Reflux in babies is very common, but not as much is known about silent reflux in babies. Although seeing your baby be sick or spitting milk back up after feeding can be alarming, it is very common and this occurs simply because your child's food pipe isn't fully developed, causing milk to come back up.
As a parent of a newborn, seeing them distressed or upset is one of the hardest things you have to go through and reflux can make babies very uncomfortable and irritable, often resulting in frequent crying. This excessive and uncontrollable crying, often caused by general stress and abdominal discomfort, is referred to as colic in babies and many believe there is a link between the two. But what about silent reflux?
What is silent reflux?
Silent reflux is effectively the same as reflux but the baby does not vomit or spit the milk back up so the symptoms are much less obvious. This means that stomach acid is causing discomfort, often behind the breastbone. It can make your baby's throat sore or burn, so if they are coughing then this is one of the main symptoms that they do tend to display.
As symptoms of silent reflux do not appear, it is a relatively unknown phenomenon which means it might go unnoticed, misdiagnosed or mismanaged. However, as a parent, you're likely to know your baby and when something is wrong.
Traditional acid reflux is known as gastroesophageal reflux disease (GERD), whereas silent reflux is often referred to as laryngopharyngeal reflux (LPR). According to Web MD "Silent reflux is common in infants because their sphincters are undeveloped, they have a shorter oesophagus, and they lie down much of the time."
If silent reflux persists it can cause long-term irritation or damage. Examples of complications in babies are:
What are the symptoms of silent reflux?
The NCT says silent reflux refers to the "condition where no outward symptoms of reflux appear, which can make diagnosis difficult. Babies show signs of being in pain, especially when not upright, and may have a persistent cough". However, your child may exhibit some of the symptoms of silent reflux which will make it easier for you to understand what is wrong. Symptoms include:
• Bringing up milk or vomiting after feeding
• Coughing or hiccuping when feeding
• Irritability and being unsettled during feeding
• Swallowing or gulping after burping or feeding
• Not gaining weight due to not being able to keep food down.
Complications caused by silent reflux
• Narrowing of the area below the vocal cords
• Contact ulcers
• Recurrent ear infections from problems with eustachian tube function
• A lasting buildup of middle ear fluid
If your baby has persistent symptoms then it is best to visit your GP to seek advice and treatment for silent reflux.
What are the treatments for silent reflux?
There are certain treatments that can be prescribed by your doctor for reflux, colic or silent reflux. However, the condition and symptoms do often tend to deteriorate over time as your baby grows. Once your baby is older, their muscles develop further and they will spend more time sitting up which should help to prevent acid from rising up in their throat.
If formula feeding, sometimes doctors or health visitors can put your baby on a thicker formula which might be easier for your baby to keep down. GP's may also prescribe an infant antacid to neutralise the acid in your baby's stomach.
Natural remedies for silent reflux
1) Gentle movement
Putting your baby in their sling or pushchair and gently moving them can help with reflux and encourage them to settle. Babies often prefer moving to sitting or lying still. Crying tends to make reflux worse and keeping your baby upright will hopefully ensure they cry less because they are close to you.
2) Give frequent, small feeds
If your baby is formula-fed, feed them less but more frequently. This will stop them from getting too full which will mean they are less likely to struggle to digest the milk.
3) Avoid tight clothing
Tight clothing can also put extra pressure on babies' sensitive tummies so it is best to put them in loose clothing if they frequently suffer from reflux.
4) Have some quiet time
After a feed try and have half an hour of quiet and still relaxing time with your baby. This is especially important for formula-fed babies as it is digested at a slower rate than breastmilk so they might need longer to settle.
5) Try and keep your baby upright
Try and keep your baby upright for half an hour after a feed. This can reduce reflux as gravity is more likely to keep the milk down.
6) Baby massage
Baby massage has been known to improve symptoms of reflux and colic. According to the NCT, baby massage has several other benefits to parents including boosting the bond with baby and improving sleep and interaction with your little one.
7) Consider how they travel
Your baby's car seat or travel systems can often make reflux worse as babies tend to slump when in them, especially when asleep. Slumping puts more pressure on their precious tummies and they are more likely to feel the pain of rising acid. Try to avoid travelling directly after feeding and buy a car seat that prevents slumping as much as possible.
8) Sleeping position
If they are old enough to roll over, it is safe for your baby to sleep on their side which might help with the symptoms of reflux. However, do not put your child on their side unless you are sure they do have the ability to roll.
9) Burp your baby
If you bottle feed your baby, you can try burping your baby gently every few minutes during a feed. If you are breastfeeding, try gentle burping after a feed or if you are swapping sides.