Helping Your Baby With Reflux (GERD) Sleep Better

 
Baby Infant Reflux GERD Sleep Tips
 

GERD may be its official name, but most of parents simply call it reflux (or perhaps acid reflux). And if you have an infant with reflux at home, then you know first-hand what sleepless feels like, don’t you?

We work with so many families who have a baby with reflux, so we’ve learned a thing or two about how to help alleviate infant reflux symptoms, and to help babies with reflux sleep soundly.

Keep reading for all details!

Symptoms of Infant Reflux/GERD

First, we should really look at what the most common symptoms of baby reflux and GERD are. Common symptoms* include:

  1. Spitting and vomiting
  2. Constant hiccups
  3. Feeding disturbances
  4. Chronic irritability
  5. Discomfort when lying on the back
  6. Sleep disturbance
  7. Chronic cough and/or congestion

*from the book Colic Solved, by Bryan Vartabedian – an excellent resource if you have a colicky baby with reflux at home!

So many parents we work with suspect their infants might have acid reflux, but haven’t checked with their healthcare providers yet. If your baby has the reflux symptoms listed above, make an appointment with your healthcare provider and take steps toward treatment. Some healthcare providers prefer to wait for symptoms to subside or improve, while others prefer to start medication sooner rather than later. Either way, you will want to plan a course of action with your healthcare provider before you start to work on improving sleep.

Also, remember that while spitting up is considered a classic sign of reflux, there is such a thing as “silent reflux”. If your baby seems fussy and uncomfortable after eating (especially if you lay him down after eating), or if you hear lots of tummy gurgling after your baby eats, silent reflux may be to blame.

Why Baby Reflux/GERD Interferes With Sleep

Speaking of sleep – why exactly does baby reflux interfere with sleep? Simply put, babies with GERD are in fairly constant pain and discomfort. The stomach acid that comes up repeatedly after feedings can seriously irritate the lining of your baby’s throat, and cause a feeling of constant heartburn.

What’s more, laying your baby flat on her back to sleep (which is the safest way for babies to sleep, in order to reduce the risk of SIDS) tends to make the symptoms of reflux and GERD even worse. So really, the best and safest sleep position for your baby is also one of the worst positions for her acid reflux!

No wonder, then, that baby reflux and GERD causes disturbed sleep! Babies with reflux tend to have trouble sleeping through the night and taking long, restorative naps, since their discomfort makes it hard for them to stay asleep.

How To Help Your Infant With Reflux/GERD Sleep Better

Keep in mind that the majority of newborns and young babies have occasional bouts of reflux – some spitting up here and there, or a bit of tummy pain is very normal for newborns, as the sphincter muscles that keep stomach contents down aren’t well-developed. Most babies outgrow their reflux symptoms as they mature. However, babies with severe reflux, or GERD, may struggle with reflux symptoms for months on end, and be extremely uncomfortable after feedings.

If your baby is young (3 months old or younger), or if your baby’s reflux symptoms are fairly mild, there’s a lot you can do to alleviate the problem at home, without medication. Those steps include:

  • Keeping a log of your baby’s feeding times, as well as periods of discomfort. This will help you cross-reference when reflux symptoms appear in comparison with when baby ate last, and that may help you see patterns that you can address.
  • Holding or sitting your baby slightly upright after feedings, for 20 or 30 minutes. You don’t want to hold your baby completely upright, but rather, you want your baby to rest at a reclined angle (think 30 or 45 degrees) until the formula or breastmilk she just drank is digested. If you lay her down flat right after a feeding, there’s a good chance that much of that meal will come right back up.
  • Consider using a wedge under your baby’s crib mattress, to help elevate her upper body. We like this one, from Dex Baby. If your baby is wiggly, and prone to sliding down off the wedge, you can use a product like the Baby Stay Asleep to help position your baby on the wedge, and prevent her from wiggling off.
  • Comfort your baby often, but try to begin weaning away from sleep associations as your baby grows. It’s so natural to want to comfort a baby who’s in pain – and that’s what you should be doing! Especially in the first few months of your baby’s life, you can’t possibly spoil her, so do whatever you need to in order to help her feel calm and cared for. Yes, things like rocking your baby to sleep, or holding her while she sleeps, may become sleep associations you have to undo later, but in the newborn stage, we recommend that you do whatever you have to do in order to get sleep – and that goes for caring for your baby with reflux, too!

