Let’s begin by saying I had never heard of infant reflux before A came along. I’d heard about adults having it and it sounded horrendous. I suffered from pretty epic heartburn whilst pregnant both times, but absolutely nothing prepared me for the total, life-changing horror of having a baby with infant reflux (AKA acid reflux, gastro-oesophageal reflux, gastric reflux).
When the symptoms first started showing I immediately jumped on Dr Google. After feeds A would start screaming, usually within 5 minutes, arch her back, flail her arms around, hiccup and go really stiff like a board yet super squirmy like a cat that doesn’t want to be petted. She was a constant bundle of misery and wouldn’t sleep for more than 10 minutes at a time. I searched for ‘baby screams after feeding’ and instantly hit on a million articles about infant reflux. I also came across a few articles about colic.
I took A straight to our family doctor who has additional specialist qualifications in childhood health, although he’s not a paediatrician. He examined her and said to me, ‘all babies cry. They’re all unsettled during the first six weeks. I wouldn’t recommend any medication – they have terrible side-effects, and besides, all babies have reflux because their oesophageal sphincters are immature. She looks fine to me. I’m sure she’ll settle down – it’s probably just colic and she’ll grow out of it.’ Well… more on our story can be found at The Story of A but suffice it to say that she most certainly did have problematic reflux and I wish I’d been able to attend that first appointment armed with more of the knowledge and confidence that I have now!
So what is infant reflux?
Infant reflux is where the contents of the baby’s stomach (food and digestive acids) are brought up into the oesophagus and regurgitated. The baby may then vomit out or ‘spit up’ the stomach contents (which in the case of very young babies is usually the milk they just drank). The acid can burn and may cause the baby great discomfort and/or pain. Adults often refer to reflux symptoms as indigestion.
In many cases reflux is simply an unfortunate side effect of an immature lower oesophageal sphincter. As the baby or child matures so does the ring of muscle at the top of the stomach, which controls the flow of food from the oesophagus into the stomach and is supposed to prevent stomach acid and digested food from going back up again.
Bryan Vartabedian’s book Colic Solved was the first thing I read that gave me a comprehensive understanding of infant reflux. The author is a paediatric gastroenterologist and the book is a thoroughly researched account of some of the real causes of ‘colic’ and ways of dealing with it. He notes that ‘many if not most cases of colic are actually caused by acid reflux’. In Chapter Three he details the ‘Seven Signs of Reflux in Your Baby’ including:
- Spitting up and vomiting (as well as ‘wet burps’)
- Constant hiccups
- Feeding disturbances
- Chronic irritability
- Discomfort when lying on the back
- Sleep disturbance
- Chronic cough and/or congestion
Dr Vartabedian also discusses gas as an ‘unexpected consequence of feeding problems’, because babies with reflux typically swallow a lot of air while they’re feeding.
The chapter that really opened my eyes was Chapter Five, ‘Milk Protein Allergy’ AKA cow’s milk protein allergy/intolerance or CMPI. As discussed in The Story of A an osteopath initially suggested to me that dairy might be the source of Ada’s woes, but it was in Colic Solved that I learned about the symptoms of CMPI and realised that it was indeed a problem.
However, as informative and practical as Dr Vartabedian’s book is, it doesn’t mention tongue or lip ties as a cause of reflux at all. Instead it urges parents of reflux babies to treat with medications, and describes seeking alternative treatments such as aromatherapy and chiropractic as ‘just a couple of the extreme measures that parents will resort to when faced with the feeling that there’s nothing that can help their baby.’ As someone who sought and found great help from osteopathy for A’s reflux, not to mention having bodywork recommended by Dr Nigro after getting A’s tongue tie and lip tie revised, I found the absence of thorough discussion on these topics and treatments disappointing.
More on tongue tie and lip tie and their connection with reflux coming soon…