Reflux and Colic

By Heidi 'The Parent & Baby Coach @theparentandbabycoach

Heidi is a mum of two, Baby sleep coach, Trainer and Author.

Digestive issues, such as reflux and colic, are specialist areas that I focus on in my work as The Parent and Baby Coach, particularly how they can affect baby’s sleep. Firstly, let’s start with Colic.

Why I Don’t Believe in Colic

Colic is such a complex area of baby development and something I’ve come to learn more about in the past few years and even more so since having my own children. Controversially: I don’t believe in colic. I genuinely believe that there is a reason for colic rather than it just being a definition or general term for an ‘unhappy baby’. The NHS definition of colic is “when your baby cries a lot, but there is no obvious cause”. For me, that is just not true. Crying is communication, so if your baby seems to be very unhappy, then it is very likely that there is a reason for that. There will be a cause, and it is your job as their parents to understand what the cause could be.

My view on this is simple, if a baby is crying for hours on end, on a regular basis then there IS something going on, and the cause of that crying is likely to be one of the following;

• Baby has wind - Wind cannot always be cleared by a baby on their own and they need help to clear it. If you’ve got a burp up after a feed and then baby goes on to cry for an hour or more you may believe that they can’t have wind because they burped; but the reality is they might have lots of tiny bubbles of air in their tummies and they need more help to get them out. Depending on your baby’s awake window, you will need to wind them after they’ve been awake for a little while and, also, before they go down for their nap, too. Wind can get stuck and start to come up at different times, not necessarily after or during a feed. There is no set amount of burps that you should get from your baby but you should keep winding them to help them feel comfortable and sleep well.
• Baby is hungry - Colic behaviour is so often accepted and so many parents I work with feel that they have to cope with a crying baby for hours on end until they grow out of it between 10 and 13 weeks of age. If your baby is crying for hours in the evening, I would look at feeding and seeing if your baby is hungry. If you’re breastfeeding, your milk supply can be a little bit lower, which can mean that baby is a little bit hungry and is crying because they’re both tired and hungry. This could show as cluster feeding but some babies give up on this and just cry, then they won’t go on the breast properly – which exacerbates the problem! One of the things you could try in this instance is making sure your baby is totally full and see if that makes a difference. If you find this to be the case you can start to unravel the feeding with power-pumping to increase milk supply, herbal supplements, top up with a bottle – whatever works for you. If you need more specific support on these topics, please click here for my 1-1s.
• Baby is overtired – I would say that 60-70% of my 1-1 clients with unhappy newborns (up to around 13 weeks) who have lots of crying in the evenings are struggling because that baby is overtired. If your baby is overtired they are going to cry lots! If they’re crying lots you might be told by well-meaning friends and family “it’s colic, they’ll grow out of it!”I would really encourage you to look at your baby’s awake windows (an hour maximum for a newborn). By looking at how long your baby is awake for, you can help them to settle by ensuring that they are falling asleep at the appropriate time.
• Baby’s gut– I really hope that, over time, parents receive more support with research on how a baby’s gut develops. At the moment, we don’t have the science to prove it but I am a firm believer that what Mum eats – when breastfeeding – can affect their baby’s gut. Some babies struggle with certain food groups that pass through a Mother’s milk or that are in their formula milk. If you have ticked off the 3 points above and baby is still crying, I’d consider whether your baby is struggling to digest something that is in their milk. I would never encourage you to go away and cut out food groups but it might be worth looking for someone who could support you around this topic.

This takes me onto my next topic – Reflux. Reflux is seen to be a medical condition and, in some instances that is absolutely right and you will need the help of your GP but there are also other instances where reflux can be fully managed by the parents without medical interventions, medications or tests. If it is mild it can be monitored at home. My services try to bridge that gap between medical advice and managing reflux before you get to the stage where you have to see a doctor for medication.

We don’t have to live with babies who are crying and uncomfortable; there is always something that we can do about it. This is my number one passion when it comes to working with babies like this and I aim to empower parents to find solutions to support their baby’s development at all stages.

