Understanding Reflux

 

Reflux can be soul destroying for some parents. When the expectation is a baby that feeds well, settles quickly and sleeps for a long time, is replaced by a reality of a fractious baby that only catnaps and is often covered in vomit it is understandable that parents who have a baby effected by reflux can often feel bewildered, exhausted and sometimes sad.

Gastro-oesophageal Reflux

Reflux occurs when the muscle between the baby’s stomach and oesphagus (food pipe) relaxes and allows the contents of the stomach to flow back up the oesphagus resulting in vomiting or positing. This is a relatively common condition and generally peaks between 1 and 4 months.

Gastro-oesphageal Disease (GORD)

Reflux can sometimes lead to complications including damage to the oesphagus (oesphagitis) and more severe symptoms. Symptoms may include:

• Vomiting
• Failure to thrive
• Irritability
• Feeding difficulties including crying while feeding and poor feeding
• Coughing

The following would need to be reviewed by your doctor more urgently:

• Vomiting bile (green/yellow fluid)
• Projectile vomiting or excessive vomiting
• Blood in vomit or stools
• Swollen or tender abdomen
• Fever
• Weight loss or poor weight gain
• Severe constipation
• Breathing problems

Silent Reflux

Babies with silent reflux often show signs of being in pain because of the upward movement of the stomach contents into the osephagus but there is no vomiting.

Managing Reflux

Reflux is a medical condition but as it presents in various degrees it may take time for a diagnosis to be made. This can be a frustrating time for the parents who are trying to cope with an unsettled and perhaps poorly feeding baby.

The management of reflux can range from practical parenting tips right though to medication and in more serious cases – hospitalisation or even surgery.

Feeding Advice

• Smaller more frequent feed
• Keeping the baby in an upright position for 30 min after a feed and avoid bouncing
• Regular burping after feeds
• If formula feeding, consider (in consultation with your Doctor) using thickened feeds or if there are allergies or sensitivities think about a hypoallergenic formula

Other Tips

• Consider using a dummy
• Change the nappy before the feed so they are not lying flat after the feed to be changed
• Avoid tight clothing around the abdomen
• Massage can be soothing and assist with digestion

Medication

If medication is required, the doctor may suggest one or a combination of the following:

• Protien Pump Inhibitors (PPI) eg Losec, Nexium, Somac and H2 Blockers eg Zantac
These medications inhibit the production of stomach acid

• Alginates eg Infant Gaviscon
These medications thicken the stomach contents and reduce the regurgitation. These should not be used with other thickening agents of thickened formula

• Analgesia eg Panadol
Panadol can be used but not for longer then 48 hours unless directed by a doctor

Look After Yourself

Being a parent of a reflux baby can be tough. It is essential you look after yourself.

• Accept help when offered and do not be afraid to ask for help
• Make sure you are eating well and sleep as often as you can
• Don’t blame your self or feel you are doing something wrong
• Trust your own parenting instinct – you know your baby better than anyone
• Watch for signs of postnatal depression. Due to the stress and lack of sleep parents of infants with reflux are more prone to PND.
• Make sometime for yourself - go for a walk or get a massage

Navigating life with an infant with reflux is challenging. It is important to seek help from a doctor and get support from other health professionals and family.

Resources and Advice

Reflux Infants Support Association

https://www.reflux.org.au/

Ngala

https://www.ngala.com.au/

Australian Breastfeeding Association

https://www.breastfeeding.asn.au/bfinfo/reflux.html

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