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Almost all babies bring up small amounts of milk after feeds and my son Albie, our first child, was no different. My midwife called it posseting, which is harmless regurgitation, and said it was perfectly normal. But when at seven weeks Albie began to bring up at least half the contents of his bottle, often more – and sometimes projectile-vomiting – my husband Jon and I became understandably concerned.
We made an appointment to see our much trusted GP, who diagnosed reflux. The problem is similar to reflux in adults – also called heartburn – which happens when an overproduction of stomach acid leads to small amounts leaking up into the oesophagus, causing pain.
Comfort: Sadie Nicholas and her young son Albie, giving him gripe water through a syringe
In babies, unlike with normal posseting, it also causes pain – and almost half of all infants suffer.
Adult reflux is usually due to poor diet or other lifestyle factors. But infant reflux is caused by the natural immaturity of the ring of muscle (sphincter) around the valve that forms a seal between the oesophagus and the stomach. When the muscle hasn’t fully developed, milk and gastric acid can be forced back up the food pipe, causing baby’s feed to be regurgitated.
Albie is bottle-fed with formula milk, but reflux affects breast and formula-fed babies equally.
Our GP suggested that we add Infant Gaviscon to Albie’s milk – small sachets of powder containing two active natural ingredients, sodium alginate and magnesium alginate. They react with the stomach contents to form a thickening gel, making it more difficult for food to be refluxed back into the oesophagus and regurgitated.
The infant version of Gaviscon is not strictly an antacid, as it doesn’t primarily work by altering the pH of the stomach contents. Even though it’s made for infants, I was alarmed at the idea, and then our GP warned it can make babies constipated, so we could be swapping one problem for another.
Since Albie was gaining weight nicely despite the sickness, we waited to see if the reflux would settle down as he approached three months old.
Unfortunately it hasn’t, even though we’ve been keeping Albie upright during feeds and for 20 minutes afterwards, and propping his cot mattress at 45 degrees with a foam reflux wedge to aid his digestion. He’s begun to squeal before being sick, clearly in discomfort and, ironically, he’s now also very constipated, presumably because not enough fluid is getting through his system. So, what can we do?
Reflux happens when an overproduction of stomach acid leads to small amounts leaking up into the oesophagus, causing pain, and can be treated with antacids
THE ADVICE
The baby guru
Alison Scott-Wright is a baby sleep guru and recognised expert on reflux, which is covered in her book The Sensational Baby Sleep Plan.
She says: ‘Many people think that crying and being sick is simply what babies do, but reflux – silent or otherwise – is a nasty condition that should be treated. The long-term regurgitation of acid and milk can lead to ear, nose and throat problems in the future in some babies.
‘I’d be inclined to seek a consultation with an infant gastroenterologist to check that baby’s reflux isn’t caused or made worse by a sensitivity, intolerance or allergy to cow’s-milk protein and or lactose.
‘A dairy-free diet for breastfeeding mums or a hypoallergenic milk could help if this is the case.
‘A medicine that reduces gastric acid could help lessen the burning pain experienced during a reflux attack. And adding a thickening agent to milk, or using a pre-thickened formula, can help keep the feed in baby’s tummy.’
The maternity nurse
Nicki Pope, 36, is a nanny and maternity nurse with Tinies childcare agency. She says: ‘I’d advise Sadie to go back to her GP as baby may now benefit from taking medication such as Infant Gaviscon to try to help settle his digestion.
‘I’ve worked with lots of babies for whom this has worked brilliantly under the supervision of their doctor, enabling them to feed comfortably until their tummy matures.
‘Many have also reaped results from an alternative treatment called craniosacral therapy. Practitioners claim that by using gentle but static touch to ‘‘read’’ the body, they can identify areas of stress or discomfort. It doesn’t work for all babies but it’s so gentle that it certainly won’t do any harm.’
The older generation
Sadie’s cousin, Sonia Cutts, 55, says: ‘My son Thomas weighed almost 10 lb when he was born and was feeding constantly. Our grandma – whose advice had never failed me – suggested that adding a raw egg yolk to the last bottle of the night would fill up a hungry baby and also help settle a sickly infant by thickening the milk. It did the trick with Thomas, who began sleeping for eight hours or more at night.
‘Alternatively, why not give craniosacral therapy a try? I have a friend who credits it with eradicating her baby’s reflux symptoms where everything else had failed.’
What Sadie did next
I was struck by what Alison said about the long-term impact of reflux and by Nicki’s reassurance about baby peptides, so I took Albie back to our GP. She prescribed a low dose of Infant Gaviscon. By ensuring he keeps more fluid down, this should actually help loosen his bowels. The sickness has reduced dramatically as a result, but he still vomits after some feeds so I’m very open to alternative treatments.
I won’t give Albie raw egg because it carries a risk of salmonella, which is highly dangerous to babies.
I researched craniosacral therapy and took Albie to see therapist Philip Humphreys at the Wellbeing Clinic in West Bridgford, Nottingham.
While Albie was propped up on a couch, Philip gently placed his hands under Albie’s back, head and neck, and then on his tummy and diaphragm, sensing tension. This was reflected in Albie becoming restless when he was touched there.
Philip then gently supported Albie’s body with his hands to allow his joints and muscles to relax. That night he wasn’t sick at all at his last feed and slept for ten hours without waking. He’s vomiting considerably less and sleeping for between eight and 11 hours a night.
It’s impossible to know whether this is due in part to therapy. But the most important thing is that my little boy is keeping more milk down and seems comfortable.
If symptoms return, I’ll take Alison’s advice to seek specialist medical help.
My health visitor recommended we give Albie gripe water, which can be mixed in with milk or squeezed into his mouth with a syringe. It contains sodium bicarbonate to help neutralise excess acid and dill seed oil to warm and relax baby’s tummy and break down trapped air.
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