Gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) are two types of infant reflux that can happen when food is vomited or regurgitated back from the stomach. Although GER is benign and has no other symptoms, GERD is associated with other symptoms and may need a visit to the doctor. Proper feeding and burping are needed to manage reflux. Despite infant reflux, babies should never be allowed to sleep on their chest or tummies and should sleep on their backs to prevent SIDS. A good mindset and a strong support system are helpful for parents whose babies have infant reflux.
It’s two in the morning, and you hear, once again, your baby fussing and crying in the middle of the night because of infant reflux.
It’s been a while since you’ve had a calm, undisturbed night of sleep, and out of sheer desperation, you prop your baby to sleep on their chest.
Unfortunately, this behavior is not safe for your child!
Letting your baby sleep on their chest at night, whether they have infant reflux or not, even if it’s the only position they’re comfortable in, should not be done at all.
Let’s read more about what infant reflux is and what safer strategies you can do as a parent to help your child feel better at night.
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What is infant reflux?
Infant reflux, also known as gastroesophageal reflux (GER), is when food or milk regurgitates back from the stomach, through the esophagus, and out through the mouth.
Parents more easily identify it as ‘spitting up.’
It sounds quite concerning, especially to first-time parents, but GER is pretty common in infants, even if it happens a couple of times a day.
About 50-85% of infants 3 months and below experience GER.
It can start as early as 2 months old, but it most often occurs in children 4-6 months old.
Most infants outgrow GER between 12-18 months old, and only about 5% will have persistent symptoms.
Why does infant reflux happen?
Babies are born with some immature and underdeveloped areas of the body, including the musculoskeletal (muscles) and nervous systems (brain, spinal cord, and nerves).
Now, the lower esophageal sphincter (LES) is a small bit of muscle found between the stomach and the esophagus. It contracts to prevent stomach contents from going back up the esophagus.
In infants, the nerves that control the contraction and relaxation of the LES muscle are not as mature as in adults.
This muscle sometimes relaxes at the wrong time, allowing stomach contents to pass freely. Babies tend to vomit or regurgitate when this happens.
Some infants are more prone to develop infant reflux because of certain conditions.
- Premature birth
- Cystic fibrosis
- Cerebral palsy
- Hiatal hernia
- Esophageal birth defects
What are the signs or symptoms of infant reflux?
Infant reflux (GER) usually presents as vomiting or regurgitation of food contents multiple times per day, occurring after feedings.
Other than that, there should be no other symptoms.
This is why babies with GER are called ‘happy spitters.’
If you notice other signs that noticeably affect your baby, then they may have gastroesophageal reflux disease (GERD) instead.
Babies with GERD often have these symptoms:
- Difficulty feeding or refusing food
- Difficulty sleeping
- Constantly irritable and crying
- Spitting up blood
- Spitting up greenish or yellow fluid
- Constant hiccups
- Difficulty gaining weight
Managing babies with GERD
Babies with GER usually do not have any serious symptoms and don’t need further treatment. However, it’s definitely hard to stay calm when your baby has GERD.
They constantly cry and wake up at night, unfortunately stressing out those who care for them at night.
Here are some ways to take care of your baby with GERD:
1. Feed them in an upright position
This allows milk or food to pass through the esophagus and stomach easily compared to other feeding positions.
After feeds, allow your baby to stay in this position for roughly 30 minutes to ensure that all food contents are safely settled in the stomach.
2. Don’t forget to burp
Air can get trapped in the stomach as a baby takes in milk. This can, unfortunately, trigger regurgitation.
Make sure to burp your child after every feed.
3. Watch how much they’re eating/drinking
Chances of regurgitation or vomiting can happen when you overfeed your child.
If you’re unsure how much milk or food they should be eating for their age, you can always schedule a visit to your friendly pediatrician.
4. Put them to sleep on their backs
This may sound strange after reading about the importance of an upright position, but it’s crucial that your baby stays on their back when it comes to sleeping time.
This is because the risk of sudden infant death syndrome (SIDS) when they sleep on their tummies is far greater than the risk of regurgitation and vomiting when they sleep on their backs.
In any case, if they do experience any regurgitation episodes at night, babies tend to turn their heads to one side on their own to spit up.
5. Visit your doctor
If at any point you feel uncomfortable or unsure of what to do, it’s always best to be safe than sorry.
List your concerns and questions, and air them out one by one with your child’s pediatrician.
In some cases, a baby may need further workup or medications for their reflux.
Remember, not all babies are the same, so a tailor-made plan for your child is better than second-guessing what to do.
6. Parents, stay strong
Unfortunately, for most cases of infant reflux, the symptoms won’t quickly go away like in other conditions.
It can last for months, even beyond one year of age.
Most people underestimate how fussy, irritable, and constantly crying babies can take a huge toll on parents and caregivers.
It’s tough to handle work or daily chores alongside a baby who happily (or unhappily) spits up throughout the day.
Having an inner, calm mind and a small support system with family and friends goes a long way.
It’s okay to let out your frustration and exhaustion once in a while to de-stress and ask for help when you know you can’t take it any longer.
Can babies with reflux sleep through the night?
It depends. If your baby only has GER, they can have occasional regurgitation episodes at night but otherwise won’t wake up.
If your baby does have GERD instead, it’s more likely that they could cry and wake up in the middle of the night because of the discomfort.
Can I elevate my baby’s legs at night to help with reflux?
Currently, there is no evidence that elevating your baby’s legs can help with reflux.
During feedings, they should stay upright, but while asleep, babies should still lie on their backs.
Can I use crib wedges to help lessen infant reflux?
Crib wedges are not safe for infants at night or during sleeping periods because of the high risk for SIDS.
This holds true even if your child has infant reflux. When it comes to your baby’s crib, you should also use mattress wrapping to prevent SIDS.
Infant reflux happens because of an immature esophageal sphincter that allows food from the stomach to be regurgitated or vomited out.
Infant reflux may or may not have other associated symptoms.
It’s important to ensure proper feeding and sleeping positions for your child, as well as a proper support system for parents and caregivers.
If you feel uncomfortable handling your child’s reflux at any point, it’s best to speak to your baby’s pediatrician.