Getting to the root cause of your baby’s reflux
Getting to the Root Cause of Your Baby’s Reflux
It is very commonplace for babies to be diagnosed with reflux, and treated with medication within the first year of their life. But, reflux is more likely to be a symptom than a disease in itself. Reflux is a common concern for parents who seek my support, because it can very frequently lead to sleep disturbances. Treating reflux effectively can drastically improve the sleep of your infant or child.
In this blog post I’ll discuss the symptoms of reflux, provide some information on how common medications for reflux work (and why they often don’t work), and then discuss ways that you can get to the root cause of your baby’s reflux in order to avoid medical intervention.
Symptoms of Reflux
Excessive crying/colic
Vomiting
Vomiting and then swallowing back down (also known as silent reflux)
Gassiness
Squirming and grunting
Congestion
Back arching
Uncomfortable laying flat on their back
Sleep disturbances
Noisy breathing
swollen/bloated tummy
What Causes Reflux?
Reflux is often blamed on the fact that your baby’s esophagus (or food pipe) is not fully developed, therefore milk can easily come back up, causing spit-up and the other uncomfortable symptoms of reflux. While it is true that the food-pipe is immature; this does not seem like the only explanation for reflux. Babies are biologically designed to consume milk, specifically breast milk from the breast; and many babies do not suffer from reflux, even though every baby has an immature esophagus. Wouldn’t it stand to reason that all babies would then suffer from reflux? In reality, babies are designed to drink milk, and should be able to do so without reflux. Reflux may be common, but it is not normal, it is the sign of something deeper going on.
Feeding Difficulties
The main cause of reflux in young infants is feeding issues. Babies who are not feeding properly are likely swallowing excess air, causing the severity of their reflux. The first thing you should do if your baby is experiencing reflux is see a lactation consultant who can make sure your baby is latching effectively, and assess your baby for tongue-tie or any other oral dysfunction that could be at play. Oftentimes, having proper breastfeeding instruction can help tremendously. If you hear clicking at the breast, experience nipple pain, have a child that is fussy at the breast, see milk spilling out the sides of your baby’s mouth when they nurse, etc. these are strong indicators of a latch problem. If you are bottle feeding or using formula, you should still have your baby assessed to ensure optimal oral function.
Another step in the right direction is choosing the best bottle. Wide “breastlike” bottles might seem like a good idea, especially if you are breastfeeding and giving pumped milk in a bottle, it can be really difficult for babies to get their mouths far enough around these bottles to get a good seal, or latch. Oftentimes babies are sucking on the very narrow nipple area of these bottles and sucking in a lot of air. A lactation consultant can help you select a bottle, nipple shape, and flow that will be optimal for feeding your baby. Some recommendations are the Evenflo and the Lansinoh bottles, which have a good nipple shape. Dr. Brown’s bottles are also known to be quite effective in helping eliminate air bubbles in the bottle.
If you are formula feeding, you are very likely shaking the bottle to mix the water and formula powder together (I myself once joked that I looked like a bartender mixing a cocktail, festively shaking together a bottle of formula for my son). In truth, the shaking is causing the formula to foam. Foam is literally just bubbles of air that your baby is then swallowing, increasing the likelihood of gas and reflux. Try instead stirring the formula to mix it, and then gently tipping it from side to side to help dissolve clumps. Additionally, you can purchase the liquid formula that requires no mixing; avoiding bubbles that way (although these do come with a higher price tag).
If you are bottle-feeding your child, you should educate yourself on the PACED method of feeding. This allows your baby to control the pace of the feed, and keeps the milk flow manageable, feeding your baby like this can prevent other issues as well such as over-feeding (which can cause reflux) and ear infections.
Birth Trauma/Body Tension
Sometimes a feeding issue might be caused by tension in the body that prevents your baby from getting full range of motion to latch and suck properly. A difficult or precipitous birth can lead to restrictions in the body, as can your baby's position in the womb. If your baby favors one side when nursing, seems to curl in on herself, seems to cry in pain in some positions, or feels tight when you try to stretch her limbs, it is worthwhile to find a body-worker, such as a pediatric chiropractor or cranio-sacral therapist, who can help release these restrictions. Oftentimes these professionals can also help return normal oral function to an infant after a tongue or lip tie revision.
Food Intolerances and Antibiotic Exposure
While feeding difficulties are the most common cause of reflux, food intolerances and antibiotic exposure can also be culprits as to what is causing your baby’s discomfort. In one study conducted from 2010-2015 found that nearly all patients who were involved in the study also tested positive for a food intolerance, with the most common intolerance being dairy. This study was conducted on adults, however, babies on formula are taking in quite a bit of dairy, and even those who are breastfed may be getting dairy if their mother is consuming it. Many babies will show improvement to reflux symptoms when switched to a hypo-allergenic formula (one that breaks down the cow’s milk protein, not a soy based formula) or when the breastfeeding mother removes dairy from her diet. If your baby is experiencing symptoms such as blood or mucus in their stool, eczema, or hives, along with their reflux symptoms,bring it to your doctor’s attention, and consider eliminating dairy, to see if it eases your child’s symptoms.
Antibiotics such as those given during C-sections, or during labor for women testing positive for Strep-B, can also have negative impacts on your baby’s gut, which can cause reflux. Talk to your doctor or a nutritionist trained to work with babies and children about probiotics, and other strategies from improving gut health.
What about Medications?
Likely if you’ve already spoken to your pediatrician about reflux concerns, you have been given options to medicate. Medications for reflux work in one of two ways. 1) they decrease the production of stomach acid, so there is less acid to spill out. This can cause digestive issues because stomach acid plays a vital role in digestion. 2) More commonly they change the PH level of the acid in your baby’s stomach so that it does not burn on the way up. Oftentimes your baby will be prescribed a medication such as Famotodine, and kept on it for the majority of the first year of their life. This is problematic because it can negatively impact the natural function of the digestive system. Babies can also experience side-effects to these drugs, such as upset stomach and headache.
In addition, the medication will not treat the root cause of the problem, so your baby with reflux will still experience a multitude of symptoms that go along with feeding problems, oral dysfunction, food intolerances, or body tension that has gone untreated.
A Few Thoughts to Leave You With
When you’re in the thick of it with reflux, no one can blame you for seeking out quick relief for your baby (and for yourself!). Unfortunately, medicine just isn’t the silver bullet that some pediatricians claim it to be, and could cause a delay in addressing the root cause of symptoms, as well as coming along with a number of side-effects. If you’re not sure what to do, start with a feeding assessment! Start there, and you’ll be well on your way to getting the answers you’re looking for.
