Reflux
Gastro-Oesophageal Reflux (reflux)
is the spontaneous passage of part or all of the stomach contents into the
oesophagus, which may or may not be associated with vomiting or possetting.
The child may experience symptoms such as regurgitation, possetting and
/ or projectile vomiting. Silent reflux is when the child is has all the
symptoms with no sign of vomiting or possetting.
Possetting is when babies vomit up small amounts of milk during or after
feeds causing reflux of some gastric juices up to the oesophagus. It is
common in babies, and is usually not harmful but can cause the baby to be
very distressed at some time during the day due to ‘heartburn’. Some parents
think they have ‘a really unsettled baby’ or ‘they are spoiling them’ by
carrying the baby around all the time as this often is the only way, other
than medications, that can give some comfort to the baby. Heartburn – burning
pain or discomfort felt by the baby due to irritation of the oesophagus
by stomach acid. Babies may show this by being unsettled, grizzly, poor
sleepers, long periods of crying.
Options
● Attend a Day Stay Service so an experienced professional
can observe and diagnose your baby and offer advice, support and relevant
medical contacts.
● Contact your local Maternal and Child Health Nurse
(or State equivalent)
● The use of medication / liquid antacids is very
effective in reducing the pain.
● Consult your doctor (GP) as the medications must
be prescribed by your GP or Paediatrician.
Signs for parents to look for:
Parents should always seek medical advice if they are worried in any way
about their infant, or themselves.
In relation to gastro-oesophageal
reflux, the parents should especially seek medical advice if:
● You can see your baby is some pain, screaming
● Lack of smiles and playfulness
● Arching of back when you hold or feed your baby
● Draws legs up in pain,
● Dislike floor time / time on back e.g. when changing
nappy
● Unable to enjoy floor time
● Poor sleeper
● Is irritable or cries excessively;
● Appears to be in pain or is very “windy” or “colicky”;
● Doesn’t sleep well, and is easily disturbed;
● Seems “snuffly” or gags or coughs often;
● Has feeding problems- either comfort feeding OR
refusal to feed;
● Vomiting / possetting after most or every feed
● No weight gain as babies have pain and pull off
breast and are ‘fussy’ feeders
● Or large weight gain as babies like to suck more
often to relieve ‘heartburn’ pain
Some relief may be obtained by:
● Keeping the baby in an upright position during
and after feeds
● Feeding baby in a more upright position ‘sitting
up with support’
● Offering smaller more frequent feeds
● Raise the head of the change mat so baby is propped
up when changing – rolling to the side for changing
● Handling baby gently particularly after feeds
● Carrying the baby in a sling and over the shoulder
to keep him upright
● Raising the head of the cot/bassinette 20 – 30
degrees
● Floor play prior to feed when the stomach is empty
● When awake, prone position on an incline of 30
degrees often gives comfort. (Not recommended for sleep).
● The amount of possetting may be reduced by changing
the position of the baby during feeds or while sleeping.
● Parents also suffer! It is the never ending and
relentless crying of the baby that is very stressful to the parents often
causing tension between partners and families when everyone is blaming one
another for the baby crying.
Parents’ reaction:
● Crying and short tempered.
● Overtired and exhausted and feeling of not coping;
● Distressed as no one seems to listen or give correct
advice.
● Carrying the baby all day
● Mixed feelings about your baby
● Confused about how to manage the baby;
● Socially isolated because of the child’s behaviour;
● Depressed, feeling down, or negative;
● Not eating; and no sleep
● Worried that you may harm your child.
Reflux Support Group - website: http://www.reflux.org.au/index.php
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