Can Reflux Affect My Baby's Sleep?
wondering if reflux is stopping them sleeping?
Sleep issues with a little one that wakes frequently or is inconsolable around nap or bedtime can feel helpless, stressful & completely draining for parents. It's hard! These often have a compound effect on your own quality of sleep too.
Do you find yourself asking questions like; why your baby doesn't sleep like your friend's baby does, unsure of what strategies are or aren't working, or feeling confused why one day they slept really well & the next it totally fell apart, even though you didn't think anything was different?
Let me tell you that it is important not to lose hope, not to feel upset or deflated if what you're trying isn't making a difference, or you aren't sure who to ask for help. So many parents feel the same as you do!
A baby that is experiencing symptoms of infant reflux, silent reflux or colic, on the other hand, is likely struggling with their sleep.
I often get asked by parents:
💤 What can I do to help them get to sleep?
💤 Is it related to my baby's reflux?
💤 Can reflux be worse at night?
💤 What sleep position is best for my baby's reflux?
💤 Why does my baby make noises in their sleep?
💤 Why is my baby worse lying flat/on their back?
💤 Should I raise the head of their crib?
💤 Why doesn't my baby sleep through the night like others do?
Many parents are looking for the same answers you are, trying all the tips & tricks you can find online, following advice given by those around you (welcomed or not welcomed, if you know what I mean!) or in books you've read.
Sadly, many will still fall short in providing you the holy grail of solutions. Want to know why? It's because finding the underlying cause of your baby's sleep issues & reflux is the only way to change things!
It's important to remember, when you're in the depths of frustration & wondering how you can help your little one sleep well, that just because your baby is having trouble sleeping now, it does not mean this will always be the case!
Did you know: disruptions to sleep can increase the risks of some chronic conditions long-term?
This may include raised blood pressure, obesity, hormonal imbalances, asthma & diabetes!
Firstly, what is infant reflux?
Infant reflux, also referred to as acid reflux or gastroesophageal reflux (GER), is when a baby is experiencing vomiting or spitting up, typically after a feed. Silent reflux is similar to reflux, but there is no physical vomiting or spit up seen because it stays within the oesophagus/food pipe or back of their throat.
It is often reported that reflux is due to a 'weakness' in the opening of the stomach between the oesophagus & stomach, called the lower oesophageal sphincter (LOS). This LOS, however, is actually just not strong enough yet, continuing to strengthen as the baby grows & develops their feeding skills in the first few months of life. There are many causes of reflux in babies, with consequences that can be long-lasting if they are not addressed early.
Reflux can occur day or night, often (but not always) causing pain & discomfort for your baby due to the constant irritation & inflammation to the lining of the oesophagus by the stomach acid.
Some common signs of reflux include:
🌻 Frequent vomiting, spitting up
🌻 Trapped wind, bloated or rock hard tummy, difficulty burping them
🌻 Lots of tension in their body, thrashing arms/legs or arching their back
🌻 Noises like grunting, coughing, gulping, gagging or even choking
🌻 Disrupted sleep, hard to settle or soothe
How does reflux affect their sleep?
We all sleep as the result of a biological process that is governed by our body. This is called our circadian rhythm, which is roughly 24 hours long. It allows our bodies to rest, restore & replenish cells in the body, among other benefits.
From the time they are born, babies nap & sleep a lot. This sleep is vital for their rapid growth in the first year of life (growth hormones are released during sleep), their brain development & function, & their formation of memories. The American Academy of Sleep Medicine (AASM) recommend infants 4-12 months get 12-16 hours of sleep in a 24 hour period (including naps), with 0-4 month olds sleeping on average 16-18 hours a day (usually over more frequent naps & sleep periods). Premature babies can spend as much as 90% of their time asleep in the initial weeks & often have lighter & less consistent sleep.
One of the possible causes of frequent startling or waking up is infant reflux. Young infants have much shorter sleep cycles, which is when the body releases specific hormones to encourage us into deep sleep, & then different hormones to bring us out of deep sleep again. Babies can wake up if something impedes this cyclical process, usually as they are beginning to stir from a state of deep sleep.
When they are asleep, they should be quiet & peaceful, in a relaxed position. A number of things can cause disruption to their sleep cycles & create havoc with the patterns they are trying to establish. If your baby is feeling pain from the stomach acid in their oesophagus, uncomfortable from the undigested food in their tummy, or unable to clear the trapped wind they have in the digestive system, they can find it difficult to remain relaxed & asleep.
Some signs your baby could be waking due to discomfort include:
🌻 Grunting or squirming in their sleep
🌻 Mouth breathing or snoring
🌻 Moving around a lot, thrashing their arms & kicking their legs
🌻 Coughing, choking or gagging that wakes them up
🌻 Sounds congested or noisy breathing
🌻 Bloated tummy or lots of wind
Why does this happen?
The AAP recommends that "all babies sleep on their back, on a flat, firm, separate sleep surface such as a bassinet, play yard or crib, and to keep the baby’s sleep space free of blankets, bumpers, toys or other objects".
Of course, safe sleep practices for your baby is, & should be, the highest priority to reduce the risk of SIDS. While this recommendation is all good & well for babies that are happy, healthy & free from reflux or other symptoms that cause discomfort, every parent with a baby & reflux knows the dread that fills you when you want to put your baby down to sleep, knowing they will likely wake up, cry or vomit - worst case, all of them!
When babies with reflux lie on their back, as recommended, the immaturity of the LOS can allow the stomach contents to push through it's barrier more readily than if baby was upright. This is because the liquid is no longer having to work against gravity. The most likely sources of the reflux are excessive air trapped in the stomach, overconsumption of milk &/or food after a feed, hiccups (as it increases the pressure on the stomach by the diaphragm spasming), & potential food reactivities.
So, how can you help your baby sleep better if they have reflux?
The typical suggestions you'll likely see come up in your internet searches will be about keeping your baby upright for long periods of time after a feed, paced feeding or switching to smaller feeds more frequently, & raising the head of their bed or using wedge cushions so they are not lying completely flat.
While these strategies may improve some of their symptoms, they are not actually addressing the cause of their symptoms of reflux or poor sleep.
Knowing WHY your baby is experiencing sleep disturbances & having difficulty lying safely on their backs, without spitting up, is what we need to identify. I can help you identify why they’re uncomfortable, giving you the knowledge & tools on how to changes things, & support you with strategies that can achieve a reflux free, happy sleeper.
If we don't change the underlying issues, the knock on effects of poor quality sleep for the entire family will start to take its toll.
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If you would like my help, you can email me, download my free reflux symptom tracker, check out my social media pages
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Please note: if you are concerned about your baby's symptoms or sleep, you should seek medical advice & contact your paediatrician or a qualified sleep consultant.
This is intended for educational purposes only & does not substitute for a medical diagnosis.