What is Reflux?

by Mirna Elsabbagh

When children cry and nag and we automatically think it's colic. However, many of those times it's actually reflux! 


I interviewed Dr. Rania Ayat Hawayek about Reflux and asked her the below questions and those were her answers. 


You always need to talk to your pediatrician about reflux and I would even recommend getting a second opinion from an expert pediatrician about reflux as well. 


If you suspect that your baby has reflux, the below will provide you with general guidelines. However, they do not replace a proper consultation with your doctor! For the full interview about reflux with Dr. Rania Ayat Hawayek, click on this link.

 

Mirna Sabbagh: Adult and Child Nutritionist

 

Question Number One: What Is Reflux? 

Reflux is when milk or food from the stomach goes upward into the esophagus and creates discomfort for the baby in the shape of burning, crying, spit up, or general aversion towards milk. 

 

Question Number Two: How Do I Know If My Baby Has Reflux? 

Your baby may have reflux if he:

 

  • Has difficulty sleeping; 
  • Pulls his head back while breastfeeding;
  • He spits up a lot;
  • Has frequent hiccups;
  • Is not putting on weight;
  • If you feel like overall he is uncomfortable. 

 

Question Number Three: What Do I Do in Case My Baby Has Reflux?

I interviewed doctor Rania from Circle Care Clinic recently, and she provided the below guidelines:

 

  1. Positioning after each feeding is the key. Make sure that the baby stays up straight after each feeding. 
  2. Make sure you burp the baby and you leave him on your shoulder for 20 to 30 minutes. Try to lay your baby down in a semi-upright position or incline position.
  3. Experiment with allowing your baby to sleep on their tummy during nap times, but only if you are monitoring them and you are next to them to avoid the risk of SIDS (Sudden Infant Death Syndrome). 
  4. Let your baby sleep on his left side, it may be more comfortable. Please discuss with your doctor how to do this with your baby to avoid the risk of SIDS. 
  5. You can allow your baby to sleep in an incline position if he has reflux in a way that is safe to avoid SIDS, such as putting the pillow under the sheets. Please do not do any of these without showing the setting to your doctor and making sure that this is indeed a safe setting for your baby. 
  6. When you're breastfeeding, breastfeed in a laid back position and if you're giving formula, give it in an upright position. 
  7. If the baby is crying after feeding, don't think that he is hungry; it could be that they need a burp as spreading out feedings; if your baby is old enough he/she can really be helpful and decreasing reflux 

 

Question Number 4: What about Formula? 

If I am giving a formula, do I have to switch it?

You can switch to a comforting formula that is more whey-based... There are some anti-reflux formulas in the market. However, they are not necessarily better and they may be too heavy on your baby. 

 

You might ask yourself: If my baby has reflux, should I start putting him on rice cereal? 

 

The answer is: Only when your baby is four months or older you should start offering solid food. You do not have to give rice cereal, but you can start with a few bites of sweet potato or vegetables for example. It is recommended that you give it before giving the milk and one of the feedings in general. And if your baby starts to eat better, you can give him another serving before bedtime. This should really help with the reflux.

 

Question Number 5: Does My Baby Need Medication? 

Your baby doesn’t need medication unless you tried everything else and he’s still not doing well when it comes to reflux. 

You should only resort to medication under your doctor's supervision while making sure you discuss it with him.

When should I stop medication? You should stop the medication when you feel like your baby's doing better and you have discussed it with your doctor. 

 

Question Number 6: When Does Reflux Go Away?

The reflux issue should be solved by the age of one. 

Another question I receive is: Could my baby not be drinking milk due to reflux? Yes, it's very possible that the fact that the baby is not drinking milk could be due to reflux because his body has created a food diversion when it comes to milk.

What should I do if my baby has reflux and is rejecting food? Allow your baby to have a relationship with food. Allow him to play with the food they might enjoy the texture or they might like hard textures and baby-led weaning more. 

Give them a chance to develop their relationship!!


Mirna Sabbagh: Adult and Child Nutritionist

We hope this was helpful! Please discuss the matter of reflux with your doctor before assuming that your baby has other health conditions such as CMPA condition or other, or even before assuming that breast milk could be the reason why your baby is having colic.



To view my full interview with dr. Rania Ayat Hawayek, click on this link.

 

Mirna Sabbagh, an adult and child dietitian, nutritionist, and lactation consultant. She also has several digital courses: Pregnancy Nutrition Course, breastfeeding course,  starting solids 6-12 months course, and also child nutrition for all children including picky eaters, that you can sign up for from the comfort of your home.

The courses are pre-recorded. As soon as you make the course purchase, you will receive a link to watch the course from your phone or laptop.

You can also e-mail Mirna for questions on info@mirnaelsabbagh.com

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