lessons in infant reflux and what’s working for us

Jai’s reflux was not always an issue. The first 2-3 weeks after he came home were pretty easy – feed, burp, hold for 10-15 minutes, Jai passes out, Mommy and Daddy settle Jai into his co-sleeper. Piece of cake. Well the party ended quickly and the reflux smacked us right in the face.

And what a rude awakening it was.

The routine almost instantly changed to: feed – burp – feed some more – try to get Jai to burp and not projectile vomit out what he just took in – hold Jai up right with constant fear that he may projectile vomit right into our face or worse, our mouth. Yikes. This was followed by trying to get him to finish the bottle while he’s arching, squirming, grimacing with discomfort – then another attempt to burp – hold for 45 minutes to an hour or more – try to put him down – crossing fingers that we doesn’t have a major spit up while he sleeps or that he doesn’t wake up from the pain of the acid burning his sweet little throat. Oh my poor baby – and oh poor mommy and daddy too! Anyone out there relate or know what you can do to stop these problems, do you feel our pain?

We looked desperately for solutions – anything to help Jai through it and us too. At the recommendation of our pediatrician, I went on an elimination diet, which meant no dairy, no soy, and no gassy food likes broccoli. Simultaneously, we tried Similiac Alimentum – a super expensive formula that also smelled nasty designed for babies with sensitivities to milk or soy protein. Come to find out, Jai did not have a milk protein allergy, so I was back to my normal diet and we chucked the Alimentum. We continued to read a lot online and talked to friends/family – (special shoutout to my girl Bhagi for being the first one to send me all her tips!). And we ended up with a lot of helpful advice and solutions.

Jai’s reflux has definitely improved, as we knew it would with time; however, I know that many of the things we tried along the way really helped us through this crazy ride. In addition, I know it helped me to hear what other parents tried and what worked or didn’t for them so I wanted to share what we tried and worked for us. I tried to organize all of the advice into an order, which I think makes some sense. Hopefully, it will help parents out there who are going crazy with their refluxing little one.

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Breast is best, if possible:
If possible, give your baby breast milk. I’m still providing it for Jai and really had a lot of incentive to for so many reasons but especially because of his reflux. Breast milk digests much quicker than formula. And the less time milk spends in your baby’s stomach equals fewer chances of spit-ups and discomfort. Although Jai is currently being supplemented with some formula too, giving him breast milk has helped tremendously.

So fresh and so clean (before feeds):
Before each feed, Jai’s diaper was changed. This is so important to do before the feed and not after since baby’s belly is full afterwards and there will be increased chances for big spit ups and discomfort. Another tip we learned is to roll baby to the side when placing a diaper under him rather than bringing his legs up toward his head or bending them. This can squish their little tummies which again can result in major spit ups.

The right bottle:
Dr. Brown’s bottles actually work. They are designed to reduce the amount of air your baby takes in because of the unique internal tubing system which removes the vacuum that builds up inside the bottle. I recommend trying Dr. Brown’s bottles if your baby is refluxing and/or gassy. There are a billion parts to this bottle so it makes it annoying to clean but I know it’s made a difference for Jai so we’re big time fans!

Wrap ’em up like a burrito:
Swaddling was essential to keep Jai organized while feeding and helped to maintain his level of comfort and security since he arched his back and squirmed around a lot in the beginning. We thought about getting him a feeding bib but he might be a little young for that at the moment. We made sure not to have the swaddle too tight around his belly area but also were certain to keep his arms and hands contained. The only swaddling blanket that really ended up working for us is the Aden and Anais swaddling blanket. We tried the Miracle Blanket when Jai was much younger, and although it worked great to keep him swaddled he got way too hot in it. I have one hot baby! The Aden and Anais blankets are made of a muslin gauze like material and really help to keep him comfortable although I have to admit, throughout each feed we have to reswaddle him several times since he manages to squirm himself out of it when being burped.

