As a new mum, you may have heard the term ‘reflux’ or ‘gastro-oesophageal reflux disease (GORD)’ bandied about at the hospital or your mother’s group. Regurgitating or bringing up a little milk after a feed (also known as posseting) is normal. But when it’s happening after every feed and becomes severe, reflux can be hard to deal with and stressful for both baby and parents.
What is GORD?
Gastro-oesophageal reflux disease (GORD) is a condition whereby the contents of the stomach are regurgitated into either the oesophagus or mouth.
“You may have a very unhappy baby, a baby with very disturbed sleep, a baby who is prone to projectile vomiting or who has greenish or very mucousy stool,” says Amanda Haberecht, naturopath at Darling Street Health Centre and Mygen Health.
Other symptoms for kids include recurrent hiccups, congestion or cold-like symptoms, recurrent respiratory infections, bad or sour-smelling breath, feeding issues such as arching, pulling away and many more. For a more detailed look at GORD generally, please take a look at the Health Direct website. Also, The Royal Children’s Hospital have produced a very useful ‘Reflux GOR fact sheet‘.
According to the Reflux Infants Support Association (RISA), reflux can affect up to 8 percent of children, with some estimating that one in five babies can be afflicted.
What causes reflux?
Reflux occurs when stomach acid leaks from the stomach and moves up into the oesophagus. In babies this is because the muscular valve at the end of the oesophagus is still developing, so food can come up from the stomach. There are other reasons, too, says Haberecht. “Clinically we’re seeing it with increased frequency. There’s definitely an association with food intolerances or too much of certain foods in the mother’s diet,” she explains.
“If you had a caesarian, that also increases the risk of reflux in the newborn due to the absence of the probiotic exchange that happens as the baby passes through the vaginal birth canal. Similarly, certain feeding positions or a fast milk flow can also increase the risk that your baby will develop reflux.”
What to do if my baby has reflux?
If you breastfeed, you may need to change feeding positions, says Haberecht. “You may need to adopt a more upright or football feeding position instead of the traditional cradled position, which may result in a lot of extra air being taken in whilst the baby is feeding,” she explains. “Beginning each feed with the breast you finished the previous feed with may also help, as more hind milk can help line your baby’s tummy to reduce the air associated with the faster and more watery fore milk.”
Breastfeeding mums also need to scrutinise their diet. “Breast milk is often termed ‘white blood’ as everything mum has been exposed to in her diet will end up arriving in the breastmilk,” says Haberecht. “Complex chemicals in foods, too much of a certain food or processed or sugary foods can often contribute to reflux in the baby. But, dietary modifications can often make a huge difference, and probiotics for both you and your baby are also often invaluable.”
Some common foods known to trigger reflux include spicy foods, garlic, onions, broccoli, cauliflower, cabbage and kale. You may also need to eradicate common allergens such as soy, nuts, dairy, wheat and eggs. “A simple test is to look at what you’ve eaten two meals before the reflux episode, as those foods may be likely culprits for the symptoms,” says Haberecht.
When to see a doctor
If your baby’s just bringing up a little milk occasionally after a feed, that’s nothing to rush to the GP about. You can simply try holding your baby upright after feeds, doing smaller feeds more regularly and being sure to burp your baby mid-feed and afterwards. But definitely seek medical advice if the reflux is happening a lot and you’re worried about your baby’s weight gain, if your baby cries a lot after feeds, as if he/she is in pain or if your baby is projectile vomiting.
Treatments can include feed thickeners (available on prescription), anti-regurgitant milks and medications such as Gaviscon. However, as your baby grows, the muscular valve at the bottom of the food pipe gets stronger and it becomes much more efficient at keeping food down, so the problem often rights itself. By ten months only about five percent of babies still have reflux.
Has your baby suffered reflux? What diet changes or treatments have you tried to alleviate the problem?