Combatting reflux

Having worked extensively in the children’s ward, nurse Stephanie Holdsworth immediately recognised the signs of infant reflux when her ten day old baby began screaming after every feed.

“My daughter started off being breastfed, at the time she would very happily feed and then would violently un-attach and start screaming,” says Stephanie.

“The scream is something a mother can never forget, it was the scream of absolute pain, her tiny fists were clenched and she arched her whole body while screaming.”

The following day Stephanie noticed blood in her baby’s vomit and rushed to the hospital.

After numerous tests, an endoscopy was ordered which showed allergic esophagitis

Because her daughter’s case was so severe, Stephanie ceased breastfeeding and began offering hourly feeds of a partially hydrolysed formula and thickener.

“Because the proteins are partially broken down in this type of formula she did not have to work so hard to digest the feed, the smaller thicker feeds also allowed her to keep the stomach contents in her tummy.

“She continued with the medication and Mylanta as needed and she quite often slept up on my husband’s chest very soundly after each feed, we never put her down after feeding”.

“Under medical advice we elevated the top of her cot by placing phonebooks under the front legs.”

Of course this case sits on the extreme end of the spectrum when it comes to reflux.

Reflux is actually a relatively common condition in newborns and can vary greatly in severity, which is why it’s important to have it diagnosed by a healthcare professional.

“Babies can have mild reflux which may make them a little grizzly and can be managed with a few diet and lifestyle changes to severe where medication and investigation is required,” says Stephanie.

What is reflux?

In basic terms reflux is a backflow of stomach contents – including gastric acid – up the oesophagus.

“The most common cause of reflux in babies is a weak muscular valve (called the Oesophageal Sphincter) that allows food to enter the stomach from the oesophagus and usually stops food traveling back up the food pipe,” says Stephanie.

“Sometimes when a baby’s small tummy is very full, stomach contents can be pushed back up through the oesophagus causing a baby to vomit.

“Food allergy and food sensitivity may also be the cause of reflux.”

What are the symptoms?

The symptoms of reflux can vary, which is another reason why it’s so important to see a professional for a definite diagnosis.

Symptoms can include:

  • Baby pulling away during feeding and back arching
  • Screaming/irritability after each feed
  • Vomiting and positing
  • Coughing after feeding
  • Cat napping or not sleeping soundly
  • Not gaining weight or losing weight
  • Recurrent ear and sinus infections
  • Recurrent chest infections

How can reflux be managed?

When reflux is mild, there are some things you can do to ease you baby’s discomfort:

  • Try to feed bub in an upright position.
  • Don’t lay baby down immediately after feeding, try to keep her upright for 20 minutes after feeding (placing over the shoulder or an upright cuddle is a great way to do this).
  • Avoid clothing which is tight around the waist, placing pressure on the stomach.
  • Offer baby smaller more regular feeds, this allows the tummy to empty keeping baby more comfortable.
  • Don’t place baby in a jumper or play a lot of bouncy games.
  • Only offer Tummy time when the tummy is empty (in between feeds).

When to Seek medical advice?

Stephanie recommends seeking medical advice if you even suspect reflux for a definite diagnosis, due to the possible variations in severity and required treatment.

Urgently seek medical advice if you notice any of the following:

  • Blood in baby’s saliva/vomit
  • Baby constantly pulls away and appears to be in pain during the feed
  • Baby consistently vomits after each feed
  • Baby has a temperature
  • Baby is losing or not gaining weight
  • Baby is screaming after each feed
  • Baby coughs persistently after each feed

Follow your instincts

The good news is, most babies outgrow reflux before their first birthday, with many only suffering from the condition for the first few months.

“Trust your instincts!” says Stephanie.

“I think you know yourself the difference between a ‘something’s not right’ cry and an ‘I’m in extreme pain’ cry.

“See your GP or child family health nurse, these people are a wealth of information and will in no way judge you.

“Sometimes we just need help and that is completely ok!”

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