Mastering feeding positions:
The more upright we held Jai while bottle feeding (I pumped and started exclusively bottle feeding less than month into Jai being home) meant that he swallowed less air which meant that less milk came back up. A baby lying flat on his back or with even a slightly turned neck will swallow more air and is more likely to reflux. Holding Jai in these special positions while feeding was hard but ended up proving to be worth it. After we mastered holding him, feeds went much more smoothly. Initially, I was holding him completely sidelined on my lap with my knees bent and legs propped on the side of the bed. Basically, he was on his right side (I’m left handed) with his feet down near my stomach. Again, this was not the most comfortable for me but very helpful for him.

Keep it short and sweet:
Since a too-full tummy can put pressure specifically on the lower esophageal sphincter (thanks to Hitesh for helping with the correct medical terminology) or just on the belly area in general, it can cause babies to spit up. Smaller feeds worked for us for a short period of time but it was hard to do this for very long because Jai was not satisfied with small feeds…which leads to me my next piece of essential advice.

Burp breaks:
This is extremely important. Burping helps to get rid of some of the air that babies tend to swallow during feeds. With most reflux babies, not being burped enough will lead to even more spit ups, which leads to more crankiness and more gassiness. Since Jai was bottle fed, we usually burped him at least after every 1.5 – 2 ounces or sometimes less if he was squirmy or showed major signs of discomfort. I read that breastfed babies with reflux should be burped when they also start squirming around and definitely when momma switches from one side to the other.

I burped Jai over my shoulder and held him close enough to me so that he did not bend, slouch or slump. I was told by a nurse to rub his back starting from his left shoulder and moving my hand clockwise. Supposedly, that is the most effective way. It worked for us. Also, gentle but firm pats worked. Sometimes and for some reason, just standing up from a seated position, worked magically to cause a burp or two.

Even burping before beginning a feed helped Jai. I know, you’re thinking what baby needs to be burped before a feed? Parents of a refluxing baby…you know exactly what I’m talking about. Sometimes your baby will let out a big burp, wet burp or a spit up even hours after a feed. This will help, try it out.

Use protection…burp cloths & bibs:
Most burp cloths I found were too thin so quickly, I switched to all cloth diapers. Anyone who has a refluxer in the house knows the value of good burp cloths. Cloth diapers have great absorbency and are definitely the way to go. We use the Babies R Us store brand cloth diapers and they work great.

As far as bibs go, I love this brand called Green Sprouts. They proved to be incredibly absorbent plus they are eco-friendly, which is a an added bonus.

The Aden and Anais burpy bib combo is awesome too. So useful and multi-functional…totally plan on getting some more of these soon.

Hold that baby:
It’s not rocket science, if you want gravity to help keep stomach contents in the stomach and out of the esophagus and onto your baby, yourself and your floor… then you want to keep your baby perpendicular to the floor pretty much all of the time. Carried babies are less stimulated and so experience fewer incidences of major spit ups and vomiting.

Since it’s super exhausting and next to impossible to do this all of the time, I have to especially stress how important it is to hold for at least 30 minutes after every feeding. With Jai, we were initially holding him for almost an hour, sometimes more to ensure that the milk stayed down. Gradually, we decreased it down to 30 minutes, which we are still doing now. The main thing we had to keep in mind as we carried Jai was to avoid putting pressure on his tummy. It’s important to make sure that your baby is not slumped in any way and that the spine is straight while you’re holding. This made holding him for long periods of time hard, but it was necessary. We also learned to never hold him on our hips as this definitely puts pressure on his tummy. The best position that I found to carry Jai was with his bottom on one forearm and my other hand behind his back to support it and keep him close to me.

There are many baby carriers and slings in the market that can help carrying baby much easier. We have a Baby Bjorn carrier which we feel will put too much pressure on Jai’s bottom so we haven’t really used it much. I’m still interested in the Moby wrap/sling but not sure if we’ll really get one at this point. Plus, my arms are getting so toned that it’s hard to justify making a change right now. 🙂

Keep calm and carry on:
Stimulation, including laughing and crying, can trigger infant reflux episodes. We limited Jai’s interactions after each feed and usually he took a good nap afterwards anyways. We also kept our movements as we held him, down to a minimum. Very gentle swaying or rocking in the rocker were ok. Anything more, and it could get messy.

