Reflux, whether it’s silent with no vomiting or projectile- vomiting, is distressing for both baby and the whole rest of the family.
But when parents visit their doctor, they are told “reflux is normal”, “baby will grow out of it” or “you don’t need to worry about it”. But their gut instinct is still telling them “no”- to letting their babies continue to suffer and because they know it’s not normal.
Doctors are not trained in baby reflux specifically, yet the NHS predicts that 50% of babies have it. All doctors can do is follow the guidelines that tell them to ‘watch and wait’ and then to just medicate.
Here are three facts about reflux that your doctor won’t tell you:
· Reflux is a symptom
Modern medicine tells us that babies get Gastro Oesophageal Reflux (GOR/GER), and if it’s causing distress it becomes Gastro Oesophageal Reflux Disease (GORD/GERD). However, reflux is not something a baby just ‘gets’, or even ‘has’.
All of our bodies reflux- think everything from a little burp to throwing up! It is something our stomachs do, rather than have. It has no pathological cause, but is instead a symptom.
This means that it shows in children as a result of something else that has gone ‘wrong’ or out of balance. It’s important to understand this because your baby’s body is not “over-producing stomach acid”.
Your baby also doesn’t have reflux because of a weak lower oesophageal valve (LES), which is the ring of the sphincter muscle between the food pipe and the stomach. All babies are born with a weak LES but not all babies reflux! Therefore, a weak LES is not the causes of reflux otherwise all babies would reflux all of the time!
Babies are born with lower muscle tone and strength in general and the LES (because it’s a muscle) applies there too. The weakness in the LES makes it easier for the stomach contents to come back up into the LES, however, on its own, is not the cause!
· “I don’t know what's causing your baby’s reflux”
Your GP is not trained to understand the symptoms and behaviours that partner reflux and probably doesn’t have time to ask about the 80 possible symptoms and behaviours that are needed to understand what the underlying what the pattern of your baby’s reflux really is.
Guidelines are provided to a doctors- in the UK, these come from the National Institute of Clinical Health and Excellence, who get their guidelines from the World Health Organisation.
When it comes to reflux, the guidelines advise the following approach:
1- Reassure parents that reflux is normal (as long as possible)
2- Trial smaller feeds more frequently (2 week trial)
3- Trial thickened milks or adding a thickener (2 week trial)
4- Trial medication: alginate therapy (2 week trial)
5- Trial gastric acid suppression medication (proton pump inhibitors such as omeprazole, or histamine-2 receptor antagonists such as ranitidine) (4 week trial)
6- Refer to a paediatrician.
If sticking to these guidelines, babies can have to wait more than 10 weeks to even get a referral to a paediatrician and then the wait for the appointments can still be months away. During this time, both baby and the whole rest of the family are left struggling with the consequence of reflux.
· Medication won’t resolve reflux for 80% of babies
Medication, when it’s used appropriately, plays a very important role for babies. However, its rate of effectiveness is very low- in a survey of over 1900 parents, less than 20% rated the improvements in their baby’s reflux as 8/10 or greater.
Often, babies are kept on medication for too long, with doctors increasing doses and adding more medications when it isn’t working. This poses longer term risks to their health and these medications are only supposed to be used for the short term. The gastric acid suppression medication that are often prescribed for babies are actually designed for reflux in adults. They often assume that there is too much acid in the stomach. However, the only time this occurs in babies is when their bodies are adjusting to these medications.
So what should we do? What is causing their reflux?
When we can answer this question, we know with confidence what specific action to take to help each baby as an individual. The main challenge comes when we ask what is causing this symptom. Reflux is always a symptom of something else, and causes range across the following and more....
Cleft lip & Palette
Excessive crying (could be due to reflux pain, or over tiredness, or over stimulation)
Oral Motor Dysfunction
Small Intestine Bacterial Overgrowth (SIBO)
Ulcers (in stomach)
When we can figure out what’s causing each baby’s reflux, we can take direct and quick action to resolve it. To know what treatment will be effective for each baby, we need to understand the specific cause for each baby first.
And the only way to do that is to play detective and looking at the clues your baby is giving you, every day.
For a lot more information about what clues to be looking for, please visit: https://www.thebabyrefluxlady.co.uk/about