that may be associated with GERD — such as frequent vomiting, refusal to eat, failure to gain weight normally or a chronic cough — schedule an appointment with your child’s doctor as soon as possible.
What Causes Gastroesophageal Reflux
A ring of muscle, called the lower esophageal sphincter, separates the esophagus from the stomach. GER symptoms happen if this ring relaxes at the wrong time or doesnt close as it should. This lets acidic fluid from the stomach flow backward into the esophagus, into the back of the throat, and sometimes out the mouth or nose.
Often, reflux is minor and no cause for concern. But in people who have GERD, reflux happens more often and causes noticeable discomfort. After many meals, they have heartburn .
In babies with GERD, breast milk or formula regularly refluxes into the esophagus, and sometimes out of the mouth. Sometimes babies regurgitate forcefully or have wet burps.
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What Formula Is Best For Babies With Reflux
If your babyâs healthcare provider thinks your babyâs formula may be causing reflux or GERD, the provider may suggest switching to a protein hydrolysate formula. This is a type of formula that is hypoallergenic. If your baby has an allergy to the proteins found in a milk- or soy-based formula, this switch may help. It may take one to two weeks for your babyâs reflux symptoms to improve after making this switch.
Why Is Reflux So Common In Babies
Compared to adults, babies have a weaker valve connecting the esophagus to the stomach. The lower esophageal sphincter is a group of muscles that controls this valve and keeps stomach acid where it belongs.
A weakened valve makes it more difficult for the body to keep the stomach contents in the stomach. As a result, the valve opens more easily and allows stomach acid to travel back up.
For some babies, the stomach contents may only travel up part of the way, in which case the contents will then travel back downwards, causing heartburn or minor breathing problems. If your childs stomach acid travels all the way back through the esophagus, it can cause vomiting. However, some children will not show any signs or symptoms at all.
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What Treatments Might The Doctor Give For My Infants Gerd
If feeding changes do not help enough, the doctor may recommend medicines to treat GERD. The medicines work by lowering the amount of acid in your babys stomach. The doctor will only suggest medicine if your baby still has regular GERD symptoms and
- You already tried some feeding changes
- Your baby has problems sleeping or feeding
- Your baby does not grow properly
The doctor will often prescribe a medicine on a trial basis and will explain any possible complications. You shouldnt give your baby any medicines unless the doctor tells you to.
Medicines for GERD in babies include
- H2 blockers, which decrease acid production
- Proton pump inhibitors , which lower the amount of acid the stomach makes
If these dont help and your baby still has severe symptoms, then surgery might be an option. Pediatric gastroenterologists only use surgery to treat GERD in babies in rare cases. They may suggest surgery when babies have severe breathing problems or have a physical problem that causes GERD symptoms.
Smaller More Frequent Feedings
Feeding a baby with reflux can be challenging. Breastfed babies who have reflux may try to soothe the pain by nursing, which can exacerbate the issue.
Formula-fed infants can go longer stretches between feedings, however, this is also not ideal for babies with reflux.
Aim to feed your baby every two to three hours while awake. This may mean reducing the number of ounces your baby gets at each feeding. Overfeeding can increase abdominal pressure, which worsens reflux symptoms.
You may also find nipples with smaller holes to be helpful for your baby. Look for bottles that are designed to reduce the amount of air your baby takes in during feedings.
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How Can I Help My Baby With Reflux
You can help prevent your baby from experiencing reflux by
- Avoiding overfeeding him
- Feeding him smaller amounts more frequently
- Burping him more frequently, both during and after each meal
- Limiting his activities, like tummy time, once heâs been fed
- Placing him in an upright position for at least 30 minutes after a feeding
- Thickening his milk or formula with up to 1 tablespoon of oatmeal
- Changing his formula, if heâs formula-fed.
Diet And Lifestyle Changes
In many cases, diet and lifestyle changes can help to ease GERD. Talk with your childs healthcare provider about changes you can make. Here are some tips to better manage GERD symptoms.
- After feedings, hold your baby in an upright position for 30 minutes.
- If bottle-feeding, keep the nipple filled with milk. This way your baby wont swallow too much air while eating. Try different nipples. Find one that lets your babys mouth make a good seal with the nipple during feeding.