No pressure please:
We still primarily dress Jai in onesies. Pressure against his belly is a big time no no, so onesies are his attire of choice, (I mean our choice) for now. They work better than any other clothing options. I can’t wait to dress him in cute shorts and pants but for now, those will have to hang patiently in his closet. The elastic around the waists will undoubtedly add unwanted pressure to his little tummy. We even keep his diaper looser than what’s considered normal just to keep added pressure off.

Pacifier perks:
Pacifier use is encouraged for all newborn babies but it’s an especially powerful tool for refluxing babies. Pacifiers encourage saliva production and saliva is a natural antacid. This Wubba Nub pacifier was a nice find since Jai could hold onto the little giraffe which helped to keep it from constantly falling out of his mouth.

According to WebMD:
• A new study shows that infants who suck on pacifiers have fewer and shorter episodes of reflux, although researchers don’t go so far as to encourage the use of pacifiers.
• Pacifiers stimulate the flow of saliva and downward contractions of the esophagus, reducing the time it takes to move the irritating stomach fluid back where it belongs.

Initially, Jai loved his pacifier and we encouraged him to use it for the reasons listed above. But now he wants nothing to do with it, so we stopped offering it.

Elevation:
Initially, we elevated the co-sleeper he slept in by propping up the side by his head with pillows. We also bought cinder blocks from the hardware store and propped up one side of the pack-n-play that he slept in once he got too big for the co-sleeper. Since we wanted him to sleep in our room in the beginning, so we decided to just move the pack-n-play in instead of moving the crib from the nursery.

Once we felt he was ready to be full time in his crib in the nursery (around month 6 for us), we purchased a crib wedge to provide some elevation. We still have this Safe Lift Universal Crib Wedge under the mattress in Jai’s crib. I am not sure if it’s because of the wedge or not or if it’s because Jai’s reflux has just gotten better, but he does sleep comfortably in the crib for the most part. I had my doubts with this wedge since I didn’t think it provided the 30-degree angle that is needed to really help with reflux. But we still are using it even now.

An awesome tip I got from a gal at Buy Buy Baby was to purchase a crib sheet protector. Boy, am I glad I got this thing. It totally protects you from having to clean dirty sheets all the time and if you have a baby that spit ups a lot, this a necessity. You just unsnap and snap around the rails of the crib…it’s that simple. SO much easier than removing all the bedding and then putting it back on each time there’s major spit up.

Chillin’ in the Nap Nanny:
This infant recliner helped Jai get comfortable and fall asleep. The incline seemed to be perfect for him and he had minimal spit ups while chillin’ in it. Of course, the Nap Nanny Chill should be used with caution and only on the floor. I have to admit, we used to keep it in between us in our king sized bed sometimes…but only when we were awake and watching close by.

Baby Bjorn Babysitter Balance:
The Baby Bjorn Babysitter Balance is really awesome. This thing is a baby bouncer and an upright chair that you can adjust the angle on, which provides you with a much needed break from carrying your little one and your little one some freedom. It definitely does give us all much needed relief. The incline your baby can get in the babysitter balance is terrific for preventing acid and spit up from coming up plus it really doesn’t add any pressure to his tummy. Usually, if Jai doesn’t fall asleep after his feed and it doesn’t look like he’s tired plus he’s already been held for at least 30 minutes, we use slide him into this. It works wonderfully. He also loves being in it for story time.

Get baby’s sleep on:
Getting your little one to sleep fast after feeds is important because this helps keep more of the feed in the stomach. I totally suggest getting a sound machine to help with this. We purchased the Cloud B Sleep Sheep. It’s a cuddly, soft stuffed sheep that has four different sounds to help your little one fall asleep. There’s the heartbeat (Jai’s favorite), rain, ocean and whale song. It has a 23 and 45 minute setting, giving you enough time to get your baby to sleep, plus it has volume control. You can attach it to the outside of the crib or anywhere else using the Velcro straps. Jai fell asleep so easily to the heartbeat sounds after feeds.

