A sleeping baby is one of the most beautiful, peaceful sights – but that sight can become frustrating and stressful if your baby isn’t sleeping well due to acid reflux.
Parents want nothing more in those moments than to soothe their baby. But how do you soothe a baby with reflux?
Rest assured there are ways to manage and alleviate acid reflux in your newborn or infant – this will help prevent further medical issues and make them more comfortable, which is key to them get better sleep with reflux – an essential ingredient to growing strong and healthy.
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Understanding Reflux in Infants
To help treat acid reflux in your baby, it’s important to know a bit about what reflux in babies is and what causes reflux in babies.
The esophagus delivers food from your baby’s throat to their little stomach. Typically, this is a straight-forward process. However, in a baby with acid reflux, food comes back into the esophagus from the stomach. This is often called spit up.
Reflux in babies happens because the lower esophageal sphincter (LES) – the muscle ring at the top of your stomach – doesn’t close completely, allowing food and stomach acids to emerge back into the esophagus. The same thing happens to us adults sometimes, but acid reflux tends to affect infants more often because their LES is weak or still developing.
You can help prevent acid reflux in babies or ease symptoms by holding your baby upright after meals, adjusting the frequency of burping, feeding them smaller portions more frequently, and considering diet modifications.
When Does Acid Reflux Start in Babies and How Long Does It Last?
Every baby is unique, but typically reflux in infants begins around four months. However, reflux in babies can begin as early as 2-3 weeks after birth.
How long acid reflux in babies lasts depends, but it usually resolves itself when a baby is between 12- and 18-month-old.
When Does Reflux Peak in Babies?
Acid reflux often peaks in babies when they are around 4 months of age.
Signs of Acid Reflux in Babies
If you’ve been wondering, "Does my baby have reflux?", watch for some of these common signs and symptoms.
General symptoms of acid reflux in your baby may include:
- Vomiting and spitting up
- Interrupted sleep
- Irritable during feedings
- Refusal to eat
- Difficulty eating or swallowing
Some rarer though more serious symptoms include:
- Your baby isn't gaining weight
- Difficulty breathing
- Chronic coughing
Your baby could have different signs of baby reflux at night, or their symptoms could seem worse. This is because some babies with reflux like to be held upright and therefore could be fussy or uncomfortable when you put them in their crib.
Noting your baby’s acid reflux symptoms can help you gauge whether your baby’s reflux is mild or serious and how to proceed with your baby’s pediatrician. This is especially true if your baby’s not gaining weight – a problem that needs to be addressed ASAP so they can grow up big and strong.
What is silent reflux?
For most babies, reflux has obvious visual or audio signs, like spitting up. Silent reflux is, well, silent. Silent reflux signs and symptoms in your baby are them acting fussy or uncomfortable, or crying after eating and burping doesn’t help. Also, even though it’s called “silent reflux in babies,” you may hear some tummy rumbling.
How to tell the difference between GERD and acid reflux
There are some circumstances that will result in more severe cases of reflux. Those can be caused by Gastroesophageal Reflux Disease (GERD), food allergies, pyloric stenosis (the narrowing of the valve between the small intestine and the stomach), eosinophilic esophagitis (when white blood cells injure the esophagus lining), and Sandifer syndrome (an affliction that resembles seizures).
Though acid reflux and GERD often have the same symptoms, GERD is more persistent and frequent than acid reflux, which tends to be more occasional. If your baby is uncomfortable, spitting up, or exhibiting other reflux symptoms after every meal, they may have GERD.
If you suspect your baby has GERD, or have a family history of any of these, consult with your health care provider about the best route forward.
How to Help a Baby with Reflux Sleep at Night
Getting your baby to sleep can be challenging enough without reflux, but that’s especially true if your baby has reflux. Many babies with reflux may struggle to sleep at night, or have a difficult time being soothed or calmed to fall asleep.
Luckily there are ways to manage reflux or help prevent reflux in babies, so they sleep better at night.
Here are tips to help a baby with reflux sleep at night:
Burp Your Baby
Burping can help reduce acid reflux in babies.
