Before I begin, I want to be clear that I am not a doctor, medical professional, or qualified to give medical advice. The information provided here is based on what I have read, and my own observations and experiences. I recommend that you talk to a qualified medical professional if you read anything here that gives you cause to think your child may have GERD/GER or another condition.
As mentioned in my previous blog, our little one has been suffering from GERD since she was born ten months ago. Since my last entry, there have been some slight improvements. I write that likely to my own peril because every time I mention there have been improvements she has a set back.
GERD/GER is becoming better understood by the medical profession and I would like to continue to help raise awareness of the condition. For some background, please review my previous entry, “Living With a GERD/GER Baby.”
GERD/GER was often dismissed as colic because it’s not easy to diagnose and a baby can’t tell you that it has a burning sensation caused by acid reflux. Unless viewed as a whole, the symptoms can be missed.
One of the most common symptoms is throwing up because the muscle that holds the contents of the stomach is underdeveloped. After GER/GERD babies eat, they vomit easily. In mild cases, this can be a little spit up, while in more severe cases it can be projectile vomiting. When it’s a more severe case, the infant can become undernourished because he/she isn’t getting enough food. Though often a main factor in diagnosing GERD/GER, it’s not always a prevalent one since babies can spit up and swallow it, or it’s passed off as something babies do because babies can puke frequently without suffering from reflux.
In my daughter’s case, she gained very well, though mostly because she wanted to eat frequently (ever hour to two) to help sooth the reflux. She did vomit a lot, and, at times, I was sure it was the whole meal she had just eaten. Thankfully, there was only one major projectile incident. You also couldn’t jostle her too much after she ate or put any pressure on her stomach because it would cause her to puke. This has mostly tapered off but she still can’t wear any pants or it bothers her stomach.
Not all babies with GER/GERD are anxious to eat. Some babies refuse to eat because they realize it causes them pain. Others, like my daughter, will start to eat, stop, cry out or just start crying, then start eating again. Naturally, when a baby refuses to eat it is also a major concern, especially when the baby fails to thrive.
As you can imagine, sleep is often disrupted for babies with reflux. When people with reflux lay down, especially flat on their backs, acid from the stomach has an easier time rising into the throat. Often, when babies with GERD/GER sleep, they cry out, arch their backs, or wake up coughing or choking. For me, this was one of the first signs that something wasn’t right. My daughter naps an average of half-an-hour (more if I’m lucky) and is up constantly at night. When it was bad, she would be up every 15 minutes to half-an-hour. If I got an hour sleep, I was lucky. Now that the condition is starting to settle, she’s up an average of every two hours on a good night.
Babies with reflux often cough because of the sensation of the acid rising in their throats. I have found that my little one also sneezes because it goes as far as her nose and she seems to have a dirty nose all the time because of it. Frequent hiccups, wet burps, and gagging are other possible signs of GER/GERD. You may notice frequent swallowing and facial grimaces as the baby tries to clear the burning sensation away. A baby could cry out suddenly as it experiences the reflux, and usually shows another symptom including arching the back, a cough, or gagging.
These are some of the signs that a baby may suffer from GER/GERD. If you suspect your baby does, the first thing you can try is elevating you infant’s mattress. Sometimes that is all a baby needs.
If you are propping up your infant’s mattress follow safety guidelines.
Never put pillows or other soft objects in the crib that pose a suffocation hazard. It is recommended that you prop up the actual crib by putting one end on the back of a foldout chair so the baby sleeps at a 45-degree angle. You can also use books to prop up the legs of one end of the crib. There are foam wedges you can purchase that go under the crib mattress as well.
If you prop up the mattress the next issues is keeping the baby from sliding to the bottom of the crib. You can purchase a sling or make one from a bed sheet to keep the baby in place. My mom made a little bed with tightly rolled up material on two sides and one on the bottom that holds the baby in place. You are more than welcome to contact me for more information on these.
Other ways you can make your baby more comfortable are to keep the baby upright as much as possible, especially for about half-an-hour after the baby eats. When you feed the baby, breastfeeding or bottle-feeding, try to feed the baby as upright as possible. That’s tricky when you are breastfeeding. To help, you can use a wedge or pillow in your lap to elevate the baby’s head or try the football hold.
You can also do small feedings, more frequently. By not filling the stomach too full, the acid doesn’t have as much chance of rising out of the stomach. I would breastfeed on one side every two hours. You just have to play with it and find out what’s right for the infant.
Sometimes when a baby starts solid foods, the condition lessens because solids are heavier and remain in the stomach easier. Unfortunately, this wasn’t the case for my little one. She has trouble sitting in the highchair because she slouches when she sits, which puts pressure on her stomach. It’s getting better, but she will often refuse to eat partway through her meal because her stomach is bothering her. I often feed her in an exersaucer (that’s not a good habit to start, but sometimes you have to do what works) or take her out of the highchair and finish the feeding on my knee (also not a good habit because she’s starting to learn that if she cries I will take her out of the highchair).
She has a lot of trouble with some foods, especially jarred baby food. Thankfully, for both my children, I make a lot of my own food. Every child is different, but here are some foods I find aggravate her stomach; sweet potatoes, apples, peaches, and I’m suspecting any of the fruits with the ascorbic acid manufactures put in to keep the colours. Other foods I suspect are watermelon, mango, and honeydew melon. I don’t know why, but after she eats those she seems to have problems. I haven’t tried her on anything that I know is acidic including foods with oranges or other citrus fruits, tomato sauce/paste, and pineapples. Water, because it’s so thin, can also cause her problems so I make sure I only give her a bit at a time.
Car seats and infant seats can also aggravate the condition because of the angle the seat is tilted back at and if the bottom of the seat forces the legs up, it can put pressure on the sensitive stomach. To help, you can roll up a washcloth and place it at the lower back to give the infant more support, as well as tightly roll some blankets and place them at the sides of the baby so it doesn’t tilt to one side.
If symptoms persist after you have tried elevating the mattress, contact a doctor to discuss the situation. There are medications infants can be put on if they have a more serious case of reflux, but it is also important to make changes at home to help your baby be more comfortable, including the elevation of the mattress, and frequent feedings of small quantities.
Most babies outgrow GERD/GER in the first year. Some get over it around four months, while others it’s between seven and 12 months. I have talked to a woman whose grandchildren didn’t grow out of it until they were two. For most babies, as they develop the ability to hold themselves upright the affliction can start to subside.
It’s a long wait for a baby to outgrow reflux with many sleepless nights, watching the baby suffer without anything you can do except hold it upright, and analyzing everything you do that may affect the baby’s stomach. It’s very stressful and heartbreaking to witness. One thing I am thankful for is that it is a condition that can be outgrown and managed, and not something more serious.
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