Ok parents of refluxers, hope this long list helped a little. And if you have your own tried and tested methods of combatting the nightmare known as reflux, we’d love to hear from you! Words of encouragement from mommas & poppas is welcome too!

-Shraddha

0 Comments

  • Bindhu

    our second had something called silent reflux which basically means she had the pain… The arching of the back, the constant crying, fussiness, hard time falling asleep and staying asleep, etc, but no spit up at all. So for the first few weeks we thought it was gas, we thought she wasn’t getting enough milk, we though gasp she may have colic. Finally at like the one month check up after I told my doc all we tried and the symptoms, a light bulb went off, she said silent reflux, and said to try Zantac. We started trying it and in under a week she was a completely different child. We did it until 6 months when solids were introduced… Solids are supposed to reduce the symptoms of reflux but I refused to give her the rice cereal in the bottle thing at such a young age.

    • Shraddha

      Hi Bindhu…thanks for sharing info on silent reflux and how you overcame it. Certainly, medicine can help and I’ve also heard about solids. We’re going to begin solids soon so hopefully, it lessens the reflux that Jai has still. I also agree with not giving rice cereal in a bottle. We were not fans of that idea at all!! Thanks again!!

    • Jessi

      My son also had silent reflux. He rarely spit up, but one night he had an episode that it obstructed his airway and he stopped breathing. Worst few days of my life…thankfully we were able to resuscitate him. After he was tested to ensure no brain damage from lack of oxygen, he was given a swallow study. Based upon it he could not tolerate thin liquids. One of the things we had to do was put a tbs of rice cereal for every two ounces of formula. He was limited on juice. Zantac was not effective so we were given Prilosec and the combination of medication and thickened liquids worked great. Once he was off the bottle we didn’t have to worry too much because of the solid foods and he had better muscle tone. When he was still using a bottle he had the greatest success with the Avent bottle, and we burped about every 2 ounces. He was able to stop medication after about a year and had had no issues since!

      • Puja

        This is so helpful! It is so scary when our babies go through this. Thank you for sharing and reading our blog Jessi!

  • Ankita

    Wow!! this is some really good information. I can only imagine how difficult it can be for both parents and the child. I am sure all the parents dealing with this will appreciate all the information that you have shared.

    • Shraddha

      Hey Ankita…it’s tough having a kid with reflux (mainly b/c as parents, you hate to see your little one go through anything even slightly annoying) but usually it’s only a matter of time before they out grow it. And yes, if this post helps even one parent out there living the nightmare of reflux…I’ll be incredibly happy. 🙂

  • girija

    Wow! Lots of wonderful information and exactly what we are facing with our 2-week baby girl. Wish I had seen this before but our nights and days have been filled and traumatic as first time parents.

    • Shraddha

      Hi there! Congrats on your baby girl! Just remember, there is no right and wrong with parenting…gotta do what works for you and your baby…you’re doing great! I felt all the same trauma, anxiety when we brought our son Jai home…but with time, you’ll feel like a pro. Hope all of the info in the post helps and let me know if you have any other questions. Hang in there!

  • Cin

    Thanks for all the tips. My baby girl suffers from silent reflux, and it’s so hard to watch her struggle. Feedings are difficult. She squirms, pulls off, and arches her back. I’m constantly burping her even 2 hrs after feeding. She wakes up crying in pain from naps and has a hard time staying asleep. She salivates excessively and constantly wants to gnaw on something. She never spits up, but I can hear it coming up. I take it day by day. I try to not to lay her flat except for diaper changes and keep her upright as much as possible. It’s hard, especially as a first time mom. This is really helpful.

    • alex

      hi there, i’m alex, from Brasil. our 3 months manuel is a refluxer too, as we even change his biodegradable diapers on a triangle pillow we ourselves made by cutting a large piece (70 x 40 x 30 cm) of pillow. we attached a cloth diaper on its upper side, by tresspassing it side to side, on what we hold his chest, below his arms. or even mom and dad do it together, holding him to not slip down while we do the changing. this way, we keep following the thing on n-e-v-e-r flatting! every improving is important. peace and good luck for you all!

