We tried everything, man.
There’s plenty of advice out there about how to manage your reflux baby’s symptoms. When I was dealing with the screamy baby from hell I spent hours trawling through them, so for this post I thought I would focus on what strategies we tried and what worked for us (with ratings for usefulness). I’m not going to list the medical strategies here – I’ll do that in a separate post later. Hopefully you find some helpful tips here.
Elevating the cot/crib/bassinet mattress so that baby’s head is higher than their toes. We just used towels but if you have the funds you can go all out and buy a special ‘reflux wedge’. I would give this strategy a 6/10 for usefulness because A was so wriggly that she would inevitably end up in a less than comfortable position (like all scrunched down the end of the bassinet!) and wake up. And scream. It did help reduce the incidences of her choking on her vomit.
Holding baby upright for 20-30 minutes after a feed. This helped us a fair bit. It ensures that most of baby’s food (ie milk) is digested by the time you lay them down so there is less available to be jettisoned up through the oesophageal sphincter. Unfortunately with a newborn it does mean that throughout the wee hours of the night you’ll need to find a way to keep both yourself and baby vertical. Not so easy when you’re chronically sleep deprived and hallucinating from exhaustion. 7/10 for usefulness.
Feeding baby in an upright position. If you’re bottle feeding this is self-explanatory (ie baby is not lying down). If you’re breastfeeding I would strongly recommend you see a lactation consultant, ideally one who is International Board Certified (AKA an IBCLC), for tips on how to do this. The LC will also assess baby’s latch to see if this is causing or exacerbating baby’s symptoms – see this previous post on aerophagia and the link between tongue-tie/lip-tie and reflux. Another thing they’ll look for is an overactive letdown, which is commonly misdiagnosed as reflux. The justification for the positioning is related to the advice to keep the baby upright after a feed – gravity helps to get more of the milk travelling in a downward trajectory. 7/10 for usefulness (a little challenging when you’re fairly generously endowed and also battling with nipple shields).
Baby (infant) massage can help with infant reflux. In addition it has the benefits of calming baby and enhancing the bond between baby and his/her caregiver. This last part is huge because in my darker moments I used to really resent A for being like she was. It’s so hard to love a baby who does nothing but scream all day, no matter how much you sympathise with them. Especially when you’re chronically sleep-deprived. The time spent massaging baby is so lovely and peaceful and they really do seem to enjoy it a great deal. 9/10 for usefulness. 10/10 for awesomeness.
Bodywork. Babies may be experiencing reflux symptoms because their little bodies are still out of alignment from birth. The process of getting out of our bodies and into the world is actually really hard work! Most lactation consultants recommend craniosacral therapy (CST), which is a very gentle, light-touch massage. If you choose to take your baby to a chiropractor, make sure they are very experienced with babies and also that they do very light adjustments. When adjusting your baby, it should just look like a light massage, nothing like what is done on an adult. We took A to see my chiropractor and saw no difference so I was sceptical about the outcomes from seeing an osteopath who specialises in CST. Nevertheless it did actually make a difference to her symptoms. 9/10 for usefulness (if only they weren’t so freaking expensive!)
Tongue-tie/lip-tie revision. For some babies it’s actually a tongue-tie and/or lip-tie that is exacerbating their reflux. See here for more information on the link between tongue and lip-ties and reflux. 7/10 for usefulness – others have had more success and we are actually planning on having A’s ties reviewed by a dentist who does laser revisions. Stay tuned for an update.
White noise helps some babies because it soothes their nervous systems and provides them with something to focus on besides the pain they are experiencing. It worked quite well for A, especially when we held her next to our excessively loud range hood in the kitchen. We ended up downloading some lovely ‘sounds of the sea’ white noise. 7/10 for usefulness.
Slippery elm is recommended by naturopaths to ease reflux symptoms because of its soothing effect on the mucous membranes of the digestive tract.
Slippery Elm (Ulmus rubra) is the inner bark derived from the slippery elm tree. Usually found in a powder form, its name comes from its ‘slippery’ consistency when it is mixed with water. 8/10 for usefulness. It’s also helpful for babies with slow gut motility who are having trouble passing stools as it makes everything a lot more… Slippery!
Iberogast is a herbal remedy containing extracts of Iberis amara (Bitter candytuft), Angelica archangelica (Angelica) root, Matricaria recuitita (Chamomile) flowers, Carum carvi (Caraway) fruit, Silybum marianum (St Mary’s thistle),
Melissa officianalis (Lemon balm) leaves, Mentha x piperitae (Peppermint) leaves, Chelidonium majus (Greater celandine), and Glycyrrhiza glabra (Liquorice) root. It was recommended to me by several naturopaths as a reflux remedy.
According to its website, ‘Iberogast has been clinically proven to treat the discomfort experienced with Irritable Bowel Syndrome (IBS) and functional dyspepsia.’ We found that Iberogast worked the same or slightly better than Colic Calm. 7/10 for usefulness. Certainly better than Zantac!
Colic calm is a homeopathic remedy containing chamomile, fennel, caraway, ginger, peppermint, lemon balm, aloe, blackthorn and vegetable carbon. Because it’s homeopathic it actually only contains minuscule amounts of these ingredients. The vegetable carbon makes the liquid black and it will give baby a black tongue (not to mention black stools!) I’m personally extremely skeptical about homeopathy, but this stuff honestly seemed to calm her down within seconds. It was an absolute godsend for those times that she was screaming non-stop and all the usual tricks didn’t help. 7/10 for usefulness.
Probiotics. I’m going to stress that these are good for all babies but especially reflux babies, and especially reflux babies with multiple food protein intolerances/allergies. Some researchers have found that reflux is exacerbated by bacterial overgrowth in the stomach and intestines. According to these researchers, successful treatment is based on restoring adequate stomach acid production and eliminating bacterial overgrowth. This can be achieved by taking a combination of slippery elm (see above), probiotics and digestive enzymes (see below). My paediatric gastroenterologist was very pleased that we were giving A probiotics. 8/10 for usefulness.
Digestive enzymes are a good adjunct to taking probiotics, because they both help to break your food down into digestible nutrients that can be better absorbed and utilised by the body. See here for more information on the differences between probiotics and digestive enzymes. We bought a product at great expense from the US because a mama on a forum I frequent was absolutely raving about how much it helped her son’s reflux. I definitely feel like it helped me while I was on the elimination diet but I’m not really sure how much it helped A. 6/10 for usefulness.