Birth Concerns #2 with Shelley the Midwife: Baby Reflux
For my first blog post of 2022, I am very excited feature a returning guest, the fabulous Shelley Wilson, founder of Baybee Beginnings, a wellness company that delves into all aspects of pregnancy, childbirth, infant feeding and beyond. Midwife, Lactation Consultant, and creator of the super fab 40-week Squad (which will nuture you throughout the whole of your pregnancy!), Shelley also offers a whole range of postnatal packages.
Shelley is passionate about empowering, nourishing and nurturing parents and babies throughout the beginning of their exciting life journey (and is also a former professional nanny like myself!). Last year I asked Shelley what concerned new parents the most about pregnancy and birth, and we began with Induction of Labour, this time, we cover another big topic, baby reflux! Shelley has very kindly agreed to provide all you need to know about this topic for our blog post together, so here we are - the low-down on baby reflux (plus how tummy time can help!)!
Shelley, What exactly is reflux?
Shelley: "The true cause of reflux is that there is too much air in the stomach. When the baby eats or drinks, laughs or cries, they fill their stomach with air at the same time, causing the stomach to contract. The air inside the stomach adds additional pressure from the inside and this means that when the stomach contracts to move food out of the stomach (usually about 30-90 minutes after a feed) the air mixed in with the milk and the stomach acid becomes a bit like rocket fuel, its an explosive force which causes a burning sensation in the throat.
"Most babies have a naturally immature digestive system, a natural weakness in their sphincter muscle. They are unable to fully digest the milk they are given, and because of this they get trapped wind which causes irritation, pain and distress. This causes them to cry, which exacerbates the reflux due to an excessive amount of air being taken in by the baby. so if they are taking in a lot of air when feeding (breast or bottle) then they may be worse. It isn’t until the infant starts sitting up straight that the stomach moves into a more upright position."
What else can cause baby reflux?
Shelley: "Causes of reflux can be:
Aerophagia (taking in air)
Poor latch ( both in breastfeeding and bottle feeding)
Physical issues e.g pyloric stenosis (the sphincter valve between the stomach and duodenum clamps closed
Cows Milk Protein Allergy
Congenital Lactase Deficiency – the baby has insufficient lactase to break down the lactose in human milk
Galactosemia – the baby’s liver cannot break down the galactose in milk
Shelly, does every baby get reflux?
Shelley: "No, not every baby gets reflux, but it is extremely common. There are varying degrees of reflux and that is probably down to the underlying cause. A baby who is taking in a lot of air when feeding (breast or bottle) may be worse than a baby who is only taking in a little bit of air. On the same note, if they have severe allergies or a more serious tongue tie then this may cause more severe reflux. As usual with babies, nothing is black and white and there is no such thing as standard reflux. Some have silent reflux, which means there is no vomiting associated with it, whereas others have excessive projectile vomiting."
What are the benefits of "tummy time" (very simply letting your baby spend a little bit of time on their tummy!), and what has it got to do with baby reflux?
Shelley: "Babies need to learn how to use their bodies freely after being tucked up in a flexed position in the womb – tummy time enables this. Tummy time also promotes natural formation of the spine and prevents flat spots at the back of the head, and allows baby to strengthen their neck, back and core muscles. It increases a baby’s sense of limb and joint awareness, thereby improving coordination, and provides invaluable bonding time. Tummy time also assists in relieving baby reflux!!"
How we can help babies with reflux by encouraging "tummy time"?
Shelley: "Placing babies in the seated position too often can exacerbate reflux symptoms. Babies younger than 6 months old tend to adopt the slumped position (“c” shape) due to a lack of postural control, and this may contribute to reflux symptoms, due to increasing pressure on the abdomen. Overuse of car seats/swings/jumparoos/bumbos and bouncers make reflux symptoms worse. Apart from car seats, these baby containers should be used for a max of 15 minutes a day. Some of the symptoms of reflux can be improved when a baby has more postural control and begins sitting, which we know tummy time supports the muscle development for.
How do I do tummy time?
Shelley: "With newborns, encourage TT on the your own tummy or lap first, before coming to the ground. TT should not be done until at least 40 mins AFTER a feed. A change in position or pressure on the tummy can make a baby with reflux bring up some stomach acid, which can cause pain and discomfort. This could be with or without vomiting, but it means that any change in position should be done slowly and steadily. Follow baby’s cues, and just do it little and often. Once the baby is a bit older and TT is on the floor use a rolled towel, or something like the Wedgehog Play Mat, to raise the infant up slightly (this helps to prevent acid going back into the oesophagus).
"How to initiate tummy time:
Start slowly, many babies struggle with TT initially
Begin with 1-5 minutes, 3-4 times a day from birth. Build these times up gradually, adding on 1 minute every 4-5 days
Aim for 60-90 minutes a day by the time the baby is 3 months old. This does not mean 60-90 minutes in one complete session, instead could be 10 minute sessions 6-9 times a day.
Change the baby’s position frequently to ensure they are getting a variety of positions
Baby must be awake and supervised by a competent adult, keeping airways clear and removing all small objects out of reach
Avoid tummy time when child is unwell or medically compromised in any way (eg breathing difficulties)
Current advice remains BACK TO SLEEP, TUMMY TO PLAY
"Important to remember: tummy time is an opportunity for parents/caregivers to connect with their baby – it is an opportunity to connect, instead of just putting the baby down on their tummy with no interaction."
Thank you so much Shelley! Good to have all info and for parents to to hear it from such a calm and professional source! If you have any more questions, you can get in touch with Shelley via her website Baybee Beginnings, full of lots of great support for parents about pregnancy, childbirth, infant feeding and beyond. And why not join her super fab 40-week Squad (which will nurture you throughout the whole of your pregnancy!).
Check out my other posts for more info and advice on screen time, dinner times, fussy eaters, buying pre-loved children's clothing, decluttering before your new baby, and more about health, nutrition, holidays, babymoons, and all things parenting!
Get in touch for more information on any of the topics mentioned here or elsewhere on my site, I would love to hear from you! Happy New Year!