GERD may be its official name, but most 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 sleeplessness 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 the 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:
- Spitting and vomiting
- Constant hiccups
- Feeding disturbances
- Chronic irritability
- Discomfort when lying on the back
- Sleep disturbance
- 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 their upper body. This wedge pillow would be a good example except we DO NOT recommend you put the baby on the pillow itself. You put it under the mattress simply to elevate the mattress. If your baby is wiggly, and prone to sliding down, you can use a product like the Baby Stay Asleep to help position baby.
- 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 serious 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.
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!
Oh, by the way I finally learnt about proper winding technique from a lady here in NZ who has years of experience dealing with unsettled and reflux babies – website is here: http://www.naturalwinding.com
@ Angela Steward — thanks so much for sharing your story with us – and for sharing that link! 🙂
After having two babies with reflux, I finally learned that the biggest contribution to it was ineffective or insufficient winding/burping. I learnt in time to help my 2nd child from when he was 5 months old, and the improvement was remarkable. I basically had to spend his entire awake time concentrating on his winding in order for him to go to sleep and sleep peacefully. However proper winding involves LYING your baby down flat until they show signs they are ready to burp – at which point you gently sit up/lift upright to release the burp. You need to continue this process until the baby is comfortable otherwise sleep will be difficult and likely cut short by the reflux of acid ‘sitting’ on top of trapped wind. I did not read this in any advice on reflux, and most parenting support out there hardly mentions a word about it. Therefore reflux has become extremely over-medicated when it may not be needed in all cases. Another big help was cutting out dairy and gluten from my diet (and his when he started solids) as this is often a problem. Doctors are reluctant to suggest it because they worry about the mother’s health but as long as you are educated about alternatives you can have great nutrition without dairy and gluten. Although it was hard to cut these foods out, it was so much easier than coping with a poor wee baby who was just miserable and could not sleep!
I wish you’d written (and I’d seen) this article about 9 months ago!! My son has mostly outgrown his reflux now, but while it was never as bad as some babies’, it did severely affect him. He lost weight for 2 months, and we’re STILL (9 months old!) working on a nap schedule. Medication helped him some, and those small, frequent feedings. He still only nurses one side at a time. Adding solids to his diet REALLY helped, too – he doesn’t spit up his solid food!
@ Ashley – awesome tips! Thanks for sharing. 🙂 Always encouraging for moms who are currently struggling to hear from “veteran” moms who’ve been there and who’ve survived.