    However, as your baby gets older, and passes the 4 month sleep regression, it’s time to start gently weaning your baby away from any sleep associations, like rocking to sleep, or sleeping in the infant swing. Remember, the reflux will eventually resolve itself, but the habits your baby develops may stick around, so do your best to begin gently undoing them as your baby grows.

  • Sleep Training A Baby With Reflux or GERD

    It’s one thing to manage your baby’s reflux, but what about when you’re sleep training? Well, for starters, we strongly recommend that you see a healthcare provider and get your baby’s reflux under control before attempting to sleep train. Again, minor reflux usually resolves itself as your baby grows, but more GERD often requires medication.

    Once your baby’s reflux is being treated, you can sleep train with confidence. We usually recommend that when you are working on sleep training, you’ll want to move the last feeding of the night to an early point in the bedtime routine, since you’ll need to hold your baby semi-upright for 20 or 30 minutes before laying him down for bed. You’ll also need to do the same for middle-of-the-night feedings, too – just be careful that as you hold and rock your baby, you don’t rock him to sleep!

    You’ll also want to be realistic in your feeding expectations, if your baby has reflux. Remember, babies with reflux need to eat smaller, more frequent meals. So it may not be realistic for you to expect a 5 month old baby with reflux to sleep 10 straight hours through the night! Instead, plan for more frequent feedings – and plan to night wean a bit later than average, as well. We often find that babies with reflux continue needing night feedings longer.

    Personalized Sleep Help That Takes Your Baby’s Health Into Account

    Sleep coaching a baby with reflux can be truly tough…you have to walk the tightrope of helping your baby feel comfortable and alleviate her pain, while also working to avoid any negative sleep associations that will mess with your sleep coaching plans.

    So why not let us help? Our team of highly-trained, caring sleep consultants has worked with thousands of families like yours – they know exactly how to account for your baby’s reflux and GERD while still ensuring that you have Personalized Sleep Plan™ that will teach your baby positive sleeping habits and move your whole family towards sleeping through the night.
     
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    Want more information about how personalized help works? Check out our FAQ page here, and get answers. You can also take a tour of the Helpdesk.

    Has reflux or GERD affected your baby’s sleep? What about sleep training? How have you coped? We love your stories and tips – let’s hear ‘em!

     
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How Your Baby’s Spit Up and Acid Reflux Affects Sleep

Baby Sleep Acid RefluxThe diagnosis of baby acid reflux appears to be on the rise. We talk to many parents each week and a good number will have babies with reflux. Although it seems to be diagnosed more now, babies having reflux is actually not new and very common. This article will talk about your baby’s spit up, infant reflux, and how it may affect your baby’s sleep.

What is baby acid reflux?

First, what is reflux? The medical name is Gastroesophageal Reflux and some know it by GER. All this means is that stomach contents come back up the esophagus. The definition of “reflux” is “a flowing back.” When put that way, it shows you just how common it is. Babies are known to spit up a lot and I’m sure many of us can relate to how cute newborn clothes are, but they are only on your baby for a couple hours at a time and you’re doing laundry daily due to spit up!

And, why do babies spit up?

Your baby spits up or has reflux due to an immature digestive tract. As your baby grows, the tract will mature and less stomach contents will be regurgitated. The ring of muscle where the esophagus meets the stomach is soft in a baby and becomes firmer as your baby grows. Most babies outgrow spitting up and reflux by 12-18 months old.

What are the signs and symptoms of reflux?

The biggest symptom, of course, is spitting up (usually after a feeding, but not always), but if your baby has “silent reflux” he can be uncomfortable without the spit up, too. Your baby may also be fussy during a feeding and some even cry while you’re feeding them. :( You might hear gurgling sounds during or after a feeding. If your baby cries a lot when laid on his back after a feeding, he may be experiencing discomfort from the food traveling back up. If your baby eats smaller, frequent meals, refusing to eat larger bottles compared to other babies his age (within reason), he may be experiencing reflux.

Do you have to worry about your baby’s spit up and reflux?

