Reflux in babies - what's normal?
Sometimes I get asked whether it’s normal for babies to get reflux, and if this is what leads to infant distress and colic.
adapting to the outside world
At birth and during the fourth trimester, babies need to adapt to the environment outside the womb. They also have an immature gut, tiny stomach and need to feed frequent.
In addition, they need lots of touch, to feel safe, have their cues responded to and be stimulated.
reflux is usually common and normal
For most babies, reflux is both common and normal (60-85% in the first two months experience this). And most will grow out of reflux without treatment, usually between 4-6 months of age.
GOR and GORD
Can babies get GORD, or gastro-oesophageal reflux disease? This is defined as ongoing reflux (GOR) causing troublesome symptoms such as oesophageal irritation, allergies or breathing issues.
Yes they can. But according to the research, rarely. Reflux fluid is largely non-acidic. Possible causes of GORD are a congenial gut/heart condition, a shorter oesophagus and dysmotility.
When you check international guidelines they state that ‘There is no symptom or symptom complex that is diagnostic of GORD, or predictive of response to therapy.’
acid-suppressing medications
Importantly, a systemic review of research showed a poor relationship between reflux symptoms with endoscopy findings and pH balance (acid alkaline). Also, acid suppressing medications showed no better results than placebo in GORD diagnosed infants.
Of concern, acid-suppressing drugs are associated in infants with an increased risk of gut infections, lung infections and childhood fractures. There may also be an increased risk of food allergies, less nutrient absorption and alterations to the microbiota (gut flora) during this critical establishment phase of the first two years of life.
In short, the potential harm of drugs could outweigh any possible benefit.
what to do
If true GORD has been ruled out, what could be causing reflux?
Apart from all the normal adaptation that’s going, feeding issues could be a problem. Lactation consultants can provide simple but powerful guidance and support on this.
Other things you can do to reduce reflux include
Break the stress–crying cycle that babies can get caught in. Some calming herbs are safe for both mother and baby like chamomilla
If breast feeding, address the mother’s dysbiosis i.e. gut flora imbalances; consider food sensitivities or allergies, commons ones being dairy, soy, peanuts, eggs, wheat and gluten, with dairy standing out. Also check other common food triggers like onion, the broccoli family and legumes. This means the mother has to give them up for a period of time
Also for breastfed babies, specific probiotics may help , but not all are transferred via breast milk. Giving them directly to babies is not always advisable
Also support the mother’s microbiota with healthy fibre to ensure the baby gets enough SCFAs (gut healing and sealing fats), and anti-inflammatory Omega 3 fats
For bottle fed babies, adding certain probiotics like Lactobacillus rhamnosus GG (LGG) to formula has shown good results in research