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Reflux

Reflux-image-for-articleYour baby seems to scream a large percentage of the time and is vomiting often and in large volumes, or not vomiting but making swallowing noises in the throat, sleeps in "cat naps", often looks uncomfortable when feeding, wants to be carried all the time, and wakes up frequently at night.

  

This has been going on for days, weeks or even months and you are desperate to find something to ease the pain, stop the screaming, get some sleep and really cherish and enjoy your baby. But what is it that is causing this behaviour? Is it Colic, which seems to be the "catch all phrase" to explain screaming, fussy babies? Or could your baby be suffering from Reflux?

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What is Reflux

Reflux is a condition which is believed to affect approximately 60% - 70% of babies at various stages of their early lives, to various degrees. It normally starts from birth, or soon thereafter, peaks around 4-6 months and then in most cases disappears by 1 year.

  

Reflux occurs when the lower oesophagus sphincter (or muscle that controls the movement of substances in and out of the stomach) is underdeveloped; or the baby reacts to something in her diet, causing the contents of the stomach, including the stomach acid, to flow back up the oesophagus (throat). This may be quick and cause no symptoms at all, or may be more prolonged and frequent burning the baby's oesophagus and causing significant discomfort and pain.

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Testing for Acid Reflux

There is no easy, inexpensive , un-invasive or especially accurate means of testing for Reflux. Most doctors generally look at symptoms and then suggest either home treatments (for example changing feeding and sleeping positions), natural remedies or medication and see if anything works. If the symptoms improve then treatment continues, however if the symptoms persist or worsen then tests are often necessary.

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Soothing Techniques

  • Use baby swings and rockers to soothe and calm your baby. Just ensure that the one you choose does not have a deep well where the baby's bum is positioned so that the position does not aggravate the Reflux. And ensure that the means of securing the baby in the chair is firm but does not tie tightly around the baby's tummy, placing pressure on his tummy. 

       

  • Consider using a dummy, as sucking a dummy helps to soothe the baby, and the additional saliva can help to neutralise the stomach acid.

        

  • Invest in a good Wrap or Baby Carrier, one that does not squash your baby's tummy. This will make carrying your baby around all the time, and doing your other chores at the same time, much easier. Ensure the carrier keeps your baby's spine as straight as possible and prevents them from slumping down.

       

  • Consider placing a Warm pack on your baby's tummy to sooth the discomfort. Just ensure it is NOT TOO HOT! Or it will BURN your baby!

      

  • Holding your baby up against your shoulder and rocking gently can help to calm your baby.
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Silent Reflux

Sometimes the symptoms of Reflux can be present, but the vomiting is not. This is then termed Silent Reflux. Silent Reflux can be more damaging than normal Reflux as the acid from the stomach burns the baby on the way up and on the way down again.

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Symptoms of Reflux

Babies suffering from Reflux can exhibit all or just a few of the symptoms listed below. The number of symptoms your baby shows has no correlation to the severity of the acid Reflux.

 

 

 

 

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Practical tips to reduce the mess and get Help

  • Cover furniture, especially couches and chairs, with blankets and throws, so that vomit can easily be washed out. It is easier to put a blanket in the washing machine than to keep scrubbing your couch clean. And make it old blankets and towels as breast milk, and especially formula, are difficult to get out.

       

  • Have a good supply of Bibs and Burp cloths, and leave a cloth in every room. That way they are always close at hand.

      

  • Have a good supply of wet wipes for both you and your baby. Leave packets in your bag, your car, the baby's bag and most rooms in the house. They are great for cleaning up vomit and spills, and wiping your clothes if they land up in the line of fire.

     

  • Ask for help from family and friends.They won't really understand what you are going through, unless they have personally experienced it, but an extra pair of hands to even help with doing the washing can be a lifesaver. I will soon be including contact details for maid/domestic worker and night nurse services, for the extra help you may need.

       

  • Accept all offers of help, especially if people offer food. It is the last thing on your priority list for the day, and yet one of the most important things... to eat!! If you don't eat, your breast milk, energy and ability to cope will be significantly impacted. Home cooked meals can even be delivered to your home.

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The information in this article was reviewed for medical accuracy by, Paediatrician and Allergy Specialist, Dr Claudia Gray (MBChB (UCT), MRCPCH (London), MScClin Pharm(Surrey), DipPaedNutrition (UK), PostgradDipAllergy (Southampton), Certified Paediatric Allergologist (SA))

Dr Gray works at the allergy clinic at the Red Cross Children's Hospital in Cape Town, and has a private practice at Vincent Pallotti Hospital in Cape Town, contact 021 531 8013.