- Adding rice cereal to feeding may be helpful for some babies.
- Burp your baby a few times during bottle-feeding or breastfeeding. Your child may reflux more often when burping with a full stomach.
- Watch your childs food intake. Limit fried and fatty foods, peppermint, chocolate, drinks with caffeine such as sodas and tea, citrus fruit and juices, and tomato products.
- Offer your child smaller portions at mealtimes. Add small snacks between meals if your child is hungry. Dont let your child overeat. Let your child tell you when he or she is hungry or full.
- If your child is overweight, contact your childs provider to set weight-loss goals.
- Serve the evening meal early, at least 3 hours before bedtime.
Other things to try:
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Treating Acid Reflux In Babies
If you have consulted a pediatrician and determined that your baby is having issues with reflux, there are a few different approaches that may help you manage your childs symptoms.
For infants, treatment methods include:
- Burping your baby when they come to natural pauses during feedings
- Making sure to keep your infant in an upright position for the 30 minutes following a feeding, and carefully supervising them during this period
- Offering smaller and more frequent feedings as long as your baby continues to eat enough to keep up with typical growth and development
- If recommended by your pediatrician, thickening your babys formula using a small amount of baby cereal may help reduce the frequency of spitting up. You should never try to thicken the formula without a doctors approval.
For an older child, it can be helpful to avoid fried or fatty foods and foods that are very acidic. Fried and fatty foods can slow down the digestive process and may promote reflux.
If your pediatrician approves it, you may be able to safely offer your child an over-the-counter antacid medicine that works to neutralize stomach acids in order to decrease symptoms of acid reflux and GERD.
It is always best to consult your doctor before giving small children or babies any over-the-counter medicine, especially if your childs symptoms are new and you have not consulted a doctor about them yet.
How Is Gastroesophageal Reflux Treated
Treatment for GER depends on the symptoms and how severe they are. In babies, doctors sometimes suggest thickening formula or breast milk with a little bit of oat or mixed grain infant cereal to reduce reflux. Making sure the baby is seated or held upright during and after feedings can also help.
Older kids often get relief by avoiding foods and drinks that trigger GER symptoms. Often, these include:
- citrus fruits
- food and drinks with caffeine
- fatty and fried foods
- tomato-based foods and sauces
Doctors may recommend raising the head of a childs bed 6 to 8 inches to help with reflux that happens at night. They also may look at other conditions that can contribute to GER symptoms, including obesity and some medicines. In teens, smoking or alcohol use can play a role in GER.
If symptoms continue, doctors might prescribe medicine, such as:
- H2 blockers, which can help block the production of stomach acid
- proton pump inhibitors, which reduce the amount of acid the stomach makes
- prokinetics, which help the esophageal sphincter work better and the stomach empty faster. This can prevent reflux episodes.
Rarely, medical treatment alone doesnt help and a child fails to grow well or has other problems. Then, a surgical procedure might be an option. In this surgery, called fundoplication , the doctor creates a valve at the top of the stomach by wrapping part of the stomach around the esophagus to strengthen the sphincter and prevent reflux.
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How To Ease Your Babys Reflux
You can help ease your babys reflux by making small changes to the way you feed them. Talk to your midwife or health visitor who might suggest:
- Gently burping your baby regularly throughout feeding.
- Ensuring they take breaks during a feed.
- Giving your baby shorter but more frequent feeds.
- Keeping your babys head higher than their bottom during feeds.
- Keeping your baby upright for a bit after feeding.
- Changing baby on their side to avoid any discomfort caused by lifting their legs up towards their stomach.
- Using thickened anti-reflux formula milk. You can buy these without a prescription but its important to talk to a healthcare professional before you do. There is some caution about their use, such as the fact that they are made at a lower temperature than is currently recommended to get rid of harmful bacteria.
- If your baby has a cows milk allergy, your doctor might suggest using special formula milk that doesnt contain cows milk.
Some parents might be advised to raise the head end of their babys cot slightly or place a rolled up towel under the mattress. Its important to say that there is no scientific evidence that this works and it might increase the risk of sudden infant death syndrome .