Here are the three best ways to burp your baby:
- Shoulder: With your baby facing you, and a cloth on your shoulder, place their chin on your shoulder while supporting their bottom with your hand or arm. Use your other hand to gently pat their back to “inspire the burp.”
- Knee: Sit your baby upright on your lap. Support their chest and head while patting their back.
- Lap: Gently lay your baby tummy down over your legs. Support their head so it’s above their chest and gently pat their backs.
Keep Up Your Bedtime Routine
Bedtime routines are the foundation of healthy baby sleep – they calm your baby before bed and the repetitive nature of routines cue it's time to sleep, creating a lifelong habit that serves them for years to come.
If your baby has acid reflux it’s especially important to keep up your routine – the comfort and familiarity of the routine can help put their mind to ease, helping them rest better, despite their discomfort.
Put Them to Sleep on Their Back
The best sleeping position for babies with reflux and gassy babies is always flat on their backs on a firm surface. This is by far the safest sleeping position for babies, despite concerns that a baby with reflux may choke or vomit while sleeping.
The American Academy of Pediatrics confirms that babies use their automatic gag reflex to cough up or swallow fluid. As such, placing your baby on an incline or in a swing is not recommended.
Back sleeping on a firm surface helps reduce the risk of Sudden Infant Death Syndrome (SIDS), a rare event when a healthy baby will unexpectedly pass away in their sleep.
Tips for Feeding a Baby with Reflux Before Sleep
There are plenty of feeding strategies parents can employ to minimize or negate baby reflux and, in turn, help them to sleep better.
- Increase Feedings but With Smaller Portions: Reducing feeding portions can help your baby digest their food more completely which can reduce baby reflux. However, if you feed your baby with reflux smaller portions before bed it’s important to increase the frequency of feedings throughout the day to guarantee they get all the nutrients they need to keep growing.
- Boost Burps: Excessive stomach gas is one cause of baby reflux. Increasing how often you pause to burp your baby throughout nighttime feedings can help reduce reflux. This action prevents air from collecting in your baby’s stomach. You can burp your baby while they are sitting upright on your lap, by putting them over your shoulder while gently patting and rubbing their back, or by laying them over your lap.
- Sit Your Baby Upright: Placing your baby with reflux on their back or in a car seat after feeding can lead to more spitting up and discomfort. To help reduce reflux in your baby after feeding, keep them upright for 20-30 minutes after they finish. Before naps you can take them for a walk around the block in their carrier. For nighttime feeds you can read them a story while sitting on your lap after feeding.
- Consider Mom’s Diet: We’ve all heard of “eating for two” – well, that’s particularly true while breastfeeding because mom’s diet can impact their baby’s. Infants and newborns with reflux may be having reflux because of their mother's diet. That said, nursing mothers whose babies have reflux may want to change their diet by reducing spicy or acidic foods.
- Switch Their Bottle: Sometimes treating acid reflux in babies is as simple as switching their bottle. Some bottle nipples let your baby swallow more air than others, which can lead to more gas. If you think your baby’s bottle is causing reflux, switch the bottle or nipple and monitor for changes. Trial and error might be the way you find the ideal bottle or nipple.
- Switch Their Formula: If your baby drinks formula, formula type is another avenue to explore to manage reflux in your baby. Some babies might be allergic to proteins found in that formula. If you think your reflux baby is allergic to their formula, try a hypoallergenic formula.
When to Contact Your Pediatrician about Reflux
If you’re concerned your baby has symptoms of acid reflux, you should discuss them with your pediatrician at your next visit or give them a call. If symptoms seem sudden or strong, or if your baby is very uncomfortable or spits up excessive amounts, it’s recommended you call your doctor.
You can call your pediatrician about how to help a baby with reflux sleep at night along with basically any other health question. They’re there to help, even if that help is simply easing your mind.
Final Thoughts
Acid reflux in infants can be frustrating, especially when the reflux disrupts your baby’s sleep.
By speaking with your pediatrician, being patient as your baby’s digestive system matures, and following the tips included in this article, your baby's reflux should improve so they get the sleep they need to thrive.
