Reflux management tips

Every parent is desperate to find some way to help their baby who suffers from reflux. Here are a few ideas that may help, however we strongly recommend that you talk to your doctor or childhood health nurse for more information.

Positioning While Awake

Each baby will have their own preferred position that makes them more comfortable. Unfortunately it may take a little trial and error to find the one that suits your baby best. Here are a few positions to try:

• Upright or with their head propped over your shoulder.
• Lying on your forearm with their head supported in the crook of your elbow and your hand holding their crutch. Create an angle of about 30 degrees.
• Seated in an upright position, do not allow your baby to slump in this position.
• Leaning backwards at about 45 degrees.
• Some babies like to lie on their tummy with their head propped up slightly.
• At nappy change time try to avoid lifting their legs up into the air. Roll them to the side instead and if possible change their nappy before a feed rather than after.
• A front pouch or sling may allow some relief for baby while giving you the opportunity of hands free time.

Feeding a Baby with Infant Reflux

If you are breastfeeding there is no reason why you should introduce formula into your baby’s diet. “Breast is Best” even for a baby that suffers from reflux. It is thought that because breastmilk is able to be digested more quickly than formula that this may be better for babies with reflux.

If you are bottle feeding there are several formulas available that are specifically designed for a baby with reflux. Check with your childhood health nurse for more information. Thickened formula makes a dramatic improvement for some reflux babies, but for others, there may be no effect. Some may even do worse on thickened formula.

Positions for Feeding

• Some breastfeeding mothers find success with the “Twins position” (under the arm) or if your baby is a little older you could try feeding with them sitting in front of you sitting upright on your lap.
• If you are bottle feeding your baby try to keep them in an up right position if possible.

Try to establish a feed/play/sleep routine to allow time for your baby’s milk to digest before lying them down for sleep. Avoid allowing your baby to fall asleep while feeding as this will probably lead to a catnap with your baby waking in pain soon after the feed has finished.

Some babies learn that the milk they crave is also the source of their pain and so are reluctant to attach or they may pull off repeatedly during a feed. Some babies learn that milk is soothing while they are drinking, and want to do so frequently (comfort feeding) Crying and back arching during feeding is common in babies with reflux.

Here are a few suggestions for feed time that may work for you; trial and error is the key until you find one that works for you both:

• Lengthen the times between feeds or alternatively shorten the time between feeds and offer less.
• Try feeding from just one breast.
• Or offering both breast with a short break in between sides.
• For older babies follow the feed with a small amount of solids, this is thought to help to keep the milk down. Younger babies may be able to cope with a small spoonful of thickened milk (formula or breastmilk).
• If you are breastfeeding you may wish to avoid some foods that may pass through your breastmilk and affect your baby. Some foods that are thought to have some affect on reflux in your baby are dairy products, caffeine, spicy, fatty or acidic foods. You may wish to follow an elimination diet, speak to your doctor for more information.
• Reflux babies are often more easily distracted during a feed so try to feed in a quiet environment, or a darkened room. You could try feeding your baby while they are still half asleep following their nap.

Sleeping a Baby with Infant Reflux

Many babies with reflux also suffer from a very disrupted sleep pattern. Lack of sleep for both you and your baby can exacerbate the general irritable feelings you experience. Here a few tips for sleep time:

• Always sleep your baby on their back.
• Raising one end (head) of the cot may be beneficial in helping your baby sleep. You can do this by placing phone books, rolled up towels or pillows underneath the mattress. If there is no noticeable improvement, there is no need to perservere.
• Possibly using a dummy at sleep time may offer some relief.

Massage!

Infant massage is a wonderful tool to use for developing a bond between parent and child and has proven benefits for your baby suffering from reflux. Here are some of the benefits to your baby.

• Relaxes your baby.
• Helps to develop a bond of trust.
• Massage can improve your baby’s sleep.
• Helps to boost the immune system.
• Improves blood circulation and skin condition.
• Massage can aid digestion.
• Massage can also give relief to babies suffering from colic and reflux.

Many hospitals and Birth Centres run courses on infant massage that you can attend during your stay or you can contact the Infant Massage Association to find a qualified instructor near you.

Here are a few tips on the basics of infant massage to get you started.

• Ensure the room is warm and your baby is not in a draft.
• Only proceed with the massage if you are feeling relaxed and your baby is generally settled, unless you are performing the massage to help relieve pain.
• Start on the legs and move upward through the body.
• Use long firm strokes.
• Do not place any pressure on the abdomen.
• When massaging to relieve pain from colic, use a circular motion starting on your baby’s right hand side of her stomach. It is best to seek advice from a qualified instructor prior to commencing this routine to ensure that you apply the correct amount of pressure.
• Use a moisturizing lotion or a cold pressed almond oil. These are beneficial to your baby’s skin and are easily absorbed.
• Some aromatherapy oils can be used to assist babies with reflux.

For books that provide a general overview of infant massage, visit the Huggies Book Club.

For more information see Baby care