  • Cat Young

    Thank you for all the advice you’ve posted, our second child had lots of symptoms of Silent reflux and thanks to my sister who suffered this with her daughter she managed to help us spot it at 3/4 wks old. After battling to get infant gaviscon prescribed he has seemed calmer, and had less episodes. He likes his dummy as well which I’ve now seen helps. I’m struggling with breast feeding purely as everything is so exhausting with his unhappiness plus feeding issues from reflux and my supply has been all over the place thanks to his comfort eating but it’s encouraging to read that this is helpful. I’m keen to carry on but will introduce a couple of bottles to help take off some of the pressure.
    It’s been a hard two weeks and all with a toddler in tow!!! It’s good to read about others & their experiences and helpful tips! Thank you

    • Shraddha

      Cat, you are so welcome!! Good luck – remember this too will pass!!

  • Jessica

    Thank you for sharing all this helpful advice! I’m a first time mom and my little one is struggling terribly with reflux. This post brought me comfort along with a lot of great ideas; I’ve already purchased several of the products you recommended and they are helping to make things a little better. In this post you mention that Jai’s reflux improved as he got older. My daughter is 2 months old now and I’m curious how long the reflux will last. When did you begin to see some improvements? And when was it completely resolved? Thanks so much!

    • Shraddha

      For us it lasted until about ten months- I know it seems forever!! Hang in there and just know, soon it will be a distant memory.

  • Rudy

    Hi shraddha, your post was really well organized. My 2 month old baby girl has reflux and it is so difficult for me to see her suffer with the arching and other symptoms. We have been trying to constantly hold her upright which can be tiring. I was wondering after you held your son upright for an hour after feeds, were you able to lay him down in the pack n’ play without spit-up?
    I considered buying the baby bjorn babysitter balance but ended up getting a momaroo; do you think they are comparable or is the baby Bjorn more upright?
    Also, could you describe again how exactly you held him for feeds? I am still looking for an optimal bottle-feed position.
    Lastly, how did your son take to the alimentum? I am thinking about trying her on it this weekend.
    Thank you so much for taking the time to answer my questions, the Las few weeks have been quite a challenge but I’m praying she gets better!

    • Shraddha

      Hi Rudy! Sorry for the delay – I was on a vacation! Anyways, I’m sure you need one after all the reflux madness…but it will end I promise! For my son, yes I was able to lay him down after a 45min to an hour of holding. I know it can be tiring. But even in the crib or pack n play, we put one end on stacks of books so it was slightly tilted. The angle helps. We also chose the bsby bjorn – it worked really well. He did not like the mamaroo at all. It’s a personal choice but the baby bjorn worked really well for us…your baby will tell you what works for her. For feeds, I held him will full support using one hand and arm along the back of his body and fingers supports neck and head. His bottom was supported by my knees and he was completely sidelined. Does that make sense? So let’s say you are sitting in a chair with your legs straight touching the floor. Then hold baby as I described above – baby will be looking at a wall hypothetically not facing you. Your arm and hand will support the baby’s head, neck and back fully and baby’s bottom will be sort of supported by your knees. Feed for a few minutes and then take a break to pat the back and burp. Do this until the endof the feed. Even before you begin a feed, burp. Of course, burp after…get a couple of good ones. We did not use alimentum for long. It didnt work and it smelled so bad. So that was not something that I can really tell you much about. Our experience was short with that formula. I am praying for you and sending you best wishes – I know it feels like it will never end. BUt it will!!!

      • Rudy

        Hii shraddha, thanks so much for the reply. Our baby girl seemed to be doing better for a while after she was started on medication but then she had a few days of constipation which worsened the reflux and now we’re back to square one with spit ups. We may switch formula again but was wondering if you used anything in particular to prevent constipation in your little one? I have been using pear juice but worry that its too acidic.

  • Sinduja

    Hi my 3 month old preemie stretch her body and grunts if I put her down. She will not do all time while sleeping but she does often,sometimes even while feeding. But she will calm down if I hold her. We feel that she has indigestion problem. Will you name this as reflux.

