Note that many of the following tips and pointers will benefit babies that are colicky from ANY cause, not just reflux. Also note: it’s not just about the babies: it’s about comforting the parents, too. Some of these tips are designed to improve your ability to “read” your baby’s signs and symptoms, improving your ability to comfort your distressed, hurting baby. “Managing” your baby’s reflux – that is, how aggressive you need to be about treating it and how long you will need to treat it – will depend on how severe the reflux is. Ask: how much is your baby’s reflux affecting with their growth and their overall health? Let’s be clear: ALL babies reflux to some extent. For some babies, their reflux causes only occasional discomfort. For others, it causes severe distress: colic. And for a rare few, reflux can cause esophagitis that is so severe that they are unable to take in enough nutrition needed to grow and gain weight: it causes failure to thrive. Those few infants warrant very aggressive treatment that may even include surgery. For the rest, treatment will focus around three key strategies:
- Feeding and foods: develop feeding patterns, and foods, that help maintain movement down instead of reflux up.
- Positioning: to use gravity to help maintain movement down instead of reflux up.
- Attachment parenting: optimize parent-baby bonding to minimize distress, and reduce crying, since crying increases gulping of air, and that increases reflux.
Here are the specific tactics for reducing your baby’s reflux; make sure you check these boxes:
Foods and Feeding
A. Nurse Your Baby
If possible, nurse – breast-feed – your baby. Breastfeeding has so many benefits, including these for reflux:
- Breast milk empties from the stomach more quickly than formula
- Breast milk is much healthier for the “microbiome” of the intestines than formula (http://www.sciencedaily.com/releases/2012/04/120429234641.htm)
- Babies who nurse naturally feed more frequently (because their stomachs empty faster – that’s a good thing)
- Breast milk is a natural antacid
- Breastfed babies have softer and easier-to-pass stools
- Mommy gets to benefit from the relaxing effects of oxytocin that is released during nursing
B. Smaller Feedings, More Frequently
Feed half as much, twice as often. Less content in the stomach means less to reflux. More frequent feedings also causes more saliva production. Interesting (for a science geek like me), saliva contains epidermal growth factor (EGF), which actually helps repair the injured lining of the esophagus. EGF in saliva is also probably why animals lick their wounds – to aid in healing.
C. Burp Frequently
Babies gulp air – when they feed, and especially when they cry. Burp your baby after every few ounces, or when switching breasts. Try to burp your baby after they have a cry. It will give you yet another excuse to hold them.
D. Minimize Air Gulping
If you are nursing, be sure your baby latches and forms a tight seal to reduce air gulping.
E. Thicken Feedings
If your baby is bottle feeding and it is time to introduce solids, and if recommended by your doctor, consider thickening your baby’s feedings using rice cereal. Note that the effect of thickened feedings is an individual thing: it reduces reflux for many infants, but may actually worsen reflux for some. Also use caution: too much rice cereal can cause constipation.
F. Keep Your Baby Away From Smoke
Of course, you’re not smoking (if you smoke: You. Must. Quit!!), but avoid anyone who smokes: passive smoking (aka “side-stream smoke”) is proven to be even more harmful than direct smoking. Amazing but true. Nicotine and other toxins in tobacco smoke can stimulate acid production in the stomach, and also open the muscles of the esophagus – a combination that worsens reflux.
Positioning
A. Keep Baby Semi-Upright
Especially during feedings, use gravity to help move food down, instead of up to reflux. Consider “wearing” your baby in a sling to help keep them more upright (boogordoctor Amazon Store affiliate link).
You might think that placing your baby in a seated position, for example, in their car seat, would be beneficial. Don’t: the seated position for babies actually bends them in the middle, increasing pressure on the stomach, causing worse reflux.
B. Don’t Bottle-Prop
Avoid the temptation to leave your baby with a bottle propped, because they seem content. Note that babies with reflux are at greater risk of aspiration – sucking feeds and saliva into their lungs – and they have a greater risk to stop breathing. Monitor your refluxing baby closely during feeding.
C. Find a Reflux-Friendly Sleep Position
We all know the “back to sleep” sleeping position on the back is safest for infants below age 6 months to minimize the risk of SIDS. However, babies with severe reflux may sleep better on their left side. Discuss this with your doctor to weigh the risk/benefit balance regarding safest and optimal sleep position for your refluxing baby. If baby sleeps in your bed, consider one of those baby wedges; also consider the “Tucker Sling” crib attachment to help maintain a head-up position during sleeping (boogordoctor Amazon Store affiliate link).
D. Dress Your Baby in Loose Clothing
Any clothing that is snug around the middle will increase pressure on baby’s stomach and increase reflux.
E. Consider a Pacifier
Obviously, the most pacifying thing for your baby is snuggling against your breast. But some infants with reflux benefit from sucking on a pacifier. The “nursing” with the pacifier may stimulate saliva production, and saliva is a natural antacid; the EGF in saliva also soothes the irritated esophagus. The pacifier also stimulates frequent swallowing, and that “peristalsis” helps keep feedings down, preventing reflux back up.
Note: Some babies will gulp more air when using a pacifier: if your baby seems to be swallowing more air when using the pacifier, stop using it. Gulping air will increase reflux.
Comforting Your Baby (and YOU)
For maximal comfort for your hurting, colicky baby, learn about (and begin practicing) Attachment Parenting: This is “high-touch” style of parenting. Attachment Parenting optimizes your baby’s sense of safety and security. For colicky babies, this will decrease crying, increase your baby’s comfort, and the increased bond between parent and baby will help you, the parent, more intuitively “read” your baby’s signals. It will increase your ability to understand what is hurting, and help you to intervene more effectively. Attachment parenting also helps parents cope. The bottom line with attachment parenting is to follow your instinctive response to comfort your hurting baby.
Don’t take it personally when your baby cries. It’s not your fault! And take some consolation in the fact that crying is a physiological process, a process that may actually help your baby release some hurt. That does not mean that you should leave an infant alone to “cry it out.” On the contrary: be supportive and comforting, but try to avoid the temptation to “shush” a crying infant or youngster.
Attachment parenting advocates “wearing” your baby; another reason to use a baby sling. Increased touch between parent and baby is beneficial for both.
Other details to consider: soothing sounds for your baby (boogordoctor Amazon Store affiliate link). Aromatherapy may also have a place in comforting your hurting baby: adding a few drops of lavender or chamomile essential oils to the water in your steam vaporizer has been shown in clinical trials to be soothing (boogordoctor Amazon Store affiliate link).. Take a look at my earlier article on how to soothe the discomfort of teething for ideas.
That concludes Part 2 of The Colicky Baby. As always, I just know that I have missed some important points. That means I’m relying on YOU to clue me in: please leave me a reply / comment below and let me know what has worked especially well for you to soothe you colicky baby. For those who leave me additional tips, I promise to include them in my eBook, Soothing Your Colicky Baby, and send you a free copy!
In Summary:
If you have a hurting, colicky baby, the problem is most likely reflux or food sensitivities (or potentially both!). If you and your doctor believe the problem is reflux, go through the steps above to help soothe your hurting baby. Again, many of these tips will benefit both you and your baby; and many of these tips will help comfort the hurting baby, no matter what the cause.
More to read: 5-Step Program to Eliminate Chronic Sinusitis