By Dr Mike Marinus, dad to Megan and James plus a Chiropractor in Blairgowrie with a special interest in family practice and paediatric care. Click here to hear his podcast. This is the 5th in our series on babies by Dr Marinus. Find his other articles here.
Imagine drinking 14 litres of milk a day and then spending 18 hours of every day on your back. Well that’s the equivalent of what babies do every day of their lives, so it’s no wonder these little guys have a tendency to throw up a lot. Babies also have the added bonus of having a valve between the Stomach and the Esophagus that takes a while to become strong enough to hold down the pressure of a full tummy. Add to this that their diet is exclusively liquid and they spend so much more time lying horizontal than our ancestors did and you realize that reflux is a normal, natural part of being a baby. This goes double for Premmy babies because their valves can take even longer to close tightly and chances are they were tube fed in hospital which means the valves have been forced open.
In fact, there is even research to show that as long as your baby is picking up weight correctly and not in any pain, that a certain amount of reflux can take the good bacteria of swallowed breastmilk and move it up into baby’s airways where it is able to fight bad bacteria and other airway disease.
Reflux happens when stomach contents move up instead of down.
Milk that should move from the Stomach into the Small Intestine moves back up the Esophagus because that valve isn’t strong enough to stop it. This is made worse by lots of stomach pressure i.e. overfeeding, general abdominal pressure and even a stomach which takes a long time to empty and doesn’t leave space for the new feed.
This is all fine as long as your baby gains weight, has tons of wet nappies and is generally happy but reflux does become a diagnosable, medical problem when it becomes complicated and that generally means stomach acid is moving up along with the milk into the Esophagus which gets burnt. The Esophagus doesn’t have a protective lining against acid like the stomach does and can be damaged by continued exposure. But even if your baby is refluxing up acid and is vomiting it out of his mouth at least here the acid is being removed from the throat and the burning is less than if it isn’t cleared at all which is the case in Silent Reflux.
Silent Reflux with acid is the one that is often mistaken for colic because no milk comes out of the mouth, so there’s no sign of milk being refluxed, but these kiddies scream with a colicky type cry because of the burning. Typically these children constantly cough, clear their throats and arch away from feeding, breaking the latch and not continuing. They can suffer complications like ear infections, chest infections, poor weight gain and failure to thrive.
What you can do at home?
There are a list of tests your doc can send you to tell if it is silent reflux and if there is acid present and we cover most of them in the podcast. But there is lots you can do at home if you suspect reflux.
- Feed your baby with its head high.
- Keep baby upright for 30 minutes after a feed
- Learn how and when to wind your baby properly
- Sleep baby on his left side after a feed to drain the stomach quickly
- Use a sling/pouch as much as possible
- Avoid extended periods in a car chair because the angle opens the valve.
- Smaller more frequent feeds
Medication / Treatment
Medication is available for reflux if needed but it most cases it is not required. Speak to your doc about what medications do what, how long to be on them and what the possible side effects could be.
In my clinic I have found Chiropractic treatment to be most beneficial when it comes to reflux babies.
Reflux tends to peak at 4 months and can last anything up to 1 to 2 years. Having said that, these babies tend to become much easier when solids are introduced around 6 months of age.