    • Shraddha

      Hi Sinduja…sounds like it to me. We seem to have experienced the same thing. It will pass but just stick with my tips and just know that this will be a distant memory in a short amount of time. Keeping them upright – I know it’s hard – is the bEST thing for them!!

  • Erin Kern

    I was wondering, if you had to choose between the nap nanny (actually the dex day dreamer now that nap nanny is recalled) and the baby Bjorn seat, which would you choose? Both are expensive and I’d like input from someone that’s used both.

    • Shraddha

      Baby Bjorn hands down!! We LOVED that thing! and we didnt even use the nap nanny after so many bad reviews the second time around with my younger son.

  • Rosemary B Martin

    Great job! I hope many people read this and are helped!

  • Shefali

    This is a great post with great tips and reader comments. All the stories sound too familiar. Our daughter has gerd and laryngomalacia. She tried Zantac, then switched to Prilosec. A world of difference in terms of pain but to avoid vomitting we hold her up literally 22 hours a day. My husband sleeps in an arm
    Chair holding her. She is now 18 weeks and we just introduced the mammaroo. Some other things that worked for us:
    We put her in mamaroo an hour after she eats, no sooner.
    We have the ergo baby carrier and she tolerates it.
    We don’t put her in car seat for 90 minutes after she eats
    She is exclusively on alimentum. We introduced it very early on, around 3 weeks, and supplemented with breast milk. I was on a no dairy and no soy diet but at 9 weeks her gastroenterologist told us to stop the Breast milk altogether in case there was something else in my diet bothering her..
    We burp her in a face down position – very important!! Hold baby face down but holding her across her chest without touching her tummy. I am not describing it well but in this position it is very unlikely that fluid will come up with any air bubbles.
    Lastly we have a boppy under her changing pad so she is on a slant even during diaper changes.
    The hardest part has been to hold her vertical. Enlist the help of family friends and neighbors or hired help to come hold the baby while you shower or cook or clean. It will really help.
    Good luck!

    • Shraddha

      Hi Shefali…thanks!! Sounds like you’ve got a great set of things that are working for you and your baby girl. Totally agree that its hard to hold vertically for practically all day…enlisting all the help you can get, that’s a great tip!! One that we didnt use that often…but that’s for many other reasons. Anyways, hang in there and know that it only will be a distant memory in a short ( know it seems like forever!!) time. Good luck and best wishes to you momma!

  • Jen

    I just wanted to share that here is a recall on the nap nanny. There have been several deaths and injuries.

    • Erin Kern

      Notice above the comment from me on June 24th of last year and the author’s response on July 6th .

  • Allison

    Hi there, hope you are still taking follow up questions. How did you know your baby did not have a dairy protein allergy? Mine is currently on alimentum, and I am not sure if it is really working or even necessary, and it is $$$. I feel it may have been a knee jerk reaction from the ped to ease his colic.

    • Shraddha

      Hi there! Sorry to hear that you’re going through this too. My baby did not have the typical dairy reactions…like loose stools, green stools, lots of crying or any type of hives or reaction to skin. Does your baby have any of these reactions?

  • Allison

    He only cried in the evenings. He had a lot of gas and at two month visit was put on Zantac. He’s doing much better. He’s still on Alimentum. I’d like to talk to doc about how to wean him off of alimentum and which formula to switch him to. What formula did you choose when stopping Alimentum?

  • Komal

    Question, what bassinet did you use/others use for a baby with acid reflux? We had gotten the Chicco Lullago Bassinet at our babyshower and it worked fine for awhile but now that we need to slightly prop his mattress we’re nervous bc the mattress for our bassinet folds. meaning there is an angle in his mattress and it’s not flat and we’re pretty sure that’s bad for baby. We’re wondering if we should go ahead and transition him to a crib early so the mattress can be propped for nights he’ll actually agree to sleep in it (unsure when that will happen again) or if we should spring for another bassinet that has a mattress that can be safely propped up. Our son is 7 weeks old tomorrow.

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