Reflux in infants: How to help my baby sleep

Updated Oct 20th 2022 | timer 6  min read

How to Help a Baby Sleep With Acid Reflux
Elissa Gross

Medically Reviewed By medical-check-mark Elissa Gross Board Certified Pediatrician & Lactation Consultant

Mandy Treeby

Written By Mandy Treeby Chief Baby Sleep Consultant

Top Tip

Since babies with reflux tend to struggle with sleep, parents and experts recommend using tools like the Smart Sleep Coach to help keep sleep in check.

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Your baby starts to recognize patterns from around 8 weeks old. A healthy bedtime routine delivered consistently can help cue your baby it’s time for sleep.

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A sleeping baby is one of the most beautiful, peaceful sights – but that sight can become frustrating and stressful if your baby isn’t sleeping due to acid reflux.

Rest assured there are ways to manage and alleviate acid reflux in your baby – this will help make them more comfortable, prevent further medical issues and, yes, help them sleep better – an essential ingredient to them growing strong and healthy.


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However, some babies will unfortunately experience things like acid reflux, which is one reason your baby might have trouble falling asleep or staying asleep. Parents want nothing more in those moments than to soothe their baby. But how?

New parents, or even second-time parents, can struggle to figure out how to alleviate the impact reflux has on their baby. The lack of sleep is one that not only affects their baby, but them as well since babies with reflux tend to have poorer sleeping habits. And if baby isn’t sleeping, chances are neither are the parents.

To help your baby sleep with acid reflux, follow these tips below.

Understanding Reflux in Infants

To help alleviate acid reflux in your baby, it’s important to know a bit about what it is and why it happens.

As you may know, the esophagus delivers food from your baby’s throat to their adorable little stomach. Typically, this is a straight-forward process. With acid reflux, though, food comes back into the esophagus from the stomach.

This reflux happens because the lower esophageal sphincter (LES) – the muscle ring at the top of your stomach – doesn’t close completely, allowing food and stomach acids to emerge back into the esophagus. The same thing happens to us adults sometimes, but acid reflux tends to affect infants more often because their LES is weak or still developing.

When Does Acid Reflux Start in Babies?

Every baby is unique, but typically reflux in infants begins around four months and usually resolves itself between the 12- and 18-month points.

Signs of Acid Reflux in Babies

If you’ve been wondering, "Does my baby have reflux?", watch for some of these common signs and symptoms.

General symptoms of acid reflux in your baby may include:

  • Vomiting and spitting up
  • Interrupted sleep
  • Irritable during feedings
  • Refusal to eat
  • Difficulty eating or swallowing

Some rarer though more serious symptoms include:

  • Your baby isn't gaining weight
  • Spits up blood
  • Blood in the stool
  • Difficulty breathing
  • Chronic coughing

Noting your baby’s acid reflux symptoms can help you gauge whether your baby’s reflux is mild or serious and how to proceed with your baby’s pediatrician. This is especially true if your baby’s not gaining weight – a problem that needs to be addressed ASAP so they can grow up big and strong.

What is Silent Reflux?

For most babies, reflux has obvious visual or audio signs, like spitting up. Silent reflux is, well, silent. A common sign of silent reflux is that your baby is fussy, uncomfortable, or crying after eating and burping doesn’t help. Also, even though it’s called “silent reflux,” you may hear some tummy rumbling. 

3 ways to burp your baby:

Burping can help reduce acid reflux in babies. Here are the three best ways to burp your baby:

  1. Shoulder: With your baby facing you, and a cloth on your shoulder, place their chin on your shoulder while supporting their bottom with your hand or arm. Use your other hand to gently pat their back to “inspire the burp.”
  2. Knee: Sit your baby upright on your lap. Support their chest and head while patting their back.  
  3. Lap: Gently lay your baby tummy down over your legs. Support their head so it’s above their chest and gently pat their backs.

Baby GERD and Severe Reflux Cases

There are some circumstances that will result in more severe cases of reflux. Those can be caused by Gastroesophageal Reflux Disease (GERD), food allergies, pyloric stenosis (the narrowing of the valve between the small intestine and the stomach), eosinophilic esophagitis (when white blood cells injure the esophagus lining), and Sandifer syndrome (an affliction that resembles seizures).

If you suspect any of these, or have a family history of any of these, consult with your health care provider about the best route forward.

How to Tell the Difference between GERD and Acid Reflux

Though acid reflux and GERD often have the same symptoms, GERD is more persistent and frequent than acid reflux, which tends to be more occasional. If your baby is uncomfortable, spitting up, or exhibiting other reflux symptoms after every meal, they may have GERD. If you suspect that’s the case, talk with your health care provider about a route forward.