What reflux actually is;

On many websites, if you research what reflux is, you’ll be told that reflux is when a baby brings up milk during or shortly after feeding. They will then go on to say that it is very common and it will get better at some point. However, what I know from working with thousands of clients is that hiccuping, coughing, not swallowing, spitting up, not settling, not gaining weight and crying can be really traumatic for many parents. It impacts sleep and families’ well-being and that is often when parents reach out to me for support

REFLUX ISN’T JUST ABOUT BEING SICK OR NOT GAINING WEIGHT: THERE IS SO MUCH MORE TO IT THAN THAT.

The definition I use of reflux can be quite different to the above because I believe reflux is many different things. The reality is there are so many other things that could fit under the umbrella term of reflux – read on for my full list of symptoms!

Reflux is the regurgitation of some stomach acid that rides up the oesophagus but it might not come out so your baby may not be sick. Reflux is regurgitation – either that comes out of the mouth or that remains inside the body. Therefore, reflux cannot be defined as a ‘baby being sick’ because silent reflux is where the burning will still happen and be sore but it doesn’t actually come out of the mouth. This is where it gets complicated!

If your baby is losing weight…

If your baby is losing weight please seek medical advice and see your GP if reflux is affecting their weight gain. For my average client with a baby who suffers from regurgitation, most of them will be gaining plenty of weight but is still uncomfortable on some level. Measuring reflux by weight-gain can be important but it isn’t the only sign to look out for.

What we are looking for if we think baby has reflux:

(This is by no means an exclusive list! A lot of these symptoms on their own are completely normal, it’s when we start to put them together that a diagnosis of reflux is likely. It is built from my years of experience in helping hundreds of clients with reflux babies and my own experience as a parent.)

• baby can be described as being quite ‘windy’
• your baby is often quite ‘sicky’ – posseting, not projectile vomiting
• projectile vomiting – quite forceful, out of the nose and mouth
• gagging / trying to swallow sick back down – signs of silent reflux
• leaking of clear liquid from the mouth – it might look like dribbling
• lots of drooling
• having a lot more saliva and blowing bubbles
• you might find your baby has an acidic smell to their sick or their drool / mouths / saliva
• grunting – either during the daytime and night-time, sometimes worse during the early hours in the morning
• nasal / respiratory congestion – a raspy sound at the back of their nose / throat made from the regurgitation of stomach acid; as if they have a permanent cold
• hiccuping regularly and often
• gulping when feeding – meaning a lot of air is being taken in
• choking on milk-flow – look at the latch and flow, if breastfeeding
• refusing to feed / feeding for a little bit and less often – babies might not want to drink a lot because it is uncomfortable
• they may overfeed – this could be because they’re uncomfortable so the milk can soothe their oesophagus
• stomach gurgling
• arching of the back and being unhappy when feeding
• crying a lot after a feed due to being uncomfortable
• they may have explosive and runny poos
• green poo – consistent green can mean reflux
• snotty mucus in their poo quite regularly
• constipation and finding it hard to go

The less obvious symptoms of reflux:

• not being able to sleep beyond one sleep cycle
• sleep habits being affected quite regularly
• difficult to settle to sleep or will only sleep on you or in the sling
• struggling to stay asleep
• not liking sleeping on their back
• waking up very quickly after falling asleep

Reflux is often over diagnosed when parents start to work on sleep because a symptom of reflux can be that baby does not sleep well, particularly in the daytime. It’s very unusual for there to be a reason why baby doesn’t sleep and interestingly it’s the daytime sleep that is most affected by reflux. This means that looking at sleep, alongside these other symptoms, can give you a really clear indication if reflux may be present or not.

My final two questions that I always ask clients if I think reflux may be present are not scientific and I wouldn’t want you to consider them as definitive when it comes to reflux! But I am sharing them because they can sometimes be really important to notice. They are:

Does your baby like the car seat?

Do they sleep well in the pram?

Reflux babies often won’t like car journeys and find it hard to sleep in the pram and, if they do sleep, they wake after 30-40 minutes. These two symptoms are ones I often see with my 1-1 clients and are things to consider when wondering if reflux could be present. Again, as ever, if your baby doesn’t like the car seat that does not mean that they have reflux but, if baby is showing some of the symptoms discussed above, then it could be linked.

If you would like to speak to me personally, please click here for my 1-1 sessions on colic and reflux or click here for my online course on this topic, both of which provide more information.