Feeding your baby with reflux
What is reflux?
Reflux describes a medical condition where the muscle at the top of the stomach doesn't work well enough to stop the contents of the stomach rising up the oesophagus resulting in vomiting. This is a common condition in babies and for most of them, won't cause any concern. However, it's estimated that approximately 8% of newborns experience either excessive reflux or 'silent' reflux which can result in a very unhappy baby.
When reflux is excessive it can affect your baby's general health and wellbeing. Excessive reflux is usually identified when the frequency and severity of the reflux begins to affect your baby's general health and wellbeing. Symptoms can include:
- Behavioural changes - as a result of associating pain with sustenance, some babies with excessive reflux will try to resist feeding.
- Failure to thrive - not enough calories are being absorbed to allow growth.
- Lung complications - aspirating even small amounts of the stomach contents can lead to lung problems such as bronchitis and even pneumonia.
- Oesophagitis - bleeding and/or inflammation of the oesophagus due to stomach acid burning the oesophagus.
Silent reflux describes a reflux condition where painful 'heartburn' symptoms are experienced rather than vomiting. It is sometimes confused with wind or colic because of this absence of vomiting.
Babies suffering silent reflux typically experience discomfort 60-90 minutes after feeding at which time the stomach's contents usually move into the intestines for absorption. Instead the weak muscle at the top of the stomach allows some food to be squeezed upwards into the oesophagus.
How to feed your baby with reflux
While breastfed and bottle fed babies suffer from reflux equally, studies have shown that reflux in breastfed babies tends to be shorter and less frequent than those who are bottle fed. This is perhaps because breast milk is more quickly digested than formula and so has less time to hang around and cause trouble. Regardless of how you are feeding your baby, you should:
Feed your baby in an upright position.If you are breastfeeding you may need to experiment with positions to find the best one that will allow your baby to remain fairly upright during feeding. Some mothers report success by having their baby face their breast while straddling their leg. Others prefer to stand up while feeding their baby in a modified twin-style hold.
Keep feeds small and frequent.Most babies with reflux like to feed often and this is actually good for them as this causes less pressure on the stomach muscle than a large sudden intake of food.
Keep baby upright.For at least half an hour after feeding, keep your baby upright. You may want to hold him on your shoulder or perhaps use a front pack or baby seat.
Introduce a reflux-friendly routine.Try to keep to a routine where your baby feeds when he wakes up so that he'll have plenty of play time to allow the milk to digest before lying down to sleep.
Don't let your baby fall asleep while feeding.Catnapping on the breast or bottle always leads to pain once the feed has finished so try to avoid feeding when your baby is tired.
Try feeding solid food first.Once your baby is old enough to be eating solid food, try offering this to him before his milk feed as this seems to keep the milk down. For younger babies, try a small amount of thickened milk at the beginning of a feed. Many bottle fed babies find relief from reflux when thickened formula is used.
Helping your baby with reflux
You can help your baby with reflux be more comfortable by:
- Burping regularly through each feed. By frequently burping your baby, you will keep the air that is gulped into the stomach during a feed to minimum, thereby reducing the volume of milk that may be vomited.
- Changing nappies before feeding. This will avoid the necessity of lying your baby down when he has a tummy full of milk.
- Avoiding reflux-y foods. If you're breastfeeding, it's best to avoid eating foods that may pass through your breast milk and upset your baby. These can include: spicy foods, caffeince, fatty foods, dairy products.
This article was written by Ella Walsh for Kidspot - New Zealand's leading parenting resource for newborns and baby. Sources include Australian Breastfeeding Association.