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Reflux & Sleep

Reflux is a condition that is most common in the first six months to one year of life.

What we call ‘reflux’ is actually ‘gastro-oesophageal reflux’ [GORD or GERD in America.]  

The valve between the oesophagus and the stomach* sometimes doesn’t work very well when babies are little. With maturity, however, it becomes more efficient. Usually, reflux gets better after about 6 months. Sometimes, but rarely, it can take a year or a little longer.

*The lower oesophageal sphincter

Reflux is when the contents of a baby’s stomach leak back into their oesophagus (food pipe or gullet) and cause posseting (bringing up small amounts of milk), vomiting and/or burning pain (heartburn) due to the acidity in the stomach. 

Some babies with reflux don’t vomit or posset and this is called “silent reflux.” 

Diagnosis can sometimes be difficult, as reflux is easily confused with colic.

Reflux symptoms

  • Vomiting or posseting [although in “silent” reflux this might not happen.]
  • Crying, especially when they are lying flat.
  • Coughing.
  • Swallowing & gulping.
  • Their vomit and/or breath can smell a little bit sour and acidic because of the acidity in their stomach.
  • Poor weight gain because of not keeping their feeds down.

Cows milk protein allergy

Sometimes reflux is caused by a CMPA [cows milk protein allergy.] This isn’t the case for every baby who has reflux, however. Equally, not all babies who have CMPA have reflux!

CMPA has other symptoms such as skin rashes,  blood in their poo and constipation.

If a baby has a milk allergy, you may be advised to cut dairy from your diet if you are breastfeeding, or if you are formula feeding, your baby will probably be prescribed a special non-dairy feed.

They might also be prescribed medicine to limit their stomach acid production or to neutralise their stomach acid.

Some reflux medicines can cause constipation so you will have to make sure to give them plenty of fluids and if they are taking solids, fibre in the form of fruit & vegetables.

Reflux and sleep

Babies who have had reflux [or colic] in the early weeks, whether simple “mechanical” reflux or caused by CMPA often develop sleep problems later.

The reason is that they have usually needed to be held and comforted to sleep, and now they don’t know any other way.

Whether your baby is still suffering from reflux or is better now but has sleep problems, here are some tips to help them.

Early weeks

  • For the first 3 or 4 months, try not to worry about holding your baby too much or getting into bad habits. You’ll find more information about settling younger babies in my new babies and sleep article.
  • Get a comfortable baby carrier so that you can keep them upright for naps if that helps.
  • After the first few weeks, try to separate feeding from sleeping.
  • Elevate the top of the cot, so that it slopes down at the foot, and place younger babies with their feet at the foot of the cot.
  • Give any prescribed medication in good time for it to work before bedtime.
  • When they are over 3 or 4 months, support them to fall asleep aware that they are in their sleep space. See my guidance on bedtime routines.

Bedtime routine

  • Give their milk about half an hour before bath time and hold them upright. Then by the time they go to bed, the milk should no longer be sitting heavily in their stomach.
  • Follow a familiar and predictable routine, to help them feel safe and secure.
  • Encourage them to settle to sleep aware that they are in the cot, with as little assistance as possible from you. 
  • Follow the principles of good sleeping generally, with a familiar and well-timed routine.

Night feeds

  • Older babies who are over about 7 kg in weight, don’t need a tummy full of milk to see them through the night, so long as they are generally well-fed and hydrated during the day.
  • Drop night feeds as soon as possible, so that they are not struggling to digest unnecessary feeds when they are lying down during the night.

Most importantly, please ask for and accept help from your family & friends. Having a baby with reflux means that your circumstances are special and you will need more support than most parents.

Further help

If you’re struggling with reflux or any sleep issues, I am here to help you.

My books

My bestselling books give you the tools to help your baby and yourself get a good night’s sleep. They are full of expert, practical advice and case studies. Each book teaches you to create your baby or child’s personal sleep plan and is written in a clear and accessible style.

They are available in all formats from Amazon and other booksellers.

My Courses

My courses are a mix of video, graphics and easy-to-read text. They are a great way to access my expert help – from your phone, tablet or laptop. The courses have no expiry date and are updated frequently. The Gentle Sleep Course is very comprehensive, easy to dip in and out of and is very empowering.

The Early Waking Course is concise and accessible – it takes around an hour to complete and it may be the best hour you’ve ever spent!

Both of the courses contain helpful schedules for day and night time sleep.

My 1:1 Consultations

If you choose to book a one-to-one consultation with me, you will receive my expert advice along with an individual sleep plan for your child. You will be in very safe, experienced hands and I treat every parent and child with kindness. As a qualified health professional, I can help families with medical and developmental issues. My success rate is outstanding, with over 15,000 face-to-face sleep consultations with families from all over the world.

See my reviews on Trustpilot

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