What is reflux?
Gastro-oesophageal reflux, commonly known as reflux, is the movement of stomach contents back up into the oesophagus (gullet) – the tube which connects the stomach to the mouth. In many infants the valve at the top of the stomach (the lower oesophageal sphincter), is not fully developed, so instead of preventing backflow it allows milk feeds to reflux. It is an unpleasant and distressing condition for your baby, but there are some simple measures you can take to help reduce the problem.
Reflux occurs in at least 50 per cent of new born babies and is very common during the first three months. The baby with mild reflux may ‘overflow’ or spill small amounts of milk after every feed. Or at least once a day, the baby will regurgitate and sometimes vomit quite forcefully after a feed. Mum finds herself with a new fashion accessory – the nappy worn over one shoulder!
Most of these babies have what is termed uncomplicated reflux. This reflux is painless and many a smiling baby happily spills over everything and continues to grow well. Generally by six to nine months reflux spilling is much less frequent and it usually resolves itself by 12 months of age.
Though spilling is a normal part of baby behaviour, reflux can range in degree from mild to severe. More severe reflux can be very distressing for both baby and parents. If vomiting is excessive, baby screams or cries and back-arches during or after feeding, or takes just a small feed then refuses more, is irritable and unsettled, of course parents become anxious, over tired and frazzled.
What can I do to reduce reflux problems?
- Continue to breast feed. Breast feeding is best for a reflux baby. Whether breast or bottle feeding, hold baby more upright when feeding. This helps prevent stomach contents flowing back up into the oesophagus.
- Avoid over feeding Give smaller, more frequent feeds to lessen the amount of milk in the stomach at any time.
- Try thickened milk feeds Consult your child health professional on using thickened feeds to reduce spilling. Karicare Food Thickener can be mixed with a small amount of expressed breast milk or boiled water and given as a gel or paste, before, after or during a breast feed. Or it can be added directly to expressed breast milk. Also available are thickened anti-reflux formulas, such as Karicare AR formulas, which help reduce regurgitation.
- Burping technique To burp, hold baby upright, with the head resting on your shoulder and legs extended. Avoid keeping your baby in the sitting position as this can increase pressure on the stomach and encourage reflux.
- Change nappy before feeding and avoid fastening nappies too tightly. Lifting baby’s legs above the stomach can encourage reflux especially after a milk feed. Prop baby up on a pillow when changing nappies.
- Upright Position When baby is awake keep him/her as upright as possible. Baby pouches, carriers and slings are hands-free ways to keep baby comfortably upright.
- Sleeping position – elevate head slightly Raising the baby’s head during sleep or while lying down can help prevent reflux. Slightly tilt the baby’s bassinette or cot, or place a small pillow or folded blanket under the mattress at the head end. It is recommended that babies be positioned to sleep on their backs. However if a baby has more severe reflux problems your doctor may suggest lying the baby on his/her left side. Discuss this with your health professional.
For more information on Gastric Reflux see http://www.cryingoverspiltmilk.co.nz/