Reflux and Sleep: The New Canadian Guidelines

By Kate Macdonald

May 21, 2019

Reflux & Sleep

Having a baby that is always spiting up or vomiting after a feed can be distressing for mama’s.  You are wondering about how much they actually got, why won’t they drink more and why are they so restless or irritable. You may have struggled to feed them and then they vomit the feed up shortly after. You’re not alone mama, it is common for babies to spit up after a feed and here is why.

Reflux occurs when food comes back up (reflux) from the stomach which the baby may or may not spit up. It is caused because the sphincter (the ring of muscle between the esophagus and stomach) is not fully matured yet so this allows stomach contents (milk) to flow back up.  Reflux can occur in healthy infant’s multiple times a day.

If you baby is growing well, gaining weight, reflux may not be seen as a concern by your health care provider. Often as baby grows older, is able to sit up, starts solids and as their sphincter matures, the symptoms will start to fade away.

You may find that doing a few changes will help your little one if they spit up a lot:
  • Burp your baby a few times during their feed
  • Keeping them upright for 20-30 mins after a feed before lying them down.
  • Feeding your baby smaller more frequent meals
  • Keep them awake during a feed…keep reading to find out why!
  • Sleeping your baby on their back is still recommended for infants from birth to 12 months old as per North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) as “the risk of SIDS outweighs the benefit that tummy or side sleep might have on your baby’s reflux.”

If your baby is not gaining weight, having difficulty feeding and/or having respiratory issues you should seek medical attention as these symptoms are cause for concern.

New Guidelines

If you baby is having bothersome symptoms of reflux, your health care provider has some new guidelines from NASPGHAN to refer to. They may suggest a few different options before they try a trial on medication.  Smaller more frequent feeds to avoid overfeeding could be suggested and even possibly thicken feeds if bottle fed under the supervision of your doctor.

“Milk protein sensitivity is sometimes a cause of unexplained crying and vomiting in infants” as per NASPGHAN and should be looked into further with your health care provider. If baby is formula fed they may recommend trying a protein hydrolysate or amino acid base formula for 2-4 weeks. If baby is breastfed, eliminating cows milk in your diet may be suggested. Eliminating dairy takes a few weeks to be cleared out of your system so it will take a few more weeks before you may notice a change in your baby. Cutting out dairy can be challenging at first but hang in there mama!!!

Sleep Issues

Reflux can cause issues with sleep!!! Lying on your back after eating liquid diets can be a recipe for some babies to spit up.The best advice I can give you from my experience with 3 babies with reflux is feeding them awake instead of feeding them to sleep. I don’t know about you but every time I feed them to sleep they would sleep for 30 mins, wake crying and spit up all over their crib.  The switch to keeping them awake for the feed made a HUGE difference!! They had time to eat, burp and then when they went to sleep, they were less restless and slept longer! YES!

Switching to feeding your baby awake and having them fall asleep independently and can be overwhelming!  Staying consistent with putting them to sleep awake is the KEY! Give it a try! And if you need support getting to this point, reach out and we would be thrilled to help you get there.  

 

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