Reflux is a condition where your baby will be unable to feed without it causing discomfort. In some cases it get's worse, causing distress. However most infants will eventually grow out of it. Reflux occurs when stomach acid makes it way up through the lower oesophageal sphincter to the back of the throat, causing a condition similar to acid heartburn. It can also cause problems such as a sore throat and coughing.
Babies who have reflux often vomit frequently after a feed, however that is not always the case as reflux can also occur in babies who have never vomited. If your baby cries after every feed, becomes distressed regularly while feeding, tenses and arches his back, cries when you settle him down to sleep and only stops crying when you hold him upright, then I suggest you seek medical advice.
There are other conditions beside reflux which can cause a baby to behave in a similar way e.g. lactose intolerance, so it is suggest it is always best to seek an opinion from a medical adviser if you are concerned in any way about your baby’s feeding habits.
Breastfed babies have been shown to have fewer and less severe reflux episodes than their formula-fed counterparts. Human milk is more easily digested and is emptied from the stomach twice as quickly. Another advantage of breastfeeding the baby is the closeness between mother and baby, nursing is nature’s perfect way to comfort your baby as it is easy to become overwhelmed and stressed when your baby is in pain or unhappy.
One common challenge that can arise when dealing with reflux is that the baby may be hesitant to drink knowing that pain may result afterwards.
Keep feedings as peaceful and calm as possible. Handle baby gently and burp often. Try to keep baby in an upright position for 15-20 minutes after feeding. Smaller, more frequent feeds are easier to digest and keep baby from overfilling his stomach and spitting up the excess.
Settle baby on a 45° incline, by raising the head end of his Moses basket or cot with the aid of a pad under the mattress.
You can achieve this by folding a small towel into a pad or rolling together two muslins and placing them under the mattress to create a comfortable sleeping incline. Alternatively you can purchase a wedge which goes under a sheet as in the above picture.
I have found in my years working as a maternity nurse that babies with reflux symptoms do not like lying flat on their backs, they prefer to lie on their sides or in an elevated position as described above. It is essential to keep baby upright for at least 15-20 minutes after completion of a feed before settling him back to sleep. Otherwise he will only be uncomfortable and unsettled and you will end up having to pick him up, soothe and resettle him again. This can be very tiring and time-consuming for a first-time mother, so try to get as much professional support and advice as you can if you are concerned your baby may have reflux.
A dummy can be a very helpful pacifier for a baby suffering from reflux (see topic – Dummies).
Some babies vomit a little, regularly, after every feed; this is quite normal. Others will posset or vomit little and often and this is also quite normal. Occasionally a baby will have a large vomit and may not have ever vomited before, this can be quite distressing and worrying, however if this only occurs once or twice and there are no other symptoms which concern you there is every chance it will not happen again. If, however, your baby vomits at every feed, is not putting on weight and seems distressed at feeding time, speak to your GP or health adviser as soon as possible as they may have reflux or some other underlying digestive problem.
If you have a large supply of breast milk and your baby chokes or gags when the milk lets down, then spits up afterwards, try offering only one breast per feed until baby is able to cope with the flow and requires both breasts to satisfy his appetite.
If your baby wants to nurse constantly, earlier than every three hours, and seems to spit up at every feed but is making an appropriate weight gain, try offering a dummy/pacifier. It may keep baby from overfilling his stomach and spitting up the excess. If however you feel your baby may have digestive problems it is essential to see your doctor as soon as possible.
Recommended books and websites to read if you are having problems.
Key Points To Take Away
- Vomiting after every feed can be a symptom of reflux
- Reflux can cause vomiting, sore throat and coughing
- Reflux can even occur in babies who do not vomit
- Lactose intolerance can produce a condition similar to reflux
- Breastfed babies may have less reflux than formula-fed
- Your baby may be reluctant to drink if they think it will cause pain
- Feed in a peaceful calm enviroment, burp often and keep your baby upright after a feed
- Settle your baby at a 45° angle by using rolled towels, muslins or a wedge
- Babies with reflux tend not to like lying flat on their back
- Dummies may help sooth your baby
- Check your milk supply is not flowing too quickly as this could aggravate your baby's reflux
- If you suspect your baby has digestive problems, vomits after each feed, appears not to be gaining weight and is constantly distressed, seek medical advice as soon as possible