Sisters Marina Fogle and Dr Chiara Hunt discuss the signs of reflux
Ill babies cry – some more than others, and some seemingly all the time. But when does excessive crying suggest there might be a medical problem? Reflux is when the muscle at the top of a baby’s stomach that keeps milk in after it’s been swallowed is not quite strong enough, allowing both milk and stomach acid to travel back up the oesophagus. This occurs mildly in a lot of babies, causing them to vomit or ‘posset’ after a feed. For most babies this doesn’t cause any pain and they keep enough milk down not to lose weight. However, when reflux is severe it can cause discomfort or worrying weight loss.
Silent reflux is when the baby doesn’t vomit but the acidy milk keeps travelling up and down the oesophagus. This is often painful and can be more difficult to diagnose, as these babies tend to scream the whole time but don’t vomit any more than normal.
Silent reflux is often confused with colic, as the symptoms are similar. Babies with both are clearly uncomfortable, but babies with reflux tend to cry all day, while colic tends to affect babies more in the evenings. Colic can be eased with over-the-counter remedies such as Infacol, and babies tend to grow out of it between 10 and 12 weeks.
Many paediatricians feel the reason we see more cases of reflux nowadays may be because we are more likely to put babies to sleep on their backs. Although babies suffering reflux would be more comfortable sleeping on their front, putting babies to sleep on their backs significantly reduces the risk of cot death. So, as tempting as it might seem to relent and put your baby to sleep on her front, don’t – it’s not safe.
Most cases of reflux can be diagnosed by a paediatrician or GP simply by examining the baby. In complicated cases, tests can be done to confirm the diagnosis, but these are somewhat invasive so are not done routinely.
The treatment for both reflux and silent reflux are the same. Most cases are mild and require only simple measures to make baby more comfortable, but others require medication prescribed by doctors.
As miserable as it can be for both of you, rest assured that the vast majority of little ones will grow out of it, most within the first six months of life, or when baby is established on solids – even without treatment. And most ‘refluxy’ babies turn out to be robust, healthy and happy toddlers, full of beans and ready to explore the world.
• Keep baby upright as much as you can, particularly during and after feeds.
• Feed little and often, particularly if your baby is vomiting a lot.
• Dummies can help as they encourage baby to suck the acid back down.
• A warm pad on baby’s tummy can ease the pain.
• Reflux is sometimes linked to cow’s milk protein allergy, especially if baby also has eczema. Try a cow’s milk-free formula, or if you’re breastfeeding, try excluding cow’s milk from your diet for two weeks.
• Gaviscon Infant coats the stomach and oesophagus, protecting it from the acid. It also acts as a thickener, causing the milk to sit more heavily in the stomach.
Dr Chiara Hunt and Marina Fogle are founders of The Bump Class, which provides antenatal classes in South Kensington and Parsons Green. thebumpclass.com