It can be difficult enough trying to settle into life with a baby even when there’s no additional health concerns, and when extra issues present themselves it can be extremely challenging for new parents. Often it’s a combination of not knowing what’s actually wrong with the baby as well as the extra fatigue dealing with the issue and the emotional upset of seeing your baby in pain. Reflux and silent reflux is a classic example of this. Reflux is often transitional and can affect almost half of all babies with a small percentage of babies experiencing more severe reflux having more than 6 episodes per day. Reflux is one way the gastrointestinal tract can let us know that something needs some attention and that can include what is being consumed and/or how it is being consumed.

Reflux is recognised in a baby when they frequently vomit up their milk and there is discomfort and pain associated with this due to stomach acid that comes up with the milk creating a burning feeling in the oesophagus. Silent reflux is when the acid still makes its way up and irritates the oesophagus but it is not necessarily accompanied by the vomiting which can make it even more difficult to diagnose.

There are a number of reasons a baby may experience reflux and these include both structural or functional reasons as well as those related to certain food triggers such as allergies and intolerances. A baby’s gastrointestinal tract is brand new at birth and it can take time to mature. The baby’s gastro intestinal tract is suddenly directly exposed to new molecules via breast milk or formula, and not only does it have to get used to the increased volume of what’s coming in, it needs to digest and absorb the new molecules it’s being exposed to. Just like us, babies have acid in their stomachs to break down protein and other nutrients, and the stomach has a protective mucous membrane lining to protect itself from this acid. There is a valve at the top of the stomach to prevent this acid from rising up into the oesophagus (which doesn’t have this protective mucous membrane lining) and it can take time for this valve to mature in babies. For those with mild or infrequent reflux, most babies grow out of it by 12 months but if it is severe it needs to be investigated further as it may be more than just an immature valve or too large portions of food being consumed in one sitting.

Some things that may help improve reflux due to structural reasons include checking with your lactation consultant about feeding positions and also ruling out tongue or lip tie as these can contribute to reflux. Feeding smaller portions at a time, keeping your baby upright after feeding and also elevating your baby’s chest and head slightly for sleep can help and improvement will often be noticed fairly quickly. 

If reflux is occurring due to dietary triggers it can take a little more detective work to establish the cause and if the baby is exclusively breastfed it becomes all about what the mother is eating and drinking. 30% of babies with severe reflux have issues with cow’s milk protein so this should be the first thing investigated. The breastfeeding mother can eliminate dairy (cows milk, yoghurt, cheese) for a period of 14 days and observe changes with the reflux. If the reflux improves the breastfeeding mother can then re-introduce yoghurt, cheese and milk one at a time, a few days apart and observe if the reflux returns with only one or all of the potential triggers and the diet can be adjusted accordingly.  Babies drinking cows milk formula can try goats milk formula as an alternative, as goats milk protein is often more tolerable in sensitive babies. If dairy is not tolerated at all and the baby is formula fed, there are dairy free options available.  For breastfeeding mothers and older babies, if dairy is not tolerated there are many other excellent sources of calcium such as green leafy vegetables, nuts and seeds, nut butters, tahini and sardines.

If eliminating dairy doesn’t improve the reflux, some other common food irritants are wheat containing food and high salicylate containing food. It’s best to undergo any elimination diet especially when breast feeding or treating a baby, under the strict guidance of a qualified, experienced nutritionist or naturopath as it’s important to be aware of all nutrient groups that are required for the healthy growth and development of the baby. Experienced naturopathic practitioners can also prescribe natural medicine to help soothe and support the gastrointestinal health of the baby. Simple remedies such as strong infusions of chamomile and fennel tea for the breast feeding mum and probiotics for both mum and baby can make improvements, and there are a number of stronger medicinal herbs which are safe and effective for treating babies with reflux and other gastrointestinal discomforts which can be prescribed by an experienced practitioner. 

There is always a time and place for pharmaceutical grade medications and sometimes it may be the best and only option. However in the case of reflux (as opposed to acute life threatening conditions) there are several other natural medicines and approaches which may be worth trying first, as there are some undesirable side effects that may occur with taking pharmaceutical reflux medications longer term. For example the minerals iron and calcium are broken down and absorbed in the stomach and when pharmaceutical ‘ant acids’ are prescribed to reduce stomach acid, it can lead to reduced absorption of iron and calcium which are two very important nutrients for babies and children. These medications should be a last resort when all other options have been thoroughly investigated first. As with any medication, read all ingredients and inserts so you are fully aware of what you are putting in your baby’s body. 

Whether your baby experiences mild or severe reflux, it needs to be addressed to help your baby become more comfortable. Working together with your doctor and naturopath can offer the best comprehensive approach.

For further information or to make an appointment please contact Diana Arundell at Avoca Naturopath on 0410 465 900.