Reflux in babies

Gastro-oesophageal reflux disease (GERD) is a common condition in infants, characterised by the involuntary reflux of stomach contents into the oesophagus. This is the first sign of oromaxillofacial dysfunctions and respiratory effort, and therefore of future chronic apnoea. GERD can cause frequent regurgitation and discomfort. This article looks at the symptoms and strategies for managing reflux in breastfed babies.

GERD symptoms

Common symptoms of GERD include:

• Frequent spitting up: Most babies spit up, often effortlessly, after feeding.
• Pain or irritability: Babies may show signs of discomfort or pain, such as crying after feeds.
• Sleep disturbances: Reflux can disrupt a baby’s sleep, and they may become restless and have difficulty sleeping on their back.
• Poor weight gain: In more severe cases, reflux can affect growth if the baby does not gain enough weight.

Distinction between regurgitation and vomiting

It is important to distinguish between regurgitation and vomiting. Regurgitation is the effortless release of milk, often after burping. Vomiting, on the other hand, is accompanied by muscle contractions and may indicate more serious problems such as gastroenteritis or food hypersensitivity.

Managing GERD in breastfed babies

1. Breastfeeding positions :
   • Keeping the baby’s head higher than the tummy: using positions such as “inverted cradle” or “lying backwards” can help reduce reflux by using gravity to keep stomach contents down.
   • Upright carrying: After feeds, keeping the baby in an upright position for 15 to 20 minutes can help aid digestion and reduce spit-up.
2. Shorter, more frequent feeds:
   • Shorter, more frequent feeds can help reduce the amount of milk in the stomach each time, reducing the risk of reflux.
3. Avoid overfeeding:
   • Avoid overfeeding your baby. Babies who are breastfed on demand often regulate their milk intake better, which can reduce reflux episodes. Babies with an intense need to suck, and therefore often with oromaxillofacial dysfunctions, are big suckers, to relieve themselves. They may have an overflow. So we advise you not to underestimate the dysfunction that may be lurking in babies who drink a lot.

Environmental and lifestyle adaptations

• Raising the mattress: for babies with severe reflux, raising the mattress slightly can help reduce nighttime symptoms.
• Clothing and nappies: avoid clothing and nappies that are too tight, which can put pressure on the baby’s abdomen, increasing the risk of reflux.
• Wearing a sling: using a sling to keep your baby upright after feeds can help reduce spit-up.

When to consult a doctor

It is important to consult a paediatrician if:

• Frequent regurgitation accompanied by obvious pain.
• Breathing difficulties, persistent coughing or recurrent lung infections.
• Poor weight gain or refusal to eat.
• Presence of blood in the spit-up.

Conclusion

Gastro-oesophageal reflux disease (GERD) is a common phenomenon in babies and requires very specific management of oro-myofacial dysfunctions. By consulting multidisciplinary professionals, adopting appropriate breastfeeding positions, adjusting the frequency and duration of feeds, and keeping the baby upright after meals, parents can help reduce reflux symptoms. In all cases, it is essential to consult a health professional for appropriate treatment.