“Reflux” itself can be a very broad definition, and the biggest problem is that there is no set of symptoms. Many babies get labelled as “reflux”, many labelled as “colic” and some mothers will even be told that reflux is normal. While some, are told that their babies just cry, and this is just something parents need to get used to.
 
There is always a reason for reflux. Children are always telling us everything we need to know from their symptoms and their behaviours. Research that looked into infants in pain showed that infants have a lower threshold for pain, which means they experience more intense pain from a similar stimulus. So, if you think that reflux during pregnancy that doesn’t feel good, a child may be experiencing reflux at a more intense level. Anytime a baby doesn’t want to lie down, they are telling us that they don’t want to lie down. When we understand the root cause, there are always specific ways to address it. Once we take the correct course of action for any individual child, we can  completely resolve their reflux 95% of the time.

• Unsettledness: Mothers are always the expert of their own child and mothers always know best. If your child is more unsettled than you think they should be, there is always a reason for it and they could have reflux. Mothers can start tuning in to what is actually going on and recognise that there is always something we can do to support them a bit better.
• Digestive discomforts: A large number of children who get diagnosed as reflux, will also have digestive complaints. These babies experience lots of bloating and lots of wind, and these digestive discomforts might be keeping them up all night. These children often get labelled as reflux because they are otherwise healthy, meeting their developmental milestones, and growing well!

• Bringing up milk: Another sign of reflux may be that these babies are bringing up milk, throwing up a lot and may even projectile vomit. Technically, reflux is a regurgitation of stomach content into oesophagus and possibly out of the mouth. Regurgitation is a normal and necessary bodily function. It is how we regulate air. In adults, we regulate air by burping and we vomit to protect ourselves. However, when this happens frequently, it is not normal regardless of whether it is during feeds or after feeds. For some kids, they will only bring things up to oesophagus, and we may not see anything come out of the mouth. But anything that comes from stomach into oesophagus is considered reflux.

There are potential dangers and lifelong risks of ignoring reflux and believing that reflux is normal.

• Not treating reflux correctly – There are long term consequences of using medication that are not designed for infant bodies. When we use gastric acid suppression medication to treat reflux, we are preventing children from absorbing calcium. Calcium is an essential nutrient for babies to develop and grow bones. Research has shown that any child who has had one of the popular gastric acid suppression medication, either Proton Pump Inhibitors (PPI) or H2 Receptor Antagonist (H2RA), increases the risk of childhood fractures by 23%. If children have both of them, this risk increases up to 33% because their bodies are not absorbing the calcium required during infancy. On the other hand, for adults who are on these medication for long term, it significantly increases the risk of osteoporosis, which is a bone density calcium issue.

• Once we stop normalising reflux and start listening to our children, we can provide them with the opportunity to be completely free from reflux. Children can then get good sleep quality and develop at their own pace including the chance for their brain chemistry to properly develop. Parents also finally get to deal with other parenting challenges without reflux being in the mix and the stress level within relationships are reduced. There will be overall improvement in the family members’ functional wellbeing!

• For example, a tongue tie that is ignored is not just about infant feeding. If a child is struggling to feed and have a tongue tie, it is causing issues. It is about the development of the mouth, the ability to digest food, the ability to speak, and the ability to sleep with mouth closed and breathe through nose. These are crucial factors that contribute to babies’ sleep quality, which will otherwise be linked to potential ADHD later on in life. We need to do everything we can to support them and we don’t want to normalise these issues.

• Does breastfeeding cause reflux? No, breastfeeding does not cause reflux, and your baby is not allergic to your breastmilk. They might have an allergy to something in mum’s diet that they are getting traces of in your breastmilk, but it is not your breastmilk. We can change the allergic reaction by changing mum’s diet.
• Do I need to burp my baby? Yes, we have to burp and wind a breastfed baby when they have too much air in them. Baby has air in their stomach, and we need to wind them to help them get it out. If a child is hiccupping, it is a sign that there is too much air in their stomach, and we need to burp them.

Birth history can have an impact on a baby’s physical comfort and ability to feed comfortably. Forceps and ventouse assistive birth involve physically squeezing the baby’s head, which puts on extra pressure on baby’s head. This may have impact and bruise a nerve and can cause asymmetrical in facial muscles. If everything does not go back to perfect alignment, the jaw may move sideways while the tongue might not be moving symmetrically as well. This may cause the baby to take on air and if the baby is drinking up too much, their stomach contracts and forces milk (with or without acid) into the oesophagus because there is no other way to go. This contributes to being one of the causes of reflux.

• Working with babies with reflux often require multidisciplinary input. We need to look at reflux from a holistic point of view and consult with the parents to look at issues that are going on with the child to identify what is the best treatment.
• It is important to help parents get to the underlying cause of reflux. Some possible solutions we may recommend include altering feeding positions, changing mum’s diet, looking at supporting babies in different ways and using specific coping strategies to support any child.

• In other cases, parents may be referred to other professionals, such as a chiropractor, osteopath, lactation consultation, tongue tie practitioner, whomever we feel is the best fit for what is going on with their child. For example, if jaw sliding is seen potentially due to forceps or ventouse delivery, we may refer them to an osteopath.

• Speech Pathologists or infant feeding specialists are other common professionals that parents are often referred to. If a child has feeding aversion or does not want to be fed, there is always a reason for it. Speech Pathologists and infant feeding specialists can complete full oral assessments to identify the underlying cause and provide the corresponding treatment for it. 

• Mismanagement in one child doesn’t necessarily mean they will have issues later on, However, it poses higher risk of ADHD, behavioural issues and allergies.

• Babies with allergies are often treated with antihistamine Ketotifen, and those diagnosed with Small Intestinal Bacterial Overgrowth (SIBO) are often treated with antibiotics. These medications have an effect of wiping the gut bacteria out of babies’ entire system. Continually treating allergies with antibiotics and antihistamines will damage internal structures and gut health. We should be removing allergens not treating it with medication.

• Gastric acids suppression medication stop body from absorbing fats because they don’t allow the fats to be broken down. If the body can’t absorb fats, there is a chance the brain isn’t getting receiving the amount of fats it is required and affecting its development, potentially creating developmental issues.

• Our gut health is correlated to overall good health and mental health. Our gut health is looked at as root cause of obesity, which is also a root cause for diabetes. Looking at gut issues such as Irritable Bowel Syndrome (IBS) and Crohn’s disease, these all have to do with how our gut is treated and what food we put in our system. Ignoring gut health in the first few years of life can lead to children becoming sugar addicts, which will imbalance their gut microbiome. This would lead to a life of suboptimal health. It is important to establish good habits in first years of life to support good lifelong health. 

To find out more, contact us at SPOT Therapy Hub on spottherapyhub@gmail.com or 02 9389 3322. Also check out our podcasts and blogs on a variety of topics at www.spottherapyhub.com.au