How Can I Help My Baby with Reflux Sleep?

Getting your baby to sleep can be challenging enough without reflux, but that’s especially true if your baby has reflux.

To help your baby sleep even if they have acid reflux, try these tips:

Keep Up Your Bedtime Routine:

Bedtime routines are the foundation of healthy baby sleep – they calm your baby before bed and the repetitive nature of routines cues them it’s time to sleep, creating a lifelong habit that serves them for years to come. And it’s especially important to keep up your routine if your baby is experiencing acid reflux – the comfort and familiarity of the routine can help put their mind to ease, helping them rest better, despite their discomfort.

With the Smart Sleep Coach App, you'll get a personalized sleep plan that will teach you how to build a sleep nourishing routine that works for you and your family. To get started, take our Free Sleep Assessment.

Back Sleeping

The best sleeping position for babies is always flat on their backs on a firm surface until they can roll over. This is by far the safest position for your baby, despite concerns that baby may choke or vomit while sleeping. The American Academy of Pediatrics confirms that babies use their automatic gag reflex to cough up or swallow fluid. As such, placing your baby on an incline or in a swing is not recommended, back sleeping on a hard surface is best, even for babies with reflux.

Back sleeping on a firm surface helps reduce the risk of Sudden Infant Death Syndrome (SIDS), a rare event when a healthy baby will unexpectedly pass away in their sleep.  

Reflux Feeding Tips for You and Your Little One

There are plenty of feeding strategies parents can employ to minimize or negate baby reflux and, in turn, help them to sleep better.

Mom’s Diet: We’ve all heard of “eating for two” – well, that’s particularly true while breastfeeding because mom’s diet can impact their baby’s.

That said, nursing mothers whose babies have reflux may want to change their diet by reducing spicy or acidic foods.

Increase Feedings but With Smaller Portions:  Reducing feeding portions can help your baby digest their food more completely, reducing reflux. However, if you do this, it’s important to increase the frequency of feedings to guarantee your baby is getting all the nutrients they need to keep growing. 

Boost Burps: Excessive stomach gas is one cause of reflux. Increasing your burp ratio during meals can be really helpful in reducing reflux Increase the number of times you pause a feeding to burp your baby. This action prevents air from collecting in your baby’s stomach. This burping action can be accomplished by either sitting your baby upright on your lap or putting them over your shoulder while gently patting and rubbing their back.

Sit Your Baby Upright: Placing your baby on their back or in a car seat after feeding can lead to more spitting up and reflux. To help reduce reflux in your baby, keep them upright for 20-30 minutes after feeding. One potential idea: a walk around the block in their carrier.

Switch Their Bottle: Sometimes treating acid reflux in babies is as simple as switching their bottle because some bottle nipples let your baby swallow more air than others, which can lead to more gas.

If you think your baby’s bottle is causing reflux, switch the bottle or nipple and monitor for changes. Trial and error might be the way you find the ideal bottle or nipple.

Switch Their Formula: Formula type is another avenue to explore. Some babies might be allergic to proteins found in the formula. If you think your baby is allergic to their formulate, try a hypoallergenic formula.

When to Contact Your Pediatrician about Reflux

Any acid reflux symptoms should be brought up at your regular visit, but feel free to call your doctor if symptoms persist or are sudden and strong and especially if your baby seems very uncomfortable or spits up an excessive amount. (Also, generally, you can call your pediatrician with basically any health question – they’re there to help, even if that help is simply easing your mind.)

We understand reflux can be frustrating, especially when it disrupts your baby’s sleep, but some combination of these tips, with perhaps an assist from your pediatrician, should solve the reflux problem and in turn, help your baby get the rest they need – and you, too!

FAQs

How should my baby sleep if he has reflux?

Babies should always sleep on their back even if they are suffering reflux. Sleeping in this position will not increase the risk of choking since the gag reflex will force baby to cough or swallow any fluid.

Is reflux worse at night for babies?

Babies with reflux prefer to be held upright and are likely to be fussy both day and night, however since experiencing acid reflux is uncomfortable it is possible that your baby  may struggle to sleep at night.

Do pacifiers help with reflux?

Possibly, since  pacifiers increase saliva flow down the esophagus, it could help to get fluids back into the stomach more quickly.

Can babies sleep through reflux?

Yes, babies can sleep through reflux, they just need more attention and care. They also might take longer to sleep through the night, however a diagnosis of reflux doesn’t mean you can’t  sleep train.

How We Wrote This Article
The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.

Sources
https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/What-is-the-safest-sleep-solution-for-my-baby-with-reflux.aspx

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