For most babies, some spit up is normal and it does not bother them too much. Some even call them “happy spitters.” If your baby is having enough wet diapers, is gaining weight appropriately, and otherwise happy and content, your doctor will most likely not prescribe any medication for the reflux. Some babies will feel uncomfortable immediately after spit up or a feeding, but otherwise may be okay, and those babies won’t usually get medication, either. For more severe cases of reflux, your baby may not eat enough or spit up too much, and can have weight gain issues. Others are simply miserable much of the day and have more frequent night-waking. For these babies, your doctor may prescribe medication, which we have begun to hear more and more about lately. If you are concerned about your baby’s spit up and suspect she may have a more severe case of acid reflux or a more serious condition, please do talk to your baby’s doctor.

How does your baby’s reflux affect sleep?

Babies with reflux typically need to eat smaller, more frequent meals. This avoids their tummy being too full, which can increase the likelihood that food will come back up. Your doctor will also likely tell you to feed your baby upright and to keep your baby upright for a period of time after eating (usually ~20-30 minutes), before laying him down on his back. A baby with reflux will then need special sleep strategies. Here are some tips:

  • Consider raising up one side of the crib mattress such that the baby is sleeping with an incline. Of course, you have to be cognizant about a mobile baby rolling too far down to the other end of the crib. You can consider something like the Baby Stay Asleep for your baby to keep her from moving around too much.
  • Have appropriate expectations. Can you get your baby with reflux who wakes every hour to sleep 12 hours straight? Maybe, Maybe not. It doesn’t mean you can’t improve your baby’s sleep and I do encourage parents to try using a No-Cry or Limited-Crying Sleep Training Method, because too much crying can aggravate the reflux.
  • For severe cases of GERD, I recommend getting the reflux under control prior to helping your baby learn to sleep better. If you’re just starting medication, allow for some time to see if the medication is working before starting to teach baby new sleep habits. If you are wondering if baby is uncomfortable because of reflux, then this will likely lead to too much inconsistency and more frustration for all of you.
  • If you are sleep training, make sure you move the feeding earlier in the bedtime routine. If you have to hold your baby for an additional 20-30 minutes after a feeding, it increases the likelihood that she will fall asleep being held. This is NOT a problem UNLESS she then wants to be held all night and is no longer a newborn. We learned that sleep associations play an integral part in your baby’s sleep.
  • You may have to night wean your baby LATER than average or other babies her age. Your baby’s health is the #1 priority and although sleep is important for her growth and development, too, making sure your baby is eating enough is a higher priority.

Although it’s been said that breastfed babies spit up less, both my boys spit up and I breastfed for their first year. My youngest spit up a TON!! He was, thankfully, a “happy spitter” though and we never had serious reflux issues. We used cloth diapers as burp cloths and rarely picked him up without one on our shoulder. We’d go through many outfits and cloth diapers every day. I have many clients with babies with reflux, and once they have the reflux under control, either by medication or by changing routines, babies with reflux can go on to be good sleepers just like the rest of us.

If you’re looking for ways to get your baby or toddler into a healthy sleeping routine, please be sure to pick up your FREE copy of 5 Ways to Help Your Child Sleep Through the Night, our e-Book with tear-free tips to help your baby sleep better. For those persistent nighttime struggles, check out The 3-Step System to Help Your Baby Sleep (babies) or The 5-Step System to Better Toddler Sleep (toddlers). Using a unique approach and practical tools for success, our e-books help you and your baby sleep through the night and nap better. For those looking for a more customized solution for your unique situation with support along the way, please consider one-on-one baby and toddler sleep consultations, where you will receive a Personalized Sleep Plan™ you can feel good about! Sometimes it’s not that you can’t make a plan. Sometimes you’re just too tired to.

How did your baby’s reflux affect sleep? Was it severe?

Sources:

Journal of Human Lactation – http://jhl.sagepub.com/content/25/2/237.citation

The Mayo Clinic – http://www.mayoclinic.com/health/infant-acid-reflux/DS00787

While The Baby Sleep Site™ publishes what we consider to be safe tips and suggestions, all The Baby Sleep Site™ content is made available on an as-is basis, with no warrantees expressed or implied. This publication is not intended for use as a source of medical advice and we encourage communication with your baby’s pediatrician, particularly for medical issues such as reflux.