Monday, August 26, 2013

Reflux Realities

I am really excited to have Amie from Our Little Clan guest posting here today!  Amie and I were dorm-mates during my brief (but awesome) time at Abilene Christian University and we have stayed in contact over the years.  We have a lot in common (cloth diapering, clean eating, love for the Lord) and one of those things happens to be having a baby with reflux.  

I asked Amie if she would mind writing something for my blog to help educate those who might not know about reflux in infants. Unfortunately for Amie, she has much more experience with this than I do as her son Alex has had a much harder time with reflux.  

Feel free to leave any questions or comments below! :) 

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Photo found here.
Reflux is defined as the stomach contents spilling up into the esophagus. The contents may come up enough to be seen in the mouth or to be spit out of the mouth of a person, with or without force.

Any baby that spits up has reflux. But wait, don’t all babies spit up? Yes, most babies will spit up and this is technically reflux but it doesn’t mean that there’s anything “wrong.”

Most babies will spit up because the sphincter at the top of the stomach isn’t developed fully and sometimes it just can’t keep the stomach sealed up after a meal. Why didn’t God just make this sphincter fully functioning at birth? I don’t know but it’s on my list to ask one day.

Most babies fall into the category of “happy spitters”. This means that they have normal, developmentally appropriate reflux and they couldn’t care less. A happy spitter is a laundry problem for mom and dad and that’s about it. Baby is happy and thriving and completely unaware that they just covered your $70 shoes in baby puke.

Some babies however are not happy spitters. If you have such a baby, you know it. (And your neighbors probably do as well.) Infant reflux becomes a problem when baby spits up so much of their feeds that they struggle to gain weight appropriately, or may even lose weight. Some babies will maintain proper weight but are in serious pain when they reflux. Some common signs of reflux pain can include crying/screaming, arching of the back (they look like they’re doing a backbend), refusal to eat/eating excessively, and lack or loss of babbling.  If you think you’re baby fits into either of these, speak with your healthcare practitioner. This may be reflux or it could be something else, only a healthcare professional can help you navigate those options.

If you have a reflux baby, or like me you have a GERD baby (severe pain with reflux), there are things that you can do to help. Some of these are specific to formula-fed babies, some to breastfed, and some will help any of them.

  • (Breast or Bottle) Smaller feeds more frequently. Breastfeeding moms can work with a lactation consultant on setting a good feeding pattern, most seem to do well with feeding from just one breast per feed. Bottle feeding moms can try to feed fewer ounces per bottle but feed more often. Speak with your doctor before changing feeding habits, especially if baby isn’t gaining well.
  • (Bottle) If baby is bottle-fed, you can thicken their formula or pumped breastmilk with rice cereal. This is pretty heavily debated among moms and doctors, but the idea is that the cereal will help absorb acid in the stomach and will make the milk heavier helping it to stay down. You may need to get faster flow nipples for your bottles or they will get clogged. Just an FYI- It does not help baby sleep through the night one bit.
  • (Breast or Bottle) Keep baby elevated for 30 minutes after each feed and in severe cases, limit horizontal time to just tummy time and keep tummy time short. (Babies still need tummy time so work with your child and your doctor to make sure they get to use their muscles.) You may also want to elevate the head of baby’s crib. You can put lifts under one end of the crib or use a wedge.
  • (Breast or Bottle) Some reflux babies have milk or soy intolerances. If you or your doctor suspect such an intolerance you can eliminate these foods from baby’s diet. Breastfeeding mothers would need to eliminate all dairy and soy from their diets. Formula-fed babies can go on a hypo-allergenic formula. Very rarely, some babies will have an intolerance to human milk and can do well on the hypo-allergenic formulas.
  • (Breast) There are positioning pillows that a breastfeeding mother can use to keep baby at an upright angle while nursing. I don’t have any experience with these, but they might be worth looking into.
Some babies will continue to have reflux problems even with all of these measures being taken. Your doctor may suggest putting such a baby on medication. They make infant versions of Zantac, Prevacid, and Nexium. These drugs can be very helpful for some babies. They are weight based and may need adjustments as your baby grows.

For most babies, the reflux gets better around 6 months when they are sitting up and start eating solids. Some babies will keep going with the reflux for a full year.

We’re going on ten months. It’s been a long journey and at first it seemed like our whole life revolved around reflux: when to give meds, how long to keep upright, trying to squeeze in tummy time before the next feed, mixing bottles, and washing burp clothes. Now, we’ve got it down and it’s just a part of life.

I give Alex his meds with his first bottle of the day. Each bottle gets mixed with the cereal and when we go out we fill the formula container with formula and cereal so it’s all ready to go. I know when he’s going to be hungry and plan to make sure he’ll be upright for at least half an hour after. When he sleeps I can tell the difference between a pain episode and him waking up. I no longer cry when he wakes up in pain, but comfort him and love on him and try to get him to drink some water. I no longer apologize for the spit-up on my clothes when I get to work; it’s my badge of honor as a reflux mom.

If you have a reflux baby I can honestly say, I feel for you. I’m so sorry you and your little one are having to deal with this, but I can also tell you that it gets better, or at least easier. You learn to keep up with the meds and refills. You learn baby’s cues on when they’re going to spew and you get pretty fast at dodging it. And even though we aren’t there, I hold out hope that they all out grow it one day and this will just an embarrassing story to tell some future girlfriend.

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