Babies with acid reflux cry constantly, which makes it almost impossible to console them. But you should remember that Gastro-oesophageal (GER) is one of the few conditions that eventually improves on its own! Almost all refluxers will outgrow the condition without any major medical interventions.
There are a few things you can do to make your baby more comfortable, which will help lessen the symptoms of reflux, but won’t necessarily fix it.
The best position for a refluxer is on his stomach with his head propped up at an angle of about 30 degrees. Due to the risk of suffocation, only do this under constant adult supervision. Change his position when he starts crying, as crying fills the stomach with air and an increase in pressure worsens the reflux.
An infant seat or swing is not the ideal position for a refluxer, as a slumping position also increases the air pressure in a baby’s stomach. However, some babies are more comfortable in an upright position, and the rocking motion of a swing may help soothe him, so let your baby’s reaction guide you. A bouncy chair with a reclining back is ideal for a refluxer, especially after feeds. Feed your baby at a 45-degree angle and hold him in that position for as long as possible after the feed.
Never bounce your baby on your knee, and don’t let him sit upright directly after a feed. In fact, it’s better if you handle your baby as little as possible after a feed. Try carrying him in a sling because the upright position helps keep his food down. Change his nappies before a feed. If you need to change your baby’s nappy after a feed, try rolling him from side to side rather than lifting up his legs.
Try to feed your baby smaller amounts more often, since over-feeding worsens reflux. Unfortunately, very few babies are satisfied with only a bit of milk at a time, and may start crying, resulting in an increase in the air pressure in the stomach. Some paediatricians recommend that a refluxer should start solid foods at around
3 months, but before you do this, wait until your baby is diagnosed with reflux and you have your paediatrician’s approval. This approach is often suggested because solid foods are ‘heavier’ than liquids and tend to stay down better. Another tactic is to give your baby a bit of solid food directly after his feeds to help keep the milk down. Use a fluid thickener to change the milk’s consistency, or use rice cereal to thicken it – but this may cause constipation. If your baby can stomach cow’s milk, try an anti-reflux formula, because it contains thickening ingredients.
Use a colic-friendly bottle. Refluxers are often vigorous suckers, resulting in stomach cramps and gas. You can also try a pacifier to help soothe your baby, but bear in mind that most babies with acid reflux are not very keen on dummies. Limit acidic foods, such as apples, bananas and oranges. Pears are the least acidic and are an excellent first food for babies suffering from reflux.
Lift the end of your baby’s crib by placing a pillow underneath the mattress. Due to the risk of suffocation, never put a pillow on top of your baby’s mattress. You can also buy a custom reflux sleep wedge or baby positioner to use under or above his mattress. Consult your paediatrician about letting your baby sleep on his tummy, especially if he is older and can lift his head on his own. While sudden infant death syndrome (SIDS) is a big risk for babies who sleep on their tummies, refluxers are often more comfortable on their tummies. Some experts even suggest it’s safer for babies to sleep on their stomachs because this position allows vomit to freely flow out of a baby’s mouth. The safest alternative is to let your baby sleep on his left side, as this helps gravity keep his food down, and gastric outlet is higher when a baby is lying on his left side.
Take it easy
You are not responsible for your baby’s reflux. Accept that you are trying your best and do not be too hard on yourself. Caring for a refluxer is tiring, so try and rest when your baby is sleeping. Look after yourself and your baby first. If you feel you can’t handle everything, get help with the housework or ask someone you trust to look after your little one so you can take a break.
A reflux baby has a profound influence on family life. Spend some ‘alone time’ with your partner. If you have other children, make extra time for them, as most of your attention is inevitably focused on your sick baby. Older children often feel left out or rejected. They need reassurance that a reflux baby’s problems aren’t anyone’s fault and that his condition will improve.
*Written by Dr Leanda Retied; Living